RESUMENAntecedentes: La mola hidatidiforme (MH) se caracteriza por la degeneración hidrópica de las vellosidades coriales, hiperplasia del trofoblasto y se clasifica en completa (MC) y parcial (MP), y difieren en su cariotipo, histopatología, clínica y riesgo de malignidad. Constituye el 1% de las pérdidas fetales en menores de 17 semanas. El objetivo de esta comunicación es exponer un caso de MP con feto de 25 semanas, al cual se le realizó autopsia en el 2014. Caso clínico: Primigesta de 21 años con pobre control prenatal y embarazo de 25 semanas con diagnóstico de preeclampsia y óbito fetal de sexo masculino de 615 g, al que se le solicitó autopsia demostrándose malformaciones múltiples con agenesia del cuerpo calloso, hidrocefalia supratentorial, hipoplasia cerebelosa, meningocele sacro, micropene, hipospadias y retardo del crecimiento intrauterino, la placenta de 750 g demostró hallazgos de enfermedad trofoblástica gestacional de tipo MP. Discusión: La MP presenta vellosidades coriónicas con hiperplasia trofoblástica y feto que tiende a fallecer en una temprana edad gestacional. El feto puede presentar anomalías congénitas secundarias a la aneuploidia y la distinción se basa en histopatología de la placenta, en casos difíciles se emplea citogenética o citometría de flujo. En el presente caso se encontraron características placentarias (degeneración hidrópica vellositaria, inclusiones e hiperplasia trofoblástica) y las malformaciones fetales relacionadas. Conclusión: El estudio histopatológico de la placenta y del producto de la gestación permiten el diagnóstico definitivo para poder determinar el seguimiento de la paciente y disminuir así las complicaciones. PALABRAS CLAVE: Mola hidatidiforme parcial, aneuploidía, enfermedad trofoblástica gestacional SUMMARYBackground: Hydatidiform moles (HM) are characterized by hydropic degeneration of chorionic villi, hyperplasia of the trophoblast and is classified in complete (CM) and partial (PM), and they are different in their karyotype, histopathology, clinical and risk of malignancy. It constitutes 1% of abortion in under 17 weeks. The purpose of this communication is to present a case of PM with 25-week fetus, which fetal autopsy in 2014. Clinical case: Primigravid of 21 years old, with a pregnancy of 25 weeks diagnosed with preeclampsia and stillbirth of 615 g, autopsy demonstrating multiple malformations with agenesis of corpus callosum, hydrocephalus, hypoplasia of the cerebellum, myeloschisis in the sacral region, micropenis, hypospadias and intrauterine growth retardation, the placenta (750 g) has findings of gestational trophoblastic disease
Background HIV/AIDS-related infections are commonly presented in a disseminated form, compromising a high variety of organs and systems, mainly the Respiratory and Central Nervous System (CNS). In developing countries, the opportunistic agent spectrum varies from what is reported in the rest of the world, being the anatomical compromise also different from developed countries reports. In Colombia there has not been published any study that characterizes the anatomopathological findings of opportunistic infections in a sample of HIV/AIDS patients this size.Methods Descriptive retrospective study, adjusted to the current regulations on human research. A review of the autopsy protocols performed at the Department of Pathology of the Universidad Industrial de Santander (UIS) between 2004 and 2016 was executed, selecting those with HIV/AIDS and at least one opportunistic infection as the final diagnosis, of these there were evaluated the pathological findings and demographic variables.ResultsAmong 3497 autopsy protocols reviewed, there were found 249 cases of HIV/AIDS associated to opportunistic infections, 183 men (73,5%) and 66 women (26,5%), with an average age of 37.94 ± 12.56 years. The main compromised systems were the Lower Respiratory Tract (LRT) with 184 cases (73,8%), mainly by M. tuberculosis (76 cases; 41,3%), followed by the Central Nervous System (CNS) with 95 cases (38,1%), mainly by Toxoplasma gondii (38 cases; 20,6%), and in third place the Lymphoreticular System (LRS) with 92 cases (50%), mainly by Histoplasma capsulatum (39 cases; 21,1%). Less prevalent agents like Trypanosoma cruzi were found compromising multiple systems, with 6 infecting the CNS and 7 causing Chagasic myocarditis.Conclusion Disseminated forms and simultaneous multiple agent compromise of one system are common features in HIV/AIDS patients, because of this the clinician must have a high level of suspicion for diagnosing coinfection when approaching a determinated organ or system compromised by an infectious agent.Disclosures All authors: No reported disclosures.
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