Resorbed co-twin as an explanation for discrepant chorionic villus results: non-mosaic 47,XX,+16 in villi (direct and culture) with normal (46,XX) amniotic fluid and neonatal blood.
Non-mosaic trisomy 16 was observed in chorionic villus cytotrophoblasts (direct) as well as cultured mesenchymal core cells derived from the pregnancy of a 38-year-old woman. Chromosome preparations from amniotic fluid and neonatal cultures (cord blood) were 46,XX. Normal fetal growth as determined by serial ultrasound examinations occurred throughout the pregnancy, which resulted in a healthy 2724 g female. Multiple biopsies taken from the umbilical cord, placental cotyledons, and fetal membranes were 46,XX. However, a placental nodule and three of six cultures initiated from membranes (amnion and chorion) showed 46,XX/47,XX,+16 mosaicism. We propose that the trisomy 16 cells arose from residual villi derived from a trisomic co-twin that never developed. This case further demonstrates that normal fetal growth may presage normal outcome irrespective of cytogenetic findings in cytotrophoblasts (direct) and cultured mesenchymal core cells.
Department of Pediatrics, University of Tennessee, Memphis 38163.
A T
AT
Tharapel
S
S
Elias
L P
LP
Shulman
L
L
Seely
D S
DS
Emerson
J L
JL
Simpson
D000328:Adult; D000653:Amniotic Fluid / Q000166:cytology*; D015193:Chorionic Villi Sampling; D002885:Chromosomes, Human, Pair 16; D005260:Female; D005312:Fetal Blood / Q000032:analysis*; D005313:Fetal Death; D005327:Fetal Resorption; D006801:Humans; D011247:Pregnancy; D014314:Trisomy; D014427:Twins