Necrotic epithelial cells in proximal renal tubules of 2nd trimester fetuses: is this "acute tubular necrosis"?
OBJECTIVE
The aim of this study is to describe the occurrence of necrotic tubular cells in kidneys of non-macerated fetuses.


METHODS
Description of histology and immunostaining results using C9 immunostain of proximal tubular epithelium of kidneys from 30 consecutive non-macerated fetuses' autopsies.


RESULTS
the gestational age ranged from 13 to 22 weeks. The mean gestational age was 18.6 weeks; the cause of death was acute chorioamnionitis in 13 cases (43.3%), termination of pregnancy for fetal anomalies in 13 (43.3%) and other causes in 4 (13.3%). Histology of the kidneys revealed vacuolation of proximal tubule epithelial cells (100%), dilatation of tubules (93.4%) and tubular cell necrosis (53.4%). C9 immunostaining was positive in 24 cases (80%) and was seen in all gestational ages.


CONCLUSIONS
These results indicate that tubular cell necrosis is not an uncommon finding in the kidneys of 2(nd) trimester fetuses and may represent acute tubular necrosis (ATN). C9 is a helpful marker in confirming this diagnosis. Future studies may further explore this preliminary observation.
Department of Histopathology, Sheffield Children's Hospital NHS Foundation Trust, Sheffield, S10 2TH, United Kingdom. cesar.peres@sch.nhs.uk
Luiz Cesar
LC
Peres
Chitra
C
Sethuraman
Mudher
M
Al-Adnani
Marta Cecilia
MC
Cohen
D001344:Autopsy; D015415:Biomarkers / Q000032:analysis; D003186:Complement C9 / Q000032:analysis; D004739:England; D004847:Epithelial Cells / Q000276:immunology / Q000473:pathology*; D005260:Female; D005865:Gestational Age; D006801:Humans; D007150:Immunohistochemistry; D007683:Kidney Tubular Necrosis, Acute / Q000196:embryology / Q000276:immunology / Q000473:pathology*; D007687:Kidney Tubules, Proximal / Q000196:embryology / Q000276:immunology / Q000473:pathology*; D009336:Necrosis; D011247:Pregnancy; D011262:Pregnancy Trimester, Second
D015415:Biomarkers; D003186:Complement C9