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Torsion Of The Gonad In The Pediatric Population: Spectrum Of Histologic Findings With Focus On Aspects Specific To Neonates And Infants.
MedLine Citation:
PMID:  23286326     Owner:  NLM     Status:  Publisher    
Abstract Background: Histopathologic findings of gonadal torsion in neonates and infants (GTNI) are poorly defined in the literature. We describe herein the histopathologic spectrum of gonadal torsion (GT) with emphasis on the pediatric population and on features specific for NI (<=1 year of age). Design: Twenty-five cases of GTNI (6 females/18 males), 35 cases of GT in older pediatric population (OPP) (19 females/14 males) and 33 cases in adults (25 females/8 males) were found in our pathology files between 2003 and 2011. Results: Our findings disclose two categories of GT: the group of NI as opposed to that of OPP and adults, the latter sharing similar presentation as acute hemorrhagic necrosis of the gonad. Although findings in NI were rather uniform, a few differences were demonstrated between the two genders. All GTNI revealed calcifications, fibrosis, siderophages and extensive necrosis. However, prominent necrotizing palisaded granulomata were seen in most (4/6) cases of ovarian torsion, but not in the testicular counterpart. Furthermore, complete gonad regression was encountered exclusively in neonatal testicular torsion cases. Conclusions: - Pathologic findings in GT are distinctly different between NI and OPP, the latter being more comparable to adults, presenting with acute hemorrhagic necrosis. - The distinctive findings in GTNI of both genders include calcifications, siderophages and fibrosis, in addition to background necrosis. - Of particular note, complete gonadal regression is seen only in the testis in GTNI. - Finally, necrotizing palisaded granulomata are unique to the ovarian subgroup and are often extensive, obscuring the nature of the process.
Wadad Sami Mneimneh; Tipu Nazeer; Timothy A Jennings
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-3
Journal Detail:
Title:  Pediatric and developmental pathology : the official journal of the Society for Pediatric Pathology and the Paediatric Pathology Society     Volume:  -     ISSN:  1093-5266     ISO Abbreviation:  Pediatr. Dev. Pathol.     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-4     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9809673     Medline TA:  Pediatr Dev Pathol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
a Albany Medical Center, Pathology.
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