Cystic Crypt Changes in Midgestational Human Vermiform Appendix: An Unrecognized Transient Histologic Feature.
Chrystalle Katte Carreon1, Eduardo D Ruchelli1, Christina Mihok1
1Department of Pathology and Laboratory Medicine, Children's Hospital of Philadelphia and Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.
Summary
Fetal vermiform appendix (VA) crypt changes (CC) are common, appearing by 17 weeks gestation and peaking between 20-25 weeks. These changes are not associated with fetal or placental infection.
Area of Science:
- Developmental biology
- Gastroenterology
- Pathology
Background:
- Microcystic cryptitis in fetal vermiform appendices (VA) was previously noted.
- Further characterization of these crypt changes (CC) and their association with infection is needed.
Purpose of the Study:
- To characterize the morphology and timing of fetal VA crypt changes (CC).
- To investigate the association between CC and fetal/placental infection or inflammation.
Main Methods:
- Evaluation of 345 fetal VA slides for CC morphology.
- Review of autopsy reports for evidence of fetal/placental infection or inflammation.
Main Results:
- CC, including crypt dilatation, apoptotic debris, and inflammatory cells, were observed in 58.5% of fetal VAs.
- CC appeared by 17 weeks gestation, peaked between 20-25 weeks, and declined after 28 weeks.
- No significant association was found between CC and fetal/placental infection status.
Conclusions:
- Underrecognized CC in fetal VA follow a distinct temporal pattern.
- CC in fetal VA do not appear to be influenced by infection, suggesting a role in normal gut development.
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