The 18p- syndrome. Report of five cases

Five children, three males and two females were found to have a short arm deletion of chromosome 18. Four of them display some of the typical features of this syndrome: microcephaly, round face, hypertelorism, broad-based nose, "carp-mouth", microrethrognathia, pterygium colli, dysplastic and low set ears, clinodactily, failure to grow, muscular hypotony and mental retardation. Different hypotheses are discussed in order to explain the variable phenotypical expression of the 18 p-syndrome.     

The 4p- syndrome,with a report of two new cases

Summary This report illustrates the typical clinical and cytogenetic findings in two children with the Wolf syndrome (4p- syndrome). The literature of previously published cases is reviewed.

---

Zusammenfassung In diesem Bericht werden die typischen klinischen und cytogenetischen Befunde bei zwei Kindern mit Wolf-Syndrom (4p--Syndrom) dargestellt. Bei dieser Gelegen-heit wird eine Übersicht über die bisher publizierten Fälle gegeben.

---

---

Supported by contract No. 20.122 F.W.G.O., Belgium

---

Bevoegd Navorser N.F.W.O., Belgium     

The 9p- syndrome.

Six patients (4 females and 2 males) with terminal deletion of the short arm of chromosome 9 distal to band p22 are described. The disorder constitutes a clinically identifiable syndrome consisting of mental retardation, sociable personality, trigonocephaly, mongoloid eyes, wide flat nasal bridge, anteverted nostrils, long upper lip, short neck, long digits mostly secondary to long middle phalanges, and predominance of whorls on fingers. The findings suggest that the clinical features are antithetical to the trisomy 9p syndrome. The deleted chromosome segment is relatively small and could be easily overlooked. It is hoped that this delineation of clinical features seen in 9,p- patients may help in focusing attention on the small deletion.     

18p- Mosaicism

Summary The case of a 5-month-old male infant with 18p- mosaic, who has intractable seizures and severe ophthalmological abnormalities in addition to many clinical manifestations usually described in the 18p- syndrome, is reported. The proportions of abnormal cells are 7–8% in blood and 55% in skin. About 35% of the short arm of chromosome 18 is deleted. To our knowledge the present report is the fifth one of 18p- mosaic. The main interest of this case resides in the fact that it shows a serious clinical picture despite the low proportion of abnormal cells in blood and the small degree of deletion of the short arm of chromosome 18.     

Trisomy 11p15 and Beckwith-Wiedemann syndrome. Report of two new cases

An association between trisomy 11p15 and Beckwith-Wiedemann syndrome is described in two brothers. The first presented at birth with gigantism and macroglossia, umbilical hernia and abdominal distention, hypoglycemia and atresia of the pulmonary artery, leading to the diagnosis of Beckwith-Wiedemann syndrome. Facial dysmorphism also included: a hypoplastic midface, hypertelorism, and a short nose with a flattened bridge. The karyotype showed a trisomy 11p15 with a monosomy 18p11, due to a t(11;18)(p154;p111)pat. His brother, born a year later, showed the same signs. The association between trisomy 11p15 and Beckwith-Wiedemann syndrome is in certain cases well established.     

Phenotypical characterization of 13q deletion syndrome: Report of two cases

Patients with 13q deletion syndrome are characterized with different phenotypical features depending on the size and location of the deleted region on chromosome 13. These patients fall into three groups: In Group 1, deleted region is in the proximal and does not extend into q32; in Group 2, deleted region involves proximal to the q32 and in Group 3 q33-q34 is deleted. We present two cases with 13q syndrome with two different deleted region and different severity on clinical features: One case with interstitial deletion belongs to the Group 1 with mild mental retardation and minor malformations and the other case with terminal deletion belongs to Group 3 with moderate to severe mental retardation and major malformations.     

Morquio syndrome (mucopolysaccharidosis IV B) associated with beta-galactosidase deficiency. Report of two cases

Two male patients, aged 6 and 25, both with normal intelligence and absence of neurological abnormalities, exhibited dysostosis multiplex, dwarfism, odontoid anomalies, cloudy corneas, exessive excretion of keratan sulfate, and abnormal urinary oligosaccharides. Leukocytes and fibroblasts of both patients were deficient in acid beta-galactosidase (beta-gal) and normal in N-acetylgalactosamine-6-sulfate sulfatase, the deficient enzyme in classical Morquio syndrome. The beta-gal deficiency was not due to an endogenous inhibitor, and the parents exhibited intermediate activities. Deficient beta-gal activity was observed toward p-nitrophenyl-beta-galactoside, 4-methylumbelliferyl-beta-galactoside (4 MU-beta-gal), lactose, GM1 ganglioside, keratan sulfate, and asialofetuin (ASF). Under standard assay conditions, the residual activity was similar for all substrates tested. Toward p-nitrophenyl-beta-glactoside, the mutant enzyme behaved as a Km variant.     

Unusual case of 18p- syndrome: diagnosis using a cloned DNA fragment

The patient with atypical clinic picture of 18p- syndrome is described. The in situ hybridization technique was used to localize chromosome 18-specific cloned sequence to metaphase chromosomes of the proband. The predominant hybridization was found in pericentromeric regions of homologous chromosome 18. The amount of pericentromeric DNA measured by in situ hybridization was different in homologous chromosomes and the number of radioactive grains was statistically greater in the normal chromosome 18 than in the chromosome 18p-. The cause of asymmetrical hybridization of probes to homologous chromosomes 18 is discussed. The results obtained indicate that this probe may be useful in clinical cytogenetics for identification of chromosome 19 in metaphase and interphase cells, determination of breakpoints or studies of pericentromeric DNA polymorphisms.     

Alveolar rhabdomyosarcoma of the vulva. Report of two cases

The cytologic and histologic findings in two cases of the extremely rare alveolar rhabdomyosarcoma of the vulva are reported. The tumor cells in fine needle aspiration smears from one case and tumor imprints from both cases were isolated or were in sheets or reticular patterns. The nuclei were round to oval; only a few cells were multinucleated. The chromatinic material was increased in amount and finely granular. Many mitotic figures were observed. The cytoplasm was scanty in general, but some cells had abundant cytoplasm; cross striations were not recognized. The tumor cells were positive with immunocytochemical stains for desmin, vimentin and myoglobin. Similar findings were observed in biopsy and surgical specimens.     

Partial deletion 10p syndrome. Report of two patients.

Two patients with partial deletion of the short arm of chromosome 10 are described. They showed most of the features observed in twenty other known patients, including growth retardation, mental deficiency, abnormally shaped skull, distinct facial dysmorphisms, cardiac and genitourinary malformations, and limbs anomalies. One of our patients also had features of the DiGeorge sequence, which has been found in five other cases with this imbalance.     

Hematoidin crystals in cervicovaginal smears. Report of two cases

Cervicovaginal smears obtained from two women, one at the 32nd week of pregnancy and the other at the immediate postpartum period, contained hematoidin crystals. These crystals were of a golden color and appeared as radially arranged fine needles forming cockleburrs or as aggregates of small irregular particles, spherules or rhomboids, in most instances associated with or within histiocytes. Hemosiderin pigment was associated with them in small amounts. The presence of hematoidin crystals is not an uncommon finding in cytologic specimens, particularly those obtained by fine needle aspiration of walled-off, necrotizing lesions with a component of hemorrhage. It is a very unusual finding in cervicovaginal smears, probably because of the ability of the uterus to promptly rid itself of blood. Certain aspects of the formation and identity of hematoidin are discussed.