Disseminated intravascular meconium in a newborn with meconium peritonitis

A 3-day-old premature infant with meconium peritonitis, periventricular leu komalacia, and pulmonary hypertension died with respiratory insufficiency. An autopsy disclosed intravascular squamous cells in the lungs, brain, live r, pancreas, and kidneys. Numerous pulmonary capillaries and arterioles wer e occluded by squamous cells, accounting for pulmonary hypertension. Brain parenchyma surrounding occluded cerebral vessels showed infarct and gliosis . A mediastinal lymph node filled with squamous cells alluded to the mechan ism by which these cells from the peritoneal cavity likely entered the bloo dstream-namely, via diaphragmatic pores connecting with lymphatics. Thus, d isseminated intravascular meconium rarely may com plicate meconium peritoni tis rand have devastating consequences. HUM PATHOL 30:592-594. Copyright (C ) 1999 by W.B. Saunders Company.