![Page 1: Spine: Myelomeningocele Lab 13, Case 1. Fetus at autopsy Note the defect in the lower lumbar region of the spinal column (arrow). The myelomeningocele](https://reader035.vdocuments.site/reader035/viewer/2022062409/56649ebe5503460f94bc8ae1/html5/thumbnails/1.jpg)
Spine: Myelomeningocele
Lab 13, Case 1
![Page 2: Spine: Myelomeningocele Lab 13, Case 1. Fetus at autopsy Note the defect in the lower lumbar region of the spinal column (arrow). The myelomeningocele](https://reader035.vdocuments.site/reader035/viewer/2022062409/56649ebe5503460f94bc8ae1/html5/thumbnails/2.jpg)
Fetus at autopsy
Note the defect in the lower lumbar region of the spinal column (arrow). The myelomeningocele can be seen protruding from this defect.
![Page 3: Spine: Myelomeningocele Lab 13, Case 1. Fetus at autopsy Note the defect in the lower lumbar region of the spinal column (arrow). The myelomeningocele](https://reader035.vdocuments.site/reader035/viewer/2022062409/56649ebe5503460f94bc8ae1/html5/thumbnails/3.jpg)
Consecutive lumbar vertebrae from this case
Note the defect (arrows) in the two vertebral bodies on the right. This defect was caused by the failure of the vertebral column to properly fuse.
![Page 4: Spine: Myelomeningocele Lab 13, Case 1. Fetus at autopsy Note the defect in the lower lumbar region of the spinal column (arrow). The myelomeningocele](https://reader035.vdocuments.site/reader035/viewer/2022062409/56649ebe5503460f94bc8ae1/html5/thumbnails/4.jpg)
Closer view of the previous photograph showing normal lumbar vertebra from this case on the left
Once again, note the defect (arrow) in the vertebral body on the right due to the failure of the vertebral column to close properly.
![Page 5: Spine: Myelomeningocele Lab 13, Case 1. Fetus at autopsy Note the defect in the lower lumbar region of the spinal column (arrow). The myelomeningocele](https://reader035.vdocuments.site/reader035/viewer/2022062409/56649ebe5503460f94bc8ae1/html5/thumbnails/5.jpg)
One of the vertebral bodies from this case
In this section there are defects (arrows) in the vertebral body but the skin can be seen over the open vertebral canal.
![Page 6: Spine: Myelomeningocele Lab 13, Case 1. Fetus at autopsy Note the defect in the lower lumbar region of the spinal column (arrow). The myelomeningocele](https://reader035.vdocuments.site/reader035/viewer/2022062409/56649ebe5503460f94bc8ae1/html5/thumbnails/6.jpg)
One of the vertebral bodies from this case
The defect (arrows) in the vertebral body is seen more clearly. The spinal cord is disrupted and there are areas of hemorrhage in this region.
![Page 7: Spine: Myelomeningocele Lab 13, Case 1. Fetus at autopsy Note the defect in the lower lumbar region of the spinal column (arrow). The myelomeningocele](https://reader035.vdocuments.site/reader035/viewer/2022062409/56649ebe5503460f94bc8ae1/html5/thumbnails/7.jpg)
Spinal cord (arrow) immediately beneath the area of hemorrhage
![Page 8: Spine: Myelomeningocele Lab 13, Case 1. Fetus at autopsy Note the defect in the lower lumbar region of the spinal column (arrow). The myelomeningocele](https://reader035.vdocuments.site/reader035/viewer/2022062409/56649ebe5503460f94bc8ae1/html5/thumbnails/8.jpg)
Spinal cord within the vertebral column shows the hemorrhage (arrows) in this region
![Page 9: Spine: Myelomeningocele Lab 13, Case 1. Fetus at autopsy Note the defect in the lower lumbar region of the spinal column (arrow). The myelomeningocele](https://reader035.vdocuments.site/reader035/viewer/2022062409/56649ebe5503460f94bc8ae1/html5/thumbnails/9.jpg)
Liver: Biliary Atresia
Lab 13, Case 2
![Page 10: Spine: Myelomeningocele Lab 13, Case 1. Fetus at autopsy Note the defect in the lower lumbar region of the spinal column (arrow). The myelomeningocele](https://reader035.vdocuments.site/reader035/viewer/2022062409/56649ebe5503460f94bc8ae1/html5/thumbnails/10.jpg)
Section of liver
Even at this magnification, areas of fibrosis can be appreciated.
![Page 11: Spine: Myelomeningocele Lab 13, Case 1. Fetus at autopsy Note the defect in the lower lumbar region of the spinal column (arrow). The myelomeningocele](https://reader035.vdocuments.site/reader035/viewer/2022062409/56649ebe5503460f94bc8ae1/html5/thumbnails/11.jpg)
Liver
Areas of portal fibrosis and bile duct proliferation (arrows)
Adjacent to this fibrotic portal region, hepatocytes are seen separated by dilated sinusoids. Throughout this section are found accumulations of yellow-brown bile pigment.
![Page 12: Spine: Myelomeningocele Lab 13, Case 1. Fetus at autopsy Note the defect in the lower lumbar region of the spinal column (arrow). The myelomeningocele](https://reader035.vdocuments.site/reader035/viewer/2022062409/56649ebe5503460f94bc8ae1/html5/thumbnails/12.jpg)
Fibrotic portal regions
Arrows: Proliferation of bile ducts
![Page 13: Spine: Myelomeningocele Lab 13, Case 1. Fetus at autopsy Note the defect in the lower lumbar region of the spinal column (arrow). The myelomeningocele](https://reader035.vdocuments.site/reader035/viewer/2022062409/56649ebe5503460f94bc8ae1/html5/thumbnails/13.jpg)
Fibrotic portal region with several bile ducts that contain inspissated (thickened, condensed, dried out) bile (arrows)
Adjacent hepatocytes also contain bile pigments.
![Page 14: Spine: Myelomeningocele Lab 13, Case 1. Fetus at autopsy Note the defect in the lower lumbar region of the spinal column (arrow). The myelomeningocele](https://reader035.vdocuments.site/reader035/viewer/2022062409/56649ebe5503460f94bc8ae1/html5/thumbnails/14.jpg)
Liver stained with trichrome stain to demonstrate portal fibrosis
The fibrous connective tissue (collagen) stains blue.
![Page 15: Spine: Myelomeningocele Lab 13, Case 1. Fetus at autopsy Note the defect in the lower lumbar region of the spinal column (arrow). The myelomeningocele](https://reader035.vdocuments.site/reader035/viewer/2022062409/56649ebe5503460f94bc8ae1/html5/thumbnails/15.jpg)
Lung: Hyaline Membrane Disease
Lab 13, Case 3
![Page 16: Spine: Myelomeningocele Lab 13, Case 1. Fetus at autopsy Note the defect in the lower lumbar region of the spinal column (arrow). The myelomeningocele](https://reader035.vdocuments.site/reader035/viewer/2022062409/56649ebe5503460f94bc8ae1/html5/thumbnails/16.jpg)
Lung demonstrating hyaline membrane disease and atelectasis
![Page 17: Spine: Myelomeningocele Lab 13, Case 1. Fetus at autopsy Note the defect in the lower lumbar region of the spinal column (arrow). The myelomeningocele](https://reader035.vdocuments.site/reader035/viewer/2022062409/56649ebe5503460f94bc8ae1/html5/thumbnails/17.jpg)
1: Lung 2: Liver
The lack of open air spaces in this neonatal lung indicates its immaturity.
![Page 18: Spine: Myelomeningocele Lab 13, Case 1. Fetus at autopsy Note the defect in the lower lumbar region of the spinal column (arrow). The myelomeningocele](https://reader035.vdocuments.site/reader035/viewer/2022062409/56649ebe5503460f94bc8ae1/html5/thumbnails/18.jpg)
Liver containing dark blue-stained cells in the hepatic sinusoids
These are immature blood cell precursors and this represents extramedullary hematopoiesis of the liver.
![Page 19: Spine: Myelomeningocele Lab 13, Case 1. Fetus at autopsy Note the defect in the lower lumbar region of the spinal column (arrow). The myelomeningocele](https://reader035.vdocuments.site/reader035/viewer/2022062409/56649ebe5503460f94bc8ae1/html5/thumbnails/19.jpg)
Shows more clearly blood cell precursors (arrows) which represent extramedullary hematopoiesis of the liver
The liver is a normal site of fetal hematopoiesis and, for this stage of gestation, EH in the liver is normal.
![Page 20: Spine: Myelomeningocele Lab 13, Case 1. Fetus at autopsy Note the defect in the lower lumbar region of the spinal column (arrow). The myelomeningocele](https://reader035.vdocuments.site/reader035/viewer/2022062409/56649ebe5503460f94bc8ae1/html5/thumbnails/20.jpg)
Lung demonstrating hypercellular pulmonary interstitium and small air spaces (as compared to adult lungs)
![Page 21: Spine: Myelomeningocele Lab 13, Case 1. Fetus at autopsy Note the defect in the lower lumbar region of the spinal column (arrow). The myelomeningocele](https://reader035.vdocuments.site/reader035/viewer/2022062409/56649ebe5503460f94bc8ae1/html5/thumbnails/21.jpg)
Lung bronchus with cartilage
Interstitial congestion with numerous red cells is apparent. Even at this magnification, hyaline membranes (arrows) can be seen lining the alveoli.
![Page 22: Spine: Myelomeningocele Lab 13, Case 1. Fetus at autopsy Note the defect in the lower lumbar region of the spinal column (arrow). The myelomeningocele](https://reader035.vdocuments.site/reader035/viewer/2022062409/56649ebe5503460f94bc8ae1/html5/thumbnails/22.jpg)
Airway with adjacent lung tissue
Some alveloi have hyaline membranes (arrows). There is severe congestion in the interstitium throughout this section.
![Page 23: Spine: Myelomeningocele Lab 13, Case 1. Fetus at autopsy Note the defect in the lower lumbar region of the spinal column (arrow). The myelomeningocele](https://reader035.vdocuments.site/reader035/viewer/2022062409/56649ebe5503460f94bc8ae1/html5/thumbnails/23.jpg)
Pink acellular homogeneous material lining the alveoli which comprises the hyaline membranes (arrows)
The interstitium shows congestion, as in previous sections.
![Page 24: Spine: Myelomeningocele Lab 13, Case 1. Fetus at autopsy Note the defect in the lower lumbar region of the spinal column (arrow). The myelomeningocele](https://reader035.vdocuments.site/reader035/viewer/2022062409/56649ebe5503460f94bc8ae1/html5/thumbnails/24.jpg)
Hyaline membranes (arrows) and congestion in the interstitum
![Page 25: Spine: Myelomeningocele Lab 13, Case 1. Fetus at autopsy Note the defect in the lower lumbar region of the spinal column (arrow). The myelomeningocele](https://reader035.vdocuments.site/reader035/viewer/2022062409/56649ebe5503460f94bc8ae1/html5/thumbnails/25.jpg)
Kidney: Wilms’ Tumor
Lab 13, Case 4
![Page 26: Spine: Myelomeningocele Lab 13, Case 1. Fetus at autopsy Note the defect in the lower lumbar region of the spinal column (arrow). The myelomeningocele](https://reader035.vdocuments.site/reader035/viewer/2022062409/56649ebe5503460f94bc8ae1/html5/thumbnails/26.jpg)
Bladder (1) attached to normal kidney (2) and a kidney with Wilms’ tumor (3)
A large mass extends from the superior pole of the affected kidney. The renal capsule can be seen extending around this tumor.
![Page 27: Spine: Myelomeningocele Lab 13, Case 1. Fetus at autopsy Note the defect in the lower lumbar region of the spinal column (arrow). The myelomeningocele](https://reader035.vdocuments.site/reader035/viewer/2022062409/56649ebe5503460f94bc8ae1/html5/thumbnails/27.jpg)
Closer view of the kidney with Wilms’ Tumor (arrows)
![Page 28: Spine: Myelomeningocele Lab 13, Case 1. Fetus at autopsy Note the defect in the lower lumbar region of the spinal column (arrow). The myelomeningocele](https://reader035.vdocuments.site/reader035/viewer/2022062409/56649ebe5503460f94bc8ae1/html5/thumbnails/28.jpg)
Lung from this case demonstrating the metastatic tumor nodule (arrow)
![Page 29: Spine: Myelomeningocele Lab 13, Case 1. Fetus at autopsy Note the defect in the lower lumbar region of the spinal column (arrow). The myelomeningocele](https://reader035.vdocuments.site/reader035/viewer/2022062409/56649ebe5503460f94bc8ae1/html5/thumbnails/29.jpg)
No tissue is present that can be readily identified as normal kidney. There does appear to be a capsule surrounding the tumor. Eosinophilic bands are seen surrounding basophilic islands of cells. These correspond to the two types of tissue in this tumor- the basophilic cellular compartment termed “blastema” can be distinguished from less cellular eosinophilic areas.
![Page 30: Spine: Myelomeningocele Lab 13, Case 1. Fetus at autopsy Note the defect in the lower lumbar region of the spinal column (arrow). The myelomeningocele](https://reader035.vdocuments.site/reader035/viewer/2022062409/56649ebe5503460f94bc8ae1/html5/thumbnails/30.jpg)
Two types of cells make up this neoplasm
The basophilic cellular component termed “blastema” (1) can be distinguished from less eosinophilic areas with fibroblast-like cells (2).
![Page 31: Spine: Myelomeningocele Lab 13, Case 1. Fetus at autopsy Note the defect in the lower lumbar region of the spinal column (arrow). The myelomeningocele](https://reader035.vdocuments.site/reader035/viewer/2022062409/56649ebe5503460f94bc8ae1/html5/thumbnails/31.jpg)
Two cell types making up this neoplasm
There are regions within the blastema where the cells form glands or “tubules” (arrows).
![Page 32: Spine: Myelomeningocele Lab 13, Case 1. Fetus at autopsy Note the defect in the lower lumbar region of the spinal column (arrow). The myelomeningocele](https://reader035.vdocuments.site/reader035/viewer/2022062409/56649ebe5503460f94bc8ae1/html5/thumbnails/32.jpg)
Two cell types making up this neoplasm
The glands or “tubules” within the blastema are better developed in this section (arrows).
![Page 33: Spine: Myelomeningocele Lab 13, Case 1. Fetus at autopsy Note the defect in the lower lumbar region of the spinal column (arrow). The myelomeningocele](https://reader035.vdocuments.site/reader035/viewer/2022062409/56649ebe5503460f94bc8ae1/html5/thumbnails/33.jpg)
“Tubule” formation within the blastema (arrows)
![Page 34: Spine: Myelomeningocele Lab 13, Case 1. Fetus at autopsy Note the defect in the lower lumbar region of the spinal column (arrow). The myelomeningocele](https://reader035.vdocuments.site/reader035/viewer/2022062409/56649ebe5503460f94bc8ae1/html5/thumbnails/34.jpg)
“Tubule” formation within the blastema
Note the numerous mitotic figures (arrows).
![Page 35: Spine: Myelomeningocele Lab 13, Case 1. Fetus at autopsy Note the defect in the lower lumbar region of the spinal column (arrow). The myelomeningocele](https://reader035.vdocuments.site/reader035/viewer/2022062409/56649ebe5503460f94bc8ae1/html5/thumbnails/35.jpg)
Difference in morphology between the blastema (1) and the fibroblast type cells (2)
![Page 36: Spine: Myelomeningocele Lab 13, Case 1. Fetus at autopsy Note the defect in the lower lumbar region of the spinal column (arrow). The myelomeningocele](https://reader035.vdocuments.site/reader035/viewer/2022062409/56649ebe5503460f94bc8ae1/html5/thumbnails/36.jpg)
Cystic Fibrosis
Lab 13, Case 5
![Page 37: Spine: Myelomeningocele Lab 13, Case 1. Fetus at autopsy Note the defect in the lower lumbar region of the spinal column (arrow). The myelomeningocele](https://reader035.vdocuments.site/reader035/viewer/2022062409/56649ebe5503460f94bc8ae1/html5/thumbnails/37.jpg)
Liver and pancreas from autopsy
The pancreas is slightly smaller than normal and it has a mucous consistency.
![Page 38: Spine: Myelomeningocele Lab 13, Case 1. Fetus at autopsy Note the defect in the lower lumbar region of the spinal column (arrow). The myelomeningocele](https://reader035.vdocuments.site/reader035/viewer/2022062409/56649ebe5503460f94bc8ae1/html5/thumbnails/38.jpg)
This section of duodenum demonstrates dilation, loss of rugae, and areas of ulceration (arrows).
![Page 39: Spine: Myelomeningocele Lab 13, Case 1. Fetus at autopsy Note the defect in the lower lumbar region of the spinal column (arrow). The myelomeningocele](https://reader035.vdocuments.site/reader035/viewer/2022062409/56649ebe5503460f94bc8ae1/html5/thumbnails/39.jpg)
Pancreas showing increased interstitial connective tissue resulting in accentuation of the lobar pattern
![Page 40: Spine: Myelomeningocele Lab 13, Case 1. Fetus at autopsy Note the defect in the lower lumbar region of the spinal column (arrow). The myelomeningocele](https://reader035.vdocuments.site/reader035/viewer/2022062409/56649ebe5503460f94bc8ae1/html5/thumbnails/40.jpg)
This higher-power photomicrograph of the pancreas shows interstitial tissue and the presence of small cystic spaces (1) within the acinar lobules. These spaces are filled with eosinophilic proteinaceous material. The islets of Langerhans (2) are unaffected.
![Page 41: Spine: Myelomeningocele Lab 13, Case 1. Fetus at autopsy Note the defect in the lower lumbar region of the spinal column (arrow). The myelomeningocele](https://reader035.vdocuments.site/reader035/viewer/2022062409/56649ebe5503460f94bc8ae1/html5/thumbnails/41.jpg)
Cystic space (1) within an acinar lobule
Islets of Langerhans (2) are also visible.
![Page 42: Spine: Myelomeningocele Lab 13, Case 1. Fetus at autopsy Note the defect in the lower lumbar region of the spinal column (arrow). The myelomeningocele](https://reader035.vdocuments.site/reader035/viewer/2022062409/56649ebe5503460f94bc8ae1/html5/thumbnails/42.jpg)
Variably-sized cystic spaces within the acinar pancreas
![Page 43: Spine: Myelomeningocele Lab 13, Case 1. Fetus at autopsy Note the defect in the lower lumbar region of the spinal column (arrow). The myelomeningocele](https://reader035.vdocuments.site/reader035/viewer/2022062409/56649ebe5503460f94bc8ae1/html5/thumbnails/43.jpg)
Cystic spaces (1) within acinar pancreas and a normal islet of Langerhans (2)
![Page 44: Spine: Myelomeningocele Lab 13, Case 1. Fetus at autopsy Note the defect in the lower lumbar region of the spinal column (arrow). The myelomeningocele](https://reader035.vdocuments.site/reader035/viewer/2022062409/56649ebe5503460f94bc8ae1/html5/thumbnails/44.jpg)
Normal layers of the intestine
1: Serosa 2: Muscularis 3: Submucosa
4: Mucosa with deep mucosal crypts 5: Cystic space within the mucosa
![Page 45: Spine: Myelomeningocele Lab 13, Case 1. Fetus at autopsy Note the defect in the lower lumbar region of the spinal column (arrow). The myelomeningocele](https://reader035.vdocuments.site/reader035/viewer/2022062409/56649ebe5503460f94bc8ae1/html5/thumbnails/45.jpg)
Bottom of the intestinal crypts and the other normal layers of the intestine
Even at this magnification, accumulations of eosinophilic debris can be seen in many of the intestinal crypts (arrows).
![Page 46: Spine: Myelomeningocele Lab 13, Case 1. Fetus at autopsy Note the defect in the lower lumbar region of the spinal column (arrow). The myelomeningocele](https://reader035.vdocuments.site/reader035/viewer/2022062409/56649ebe5503460f94bc8ae1/html5/thumbnails/46.jpg)
Eosinophilic debris in many of the intestinal crypts (arrows)
![Page 47: Spine: Myelomeningocele Lab 13, Case 1. Fetus at autopsy Note the defect in the lower lumbar region of the spinal column (arrow). The myelomeningocele](https://reader035.vdocuments.site/reader035/viewer/2022062409/56649ebe5503460f94bc8ae1/html5/thumbnails/47.jpg)
Eosinophilic debris in the intestinal crypts (arrows)
![Page 48: Spine: Myelomeningocele Lab 13, Case 1. Fetus at autopsy Note the defect in the lower lumbar region of the spinal column (arrow). The myelomeningocele](https://reader035.vdocuments.site/reader035/viewer/2022062409/56649ebe5503460f94bc8ae1/html5/thumbnails/48.jpg)
Saggital sections of the intestinal crypts show the crypts along their full length, extending to the mucosal surface.
![Page 49: Spine: Myelomeningocele Lab 13, Case 1. Fetus at autopsy Note the defect in the lower lumbar region of the spinal column (arrow). The myelomeningocele](https://reader035.vdocuments.site/reader035/viewer/2022062409/56649ebe5503460f94bc8ae1/html5/thumbnails/49.jpg)
Vacuolated intestinal epithelial cells lining the crypts and necrotic debris and inspissated secretions within the crypts (arrows).
![Page 50: Spine: Myelomeningocele Lab 13, Case 1. Fetus at autopsy Note the defect in the lower lumbar region of the spinal column (arrow). The myelomeningocele](https://reader035.vdocuments.site/reader035/viewer/2022062409/56649ebe5503460f94bc8ae1/html5/thumbnails/50.jpg)
Vacuolated intestinal epithelial cells lining the crypts and necrotic debris and inspissated secretions within the crypts (arrows).
![Page 51: Spine: Myelomeningocele Lab 13, Case 1. Fetus at autopsy Note the defect in the lower lumbar region of the spinal column (arrow). The myelomeningocele](https://reader035.vdocuments.site/reader035/viewer/2022062409/56649ebe5503460f94bc8ae1/html5/thumbnails/51.jpg)
Meningococcemia
Lab 13, Case 6
![Page 52: Spine: Myelomeningocele Lab 13, Case 1. Fetus at autopsy Note the defect in the lower lumbar region of the spinal column (arrow). The myelomeningocele](https://reader035.vdocuments.site/reader035/viewer/2022062409/56649ebe5503460f94bc8ae1/html5/thumbnails/52.jpg)
Photograph from autopsy
Note the areas of hemorrhage in the inguinal region
![Page 53: Spine: Myelomeningocele Lab 13, Case 1. Fetus at autopsy Note the defect in the lower lumbar region of the spinal column (arrow). The myelomeningocele](https://reader035.vdocuments.site/reader035/viewer/2022062409/56649ebe5503460f94bc8ae1/html5/thumbnails/53.jpg)
Inguinal region at autopsy
The areas of hemorrhage include purpura and petechiae (arrows).
![Page 54: Spine: Myelomeningocele Lab 13, Case 1. Fetus at autopsy Note the defect in the lower lumbar region of the spinal column (arrow). The myelomeningocele](https://reader035.vdocuments.site/reader035/viewer/2022062409/56649ebe5503460f94bc8ae1/html5/thumbnails/54.jpg)
Abdomen at autopsy
There are petechial hemorrhages on the viscera (arrows).
![Page 55: Spine: Myelomeningocele Lab 13, Case 1. Fetus at autopsy Note the defect in the lower lumbar region of the spinal column (arrow). The myelomeningocele](https://reader035.vdocuments.site/reader035/viewer/2022062409/56649ebe5503460f94bc8ae1/html5/thumbnails/55.jpg)
This photomicrograph of the skin shows thrombi and fibrin clots in small vessels in the dermis. This is indicative of the endothelial damage caused by the Neisseria meningitidis endotoxin. This endotoxin-induced damage to the endothelium of small blood vessels throughout the body results in widespread petechiae and purpura.
![Page 56: Spine: Myelomeningocele Lab 13, Case 1. Fetus at autopsy Note the defect in the lower lumbar region of the spinal column (arrow). The myelomeningocele](https://reader035.vdocuments.site/reader035/viewer/2022062409/56649ebe5503460f94bc8ae1/html5/thumbnails/56.jpg)
Cross section through the adrenal glands from this case
Both adrenal glands are markedly hemorrhagic.
![Page 57: Spine: Myelomeningocele Lab 13, Case 1. Fetus at autopsy Note the defect in the lower lumbar region of the spinal column (arrow). The myelomeningocele](https://reader035.vdocuments.site/reader035/viewer/2022062409/56649ebe5503460f94bc8ae1/html5/thumbnails/57.jpg)
Adrenal gland
Note the entire gland is hemorrhagic.
![Page 58: Spine: Myelomeningocele Lab 13, Case 1. Fetus at autopsy Note the defect in the lower lumbar region of the spinal column (arrow). The myelomeningocele](https://reader035.vdocuments.site/reader035/viewer/2022062409/56649ebe5503460f94bc8ae1/html5/thumbnails/58.jpg)
Adrenal gland
Hemorrhagic necrosis
![Page 59: Spine: Myelomeningocele Lab 13, Case 1. Fetus at autopsy Note the defect in the lower lumbar region of the spinal column (arrow). The myelomeningocele](https://reader035.vdocuments.site/reader035/viewer/2022062409/56649ebe5503460f94bc8ae1/html5/thumbnails/59.jpg)
Smear of cerebrospinal fluid taken at autopsy
Note the Gram-negative cocci in this smear, indicative of N. meningitidis.