Mosaic 46,XY,der(15)t(6;15)(q25.1;p12)/46,XY at amniocentesis in a pregnancy associated with a favorable fetal outcome and postnatal decrease of the aneuploid cell line with the unbalanced translocation

Abstract

Objective: We present mosaic 46,XY,der(15)t(6;15)(q25.1;p12)/46,XY at amniocentesis in a pregnancy associated with a favorable fetal outcome and postnatal decrease of the aneuploid cell line with the unbalanced translocation. Case report: A 34-year-old primigravid woman underwent amniocentesis at 17 weeks of gestation because of advanced maternal age. Amniocentesis revealed a karyotype of 46,XY,add(15)(p12)[17]/46,XY[5]. A second amniocentesis at 19 weeks of gestation revealed a karyotype of 46,XY,der(15)t(6;15)(q25.1;p12)[12]/46,XY[8], and array comparative genomic hybridization (aCGH) analysis on the DNA extracted from uncultured amniocytes revealed arr arr 6q25.1q27×2-3 with 40% mosaic level. She was referred for genetic counseling. Prenatal ultrasound and the parental karyotypes were normal. A third amniocentesis at 24 weeks of gestation revealed a karyotype of 46,XY,der(15)t(6;15)(q25.1;p12)[23]/46,XY[1], and in uncultured amniocytes, aCGH analysis revealed arr 6q25.1q27×2.5, interphase fluorescence in situ hybridization (FISH) revealed 51% mosaicism (51/100 cells) for partial trisomy 6q and quantitative fluorescence polymerase chain reaction (QF-PCR) analysis determined maternal origin of the aberrant chromosome and excluded uniparental disomy (UPD) 15 and UPD 6. A fourth amniocentesis at 27 weeks of gestation revealed a karyotype of 46,XY,der(15)t(6;15)(q25.1;p12)[21]/46,XY[5], and in uncultured amniocytes, aCGH analysis revealed arr 6q25.1q27×2.46, and interphase FISH revealed 35% mosaicism (35/100 cells) for partial trisomy 6q. At 39 weeks of gestation, a healthy 3028-g male baby was delivered without any phenotypic abnormality. The karyotypes of cord blood, umbilical cord and placenta were 46,XY,der(15)t(6;15)(q25.1;p12)[2]/46,XY,der(15)t(6;15)(q25.1;p12)[29]/46,XY[11] and 46,XY, respectively. When follow-up at age one month, the neonate was phenotypically normal, the peripheral blood had a karyotype of 46,XY (40/40 cells), and FISH analysis on 105 buccal mucosal cells detected five cells with partial trisomy 6q compared with 2% mosaicism (2/100 cells) in the normal control. Conclusion: Mosaicism for an unbalanced translocation with a normal cell line without UPD at amniocentesis can be a transient and benign condition, and can be associated with a favorable fetal outcome and postnatal decrease of the aneuploid cell line.

Keywords

• 6q25.1q27 duplication
• Amniocentesis
• Favorable fetal outcome
• Mosaicism
• Unbalanced translocation