Ikeda H, Yoshimoto T
Division of Neurosurgery, Tohoku Graduate School of Medicine, Sendai, Japan.
Clin Neuropathol. 2002 Mar-Apr;21(2):82-91.
The clinical, radiological and pathological characteristics of Rathke's cleft cyst are analyzed and compared with those of ciliated and goblet cell craniopharyngioma (a subset of papillary craniopharyngioma) to clarify the clinicopathological differences between these conditions. We analyzed 42 patients with Rathke's cleft cyst and 3 patients with ciliated and goblet cell craniopharyngioma. Cyst contents and MRI findings of the cyst generally reflected changing pathology of Rathke's cleft cyst. Turbid and less viscous cyst content and heterogeneous T1 and/or T2 signals on MRI sometimes represented predominance of squamous epithelium in the cyst wall. Pathological study disclosed smooth transition from ciliated columnar epithelium typical for Rathke's cleft cyst, via ciliated squamous epithelium, to squamous epithelium typical for craniopharyngioma in the same patients. Ki-67 immunostaining disclosed that the proliferative index of squamous epithelium of Rathke's cleft cyst is significantly higher than that of simple or pseudostratified epithelium of Rathke's cleft cyst (p < 0.05). In conclusion, our extensive study on Rathke's cleft cyst revealed that the high possibility of progression from Rathke's cleft cyst, in which either the cyst content or cyst wall are atypical or squamous epithelium is predominant, compared to ciliated and goblet cell craniopharyngioma and again to papillary craniopharyngioma.
分析拉克氏裂囊肿的临床、影像学和病理特征，并与纤毛和杯状细胞颅咽管瘤（乳头状颅咽管瘤的一个亚型）的特征进行比较，以明确这些疾病之间的临床病理差异。我们分析了42例拉克氏裂囊肿患者和3例纤毛和杯状细胞颅咽管瘤患者。囊肿内容物和囊肿的MRI表现通常反映了拉克氏裂囊肿不断变化的病理情况。浑浊且粘性较小的囊肿内容物以及MRI上不均匀的T1和/或T2信号有时提示囊肿壁鳞状上皮占优势。病理研究显示，在同一患者中，从拉克氏裂囊肿典型的纤毛柱状上皮，经纤毛鳞状上皮，平稳过渡到颅咽管瘤典型的鳞状上皮。Ki-67免疫染色显示，拉克氏裂囊肿鳞状上皮的增殖指数显著高于拉克氏裂囊肿的单层或假复层上皮（p<0.05）。总之，我们对拉克氏裂囊肿的广泛研究表明，与纤毛和杯状细胞颅咽管瘤以及乳头状颅咽管瘤相比，拉克氏裂囊肿（囊肿内容物或囊肿壁不典型或鳞状上皮占优势）进展的可能性较高。
