Department of Forensic Pathology, University of Foggia, Foggia, Italy.
Diagn Pathol. 2012 Oct 18;7:144. doi: 10.1186/1746-1596-7-144.
Colloid cysts are rare congenital, intracranial neoplasms, commonly located in the third ventricle. Colloid cysts are endodermal congenital malformations. The cysts commonly range in size from 1-2 cm in diameter, although large cysts >3 cm in size have been reported. The components of the cyst include an outer fibrous capsule over an inner epithelium. The epithelium is usually a single layer of mucin-producing or ciliated cells. Such cysts contain mucoid and gelatinous material, which is positive for both Periodic acid Schiff (PAS) and mucicarmen staining. Although colloid cysts usually represent histopathologically benign neoplasms, they can result in sudden, unexpected and potentially lethal complications. The mechanism(s) of death is still a controversial subject and several mechanisms have been postulated to explain the sudden onset of severe symptoms and of fatal rapid deterioration in patients with colloid cysts. In this case, macroscopic and histological findings addressed the diagnosis of colloid cyst of the third ventricle with diffuse myocardial injury (coagulative myocytolysis or contraction band necrosis, CBN) and led us to conclude that acute cardiac arrest due to hypothalamus stimulation in the context of colloid cyst of the third ventricle was the cause of death. As the hypothalamic structures which are involved in neuroendocrine and autonomic regulation playing a key role in cardiovascular control are located close to the walls of the third ventricle which is the most frequent anatomical site of colloid cyst, this may suggest that reflex cardiac effects due to the compression of the hypothalamic cardiovascular regulatory centers by the cyst explain the sudden death in patients harboring a colloid cyst when signs of hydrocephalus or brain herniation are lacking.
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胶样囊肿是罕见的先天性颅内肿瘤，通常位于第三脑室。胶样囊肿是内胚层先天性畸形。囊肿的大小通常在 1-2 厘米之间，尽管已经报道了>3 厘米大小的大囊肿。囊肿的组成部分包括一个纤维囊，内有一层内层上皮。上皮通常是单层黏液产生或纤毛细胞。这些囊肿含有黏液样和胶状物质，对过碘酸雪夫（PAS）和粘卡门染色均为阳性。虽然胶样囊肿通常代表组织病理学上良性肿瘤，但它们可能导致突然、意外和潜在致命的并发症。死亡机制仍然是一个有争议的话题，已经提出了几种机制来解释胶样囊肿患者突发严重症状和致命性迅速恶化的机制。在这种情况下，宏观和组织学发现解决了第三脑室胶样囊肿伴弥漫性心肌损伤（凝固性肌溶解或收缩带坏死，CBN）的诊断，并使我们得出结论，由于第三脑室胶样囊肿刺激下丘脑导致急性心脏骤停是死亡的原因。由于涉及神经内分泌和自主调节的下丘脑结构在心血管控制中起着关键作用，它们靠近第三脑室的壁，第三脑室是胶样囊肿最常见的解剖部位，因此这可能表明，由于囊肿对下丘脑心血管调节中心的压迫，导致反射性心脏效应，解释了缺乏脑积水或脑疝迹象的胶样囊肿患者的突然死亡。
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