Shirataki K, Okada S, Matsumoto S
Department of Neurological Surgery, Kobe University School of Medicine, Japan.
No To Shinkei. 1988 Feb;40(2):133-9.
Specimens from operation of 211 sellar and juxta-sellar tumors were observed histopathologically, and discussed about the true form of "cholesterol granuloma reaction" in those tumors. Depending on the characteristic histological feature, "cholesterol granuloma reaction" was classified into 3 groups, each of which also represented a step of process of organization. Group I (cholesterol clefts predominates in hemorrhagic and necrotic foci), group II (foreign body giant cells, macrophages, round cell infiltrations are present other than cholesterol clefts, signifying active organization), group III (numerous cholesterol clefts predominates in fibrous scar tissue). Feature of "cholesterol granuloma reaction" were seen in 6 cases among 37 cases of craniopharyngioma with verified histology (16%), 8 among 165 in pituitary adenomas (5%) and 1 among 5 in pituitary epithelial cysts (20%). In addition, there were 4 cases in which histologic sections of the surgical specimen showed only the feature of "cholesterol granuloma reaction", in the absence of tumorous epithelial components. "Cholesterol granuloma reaction" is thought to develop as a secondary reaction to hemorrhage or tissue necrosis (pituitary adenomas), or to keratinization (craniopharyngiomas). In occasions in which surgical specimen show only a feature of "cholesterol granuloma reaction", making the final diagnosis is necessary to be careful, taking account of other lesions as well as craniopharyngiomas.
对211例鞍区及鞍旁肿瘤手术标本进行了组织病理学观察，并探讨了这些肿瘤中“胆固醇肉芽肿反应”的真实形态。根据特征性组织学表现，“胆固醇肉芽肿反应”分为3组，每组也代表了机化过程的一个阶段。I组（出血坏死灶中胆固醇裂隙占主导），II组（除胆固醇裂隙外，还有异物巨细胞、巨噬细胞、圆形细胞浸润，提示活跃机化），III组（纤维瘢痕组织中大量胆固醇裂隙占主导）。在37例经组织学证实的颅咽管瘤中，6例（16%）出现“胆固醇肉芽肿反应”特征；垂体腺瘤165例中有8例（5%）；垂体上皮囊肿5例中有1例（20%）。此外，有4例手术标本的组织学切片仅显示“胆固醇肉芽肿反应”特征，而无肿瘤上皮成分。“胆固醇肉芽肿反应”被认为是对出血或组织坏死（垂体腺瘤）或角化（颅咽管瘤）的继发反应。当手术标本仅显示“胆固醇肉芽肿反应”特征时，在做出最终诊断时必须谨慎，要考虑到除颅咽管瘤之外的其他病变。
