From the Department of Neurosurgery, La Princesa University Hospital, Madrid, Spain.
Department of Neurosurgery, Puerta de Hierro University Hospital, Madrid, Spain.
J Neuropathol Exp Neurol. 2022 Apr 27;81(5):330-343. doi: 10.1093/jnen/nlac020.
This study investigates the presence of a hollow recess at the midline undersurface of tumors primarily localized within the third ventricle (3V). This structure was originally identified by magnetic resonance imaging (MRI) of 6 3V craniopharyngiomas (CPs) from our series and was then methodically scrutinized in autopsy studies (n = 1091) and MRI scans (n = 5558) of CPs and in 1251 3V tumors reported in the medical literature from 1839 to 2021. A recess at the tumor base was identified in 110 CPs, 95 with a verified papillary histology (papillary craniopharyngioma [PCP]) and 15 with typical gross appearance of PCP. Topographically, 90 tumors were strictly within the 3V (82%); 20 developed at the infundibulo-tuberal region of the 3V floor (18%). Morphologically, 2 main types of recess were identified: (i) a long, narrow recess with either a duct-like or a tubular shape that reached the central region of the CP (n = 47, 42.5%); and (ii) a short recess extending only a few millimeters into the lesion, either with a duct-like or a shallow cleft-like morphology (n = 63, 57.5%). Thus, the presence of a basal recess represents a pathological hallmark of a subpopulation of 3V PCPs. The presumed nature and diagnostic significance of this novel finding is comprehensively addressed.
本研究调查了主要位于第三脑室（3V）内的肿瘤中线下表面存在中空凹陷的情况。该结构最初是通过对我们系列中的 6 例 3V 颅咽管瘤（CP）的磁共振成像（MRI）发现的，然后在尸检研究（n=1091）和 CP 的 MRI 扫描（n=5558）以及在 1839 年至 2021 年的医学文献中报告的 1251 例 3V 肿瘤中进行了系统性研究。在 110 例 CP 中发现了肿瘤基底处的凹陷，其中 95 例具有证实的乳头组织学（乳头状颅咽管瘤 [PCP]），15 例具有典型的大体外观。从解剖学角度来看，90 个肿瘤完全位于 3V 内（82%）；20 个肿瘤位于 3V 底部漏斗管区域（18%）。从形态学上看，确定了 2 种主要类型的凹陷：（i）长而狭窄的凹陷，呈管状或管状，可到达 CP 的中央区域（n=47，42.5%）；（ii）仅延伸几毫米进入病变的短凹陷，呈管状或浅裂状（n=63，57.5%）。因此，基底凹陷的存在代表了一部分 3V PCP 的病理学特征。全面探讨了这种新发现的假定性质和诊断意义。
