Harper Stuart D, Perryman Travis, Dudley Lindsey A, Prabhu Ashna S, Carson Amani, Delgadillo Alondra, Oduro Eliana S, Sparks Othneil, Gor Aidan, Baisiwala Shivani, Zhang Ting, Rodriguez Fausto, Patel Kunal S
Department of Neurosurgery, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States.
The Intellectual and Developmental Disabilities Research Center and Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States.
J Neuropathol Exp Neurol. 2025 Jul 1;84(7):617-625. doi: 10.1093/jnen/nlaf029.
Benign-appearing intracranial cysts may become symptomatic due to mass effect and require surgical treatment. Mechanisms underlying cyst formation and growth remain poorly understood. This study identified 16 patients who underwent surgical treatment for benign intracranial cysts. Cyst wall pathologic samples (n = 8) were characterized as arachnoid or glioependymal cysts using H&E and immunofluorescence staining. Five samples (62.5%) were found to be glioependymal while three (37.5%) were arachnoid cysts. Cyst fluid examined in 4 cases resembled cerebrospinal fluid (CSF) and showed no significant differences in composition between pathological subtypes. Single-cell sequencing and RNA expression profile comparisons between glioependymal and arachnoid cysts revealed distinct cellular profiles. Analyses of the innermost cell layer (ependymal cells versus arachnoid cells) suggested differing mechanisms of pathogenesis. Glioependymal cysts harbored upregulated expression of sodium transporters and aquaporin channels, which suggests possible CSF-like fluid production whereas arachnoid cysts may be associated with mechanical fluid accumulation. Thus, intracranial cysts represent multiple unique pathologic entities with differing cell types and RNA expression profiles. Further study into mechanisms of glioependymal cyst formation may allow for targeted interventions to reduce fluid production and avoid surgery.
看似良性的颅内囊肿可能因占位效应而出现症状，需要手术治疗。囊肿形成和生长的机制仍知之甚少。本研究纳入了16例接受良性颅内囊肿手术治疗的患者。使用苏木精-伊红染色和免疫荧光染色，将囊肿壁病理样本（n = 8）鉴定为蛛网膜囊肿或胶质室管膜囊肿。发现5个样本（62.5%）为胶质室管膜囊肿，3个（37.5%）为蛛网膜囊肿。4例囊肿液检查结果类似于脑脊液（CSF），病理亚型之间的成分无显著差异。胶质室管膜囊肿和蛛网膜囊肿之间的单细胞测序和RNA表达谱比较显示出不同的细胞特征。对最内层细胞层（室管膜细胞与蛛网膜细胞）的分析提示了不同的发病机制。胶质室管膜囊肿中钠转运体和水通道蛋白通道的表达上调，这提示可能产生类似脑脊液的液体，而蛛网膜囊肿可能与机械性液体蓄积有关。因此，颅内囊肿代表了具有不同细胞类型和RNA表达谱的多种独特病理实体。对胶质室管膜囊肿形成机制的进一步研究可能有助于采取针对性干预措施以减少液体生成并避免手术。
