Yamamoto M, Takara E, Imanaga H, Jimbo M, Kubo O
No Shinkei Geka. 1984 Apr;12(5):609-16.
Two cases of Rathke's cleft cysts were reported. Case 1. A 57-year-old man was admitted to our hospital on Sep. 29th. 1982, complaining of visual field defect. Visual acuity was 0.7 in the left eye and 0.1 in the right eye. Visual field examination revealed upper temporal quadrantanopsia on the left side and incomplete temporal hemianopia on the right side. He was neurologically free otherwise. Endocrinological study disclosed general hypopituitarism except for elevated serum prolactin level. CT scan showed a high density mass in the enlarged sellar cavity extending to suprasellar area. Right frontal craniotomy was performed on Oct. 26th, 1982, and about 3 ml of reddish-brown colloid substance was aspirated and the capsule of the cyst was excised. Postoperative course was uneventful. The visual acuity and field defects were improved. Microscopic section of the cyst demonstrated a loose fibrous wall, lined by single layer of ciliated columnar epithelial cells containing secreting vesicles. Histological diagnosis was Rathke's cleft cyst. Case 2. A 43-year-old female was attacked by subarachnoid hemorrhage on Jan. 1st, 1983. Angiography revealed an anterior communicating aneurysm. Operation was performed on Jan. 18th, 1983 and the aneurysm was successfully clipped. During surgery a suprasellar cystic mass was incidentally discovered and the cyst wall was resected. Microscopic section of the cyst demonstrated one layer of cuboidal cells supported by thick connective tissue. Precise check of her early history disclosed that her menstruation had been delayed and visual acuity had been impaired. CT scan was negative as far as the suprasellar region was concerned.
报告了两例拉克氏裂囊肿。病例1:一名57岁男性于1982年9月29日入院,主诉视野缺损。左眼视力为0.7,右眼视力为0.1。视野检查显示左侧颞上象限盲和右侧不完全颞侧偏盲。其他神经系统检查未见异常。内分泌学研究显示除血清催乳素水平升高外,存在全垂体功能减退。CT扫描显示扩大的蝶鞍腔内有一高密度肿块,延伸至鞍上区域。1982年10月26日行右额开颅手术,吸出约3毫升红棕色胶样物质,并切除囊肿包膜。术后病程顺利。视力和视野缺损有所改善。囊肿的显微镜切片显示有一层疏松的纤维壁,内衬单层含有分泌小泡的纤毛柱状上皮细胞。组织学诊断为拉克氏裂囊肿。病例2:一名43岁女性于1983年1月1日发生蛛网膜下腔出血。血管造影显示前交通动脉瘤。1983年1月18日进行手术,成功夹闭动脉瘤。手术中偶然发现一个鞍上囊性肿块,并切除囊肿壁。囊肿的显微镜切片显示一层立方体细胞,由厚结缔组织支撑。对其早期病史的详细检查发现她曾有月经推迟和视力受损的情况。就鞍上区域而言,CT扫描结果为阴性。