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Brain and Nerve No to Shinkei Volume 40, Issue 2 （February 1988）

Brain and Nerve 脳と神経 40巻2号（1988年2月発行）

Japanese English

原著

トルコ鞍部腫瘍におけるコレステロール肉芽腫性反応に関する病理組織学的検討 HISTOPATHOLOGICAL STUDY OF "CHOLESTEROL GRANULOMA REACTION" IN THE SELLAR AND JUXTA-SELLAR TUMORS 白瀧邦雄 ¹ , 岡田聡 ² , 松本悟 ¹ Kunio Shirataki ¹ , Satoshi Okada ² , Satoshi Matsumoto ¹ ¹神戸大学医学部脳神経外科 ²神戸大学医学部病院病理 ¹Department of Neurological Surgery, Kobe University School of Medicine ²Department of Pathology, Kobe University School of Medicine pp.133-139

発行日 1988年2月1日 Published Date 1988/2/1

DOI https://doi.org/10.11477/mf.1406206054

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Abstract 文献概要
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　抄録　トルコ鞍部腫瘍211例の摘出材料を病理組織学的に検索し，同部腫瘍におけるコレステロール肉芽腫性反応（「コ反応」）の実体について検討した。「コ反応」像をその組織像に従い，I群（出血巣や壊死巣中にコレステロール裂隙（「コ裂隙」）を含むもの），II群（「コ裂隙」以外に異物巨細胞，大食細胞，炎症細胞などが混在し，「コ反応」の旺盛な時期のもの），およびIII群（線維化が進み，複雑に交錯する「コ裂隙」から成る瘢痕組織が主体を占めるもの）に分けた。「コ反応」像は頭蓋咽頭腫37例，下垂体腺腫165例，下垂体上皮性嚢腫5例中，それぞれ6例，8例，1例に認められ，その他摘出標本が「コ反応」像のみのものも4例存在した。「コ反応」は下垂体腺腫では出血時の血球崩壊や組織破壊，頭蓋咽頭腫や下垂体上皮性？腫では主に角化物質や粘液に対する二次的な反応性の結果として生じるものと考えられる。また，摘出標本で「コ反応」組織像のみが得られた場合，頭蓋咽頭腫の可能性が高いものの，それ以外の非腫瘍性病変も考慮して，慎重な検討が必要である。

Specimens from operation of 211 sellar and juxta-sellar tumors were observed histopathologi-cally, and discussed about the true form of "cho-lesterol granuloma reaction" in those tumors. Depending on the characteristic histological fea-ture, "cholesterol granuloma reaction" was classi-fied into 3 groups, each of which also repre-sented 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 chole-sterol clefts predominates in fibrous scar tissue). Feature of "cholesterol granuloma reaction" were seen in 6 cases among 37 cases of craniopharyn-gioma with verified histology (16%), 8 among 165 in pituitary adenomas (5%) and 1 among 5 in pitui-tary 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 re-action" is thought to develop as a secondary reac-tion to hemorrhage or tissue necrosis (pituitary adenomas), or to keratinization (craniopharyn-giomas). In occasions in which surgical specimen show only a feature of "cholesterol granuloma re-action", making the final diagnosis is necessary to be careful, taking account of other lesions as well as craniopharyngiomas.