Chemical meningitis is a rare phenomenon due to rupture of a craniopharyngioma cyst; it develops because of presence of cholesterol crystals in cyst fluid secreted by the squamous epithelium lining of the cyst. Spontaneous rupture of the cyst may present with or without meningitis, depending upon the cholesterol contents of cystic fluid of tumor. A decrease in the size of cyst may or may not be noted. Here we report two cases of craniopharyngioma, one which had a recurrent episode of chemical meningitis after surgery due to leak from residual component of the craniopharyngioma without evidence of recurrence of lesion, or decrease in the size of the cyst. Another case presented with initial symptoms and signs of meningitis, with no change in the size of the lesion after the second episode of chemical meningitis. KeywOrds:Chemical meningitis, Craniopharyngioma, Rupture of craniopharyngioma cyst ÖZ Kraniofarenjioma kistinin rüptürü sonucu oluşan kimyasal menenjit nadir görülen bir fenomendir. Kraniofarenjioma kistini döşeyen skuamöz epitelin sekresyonu içinde yer alan kolesterol kristallerine karşı gelişen reaksiyon sonucu kimyasal menenjit oluşur. Kraniofarenjioma kisti rüptürü sonucu her zaman kimyasal menenjit gelişmez, kimyasal menenjit gelişimi için kist içeriğinde kolesterol kristallerinin olması gereklidir. Kist boyutlarında küçülme ile ilgili bir bilgiye rastlamamıştır. İki ayrı kraniofarenjioma olgumuzda kimyasal menenjit görüldü. İlk olgumuzda cerrahi sonrası tekrarlayan menenjit atakları görüldü. Bu görülen menenjitin tümörde rekürens olmadan direkt olarak rezidüel dokuya bağlı olduğu düşünüldü. Diğer olguda ise ilk semptom olarak menenjit ortaya çıktı, ikinci menenjit atağı sırasında yapılan kontrollerde kist çapında bir değişiklik görülmedi.

Background:The diagnosis of Pott's disease is mostly based on clinicoradiological observations substantiated by the bacterial culture, staining and histopathology. Since, no single technique is enough to conclude Pott's disease in diagnosis, the present study was undertaken to correlate the clinicoradiological, microbiological, histopathological and molecular method to evaluate the effectiveness in diagnosis of Pott's disease.Materials and Methods:62 clinicoradiologically suspected cases of Pott's disease were included in this study. The specimens for diagnostic work up were collected either during surgery or by computed tomography guided fine needle aspiration. All these specimens were tested for tuberculosis (TB) through Ziehl-Neelsen (ZN) microscopy, BACTEC culture, histopathology and polymerase chain reaction (PCR). The final diagnosis was established by the results of performed tests and clinicoradiological improvement of cases at the end of 6 months on anti tubercular treatment.Results:Out of 62 cases, 7 were excluded from this study as these were turned out to be neoplastic lesions on histopathology. Amongst remaining 55 cases, the TB was diagnosed in 39 (71%) on histopathology, 37 (67.5%) on PCR, 27 (49%) on BACTEC culture and 20 (36.3%) on ZN microscopy. Ultimately 45 cases were tested as positive and 10 were detected as negative for TB in combination of ZN microscopy, BACTEC culture and histopathology. PCR was positive in 37 of 45 cases and 10/55 cases remained negative. On clinical analysis of these 10 cases, it was noted that these were cases of relapse/poor compliance. The combination of PCR and histopathology was also shown positive for TB in 45 cases. Hence, the PCR showed a fair positive agreement (Κc = 0.63) against the combined results of all performed traditional methods.Conclusions:The combination of PCR and histopathology is a rapid and efficient tool for diagnosis of Pott's disease.

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to the submandibular gland with hydrogel spacing was noted in the specimen with the smallest baseline gland volume. Conclusion: Injection of biodegradable radiopaque hydrogel successfully displaces the contralateral submandibular gland, providing the opportunity for dosimetrically sparing the gland. This minimally invasive technique should be tested in a clinical trial for reduction of xerostomia.