Intraoperative cytologic diagnosis of suprasellar and sellar cystic lesions

Smith, Allan; Elsheikh, Tarik M.; Silverman, Jan F.

doi:10.1002/(sici)1097-0339(199903)20:3<137::aid-dc5>3.0.co;2-k

Cited by 26 publications

(7 citation statements)

References 38 publications

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“…Craniopharyngiomas (CP), Rathke's cleft cysts (RCC), and xanthogranulomas (XG) of the sellar region demonstrate several overlapping clinical and histologic features, including a common location in the sellar and suprasellar areas, and similar histologic appearance in tissue sections when only limited epithelium is present for evaluation [1][2][3][4]. Of the CP, two clinicopathologically distinct variants are recognized: the more common adamantinomatous CP, and the less common papillary CP that almost exclusively occur in adulthood, with a more uniform appearance on radiographic imaging.…”

Section: Introductionmentioning

confidence: 99%

“…Of the CP, two clinicopathologically distinct variants are recognized: the more common adamantinomatous CP, and the less common papillary CP that almost exclusively occur in adulthood, with a more uniform appearance on radiographic imaging. On histologic sections, adamantinomatous CP, unlike papillary CP, typically demonstrate the distinguishing features of calcifications, the presence of "wet " keratin, and ghost cells, frequently accompanied by xanthomatous, inflammatory changes, showing histologic similarity and overlap with ameloblastoma and other odontogenic lesions [1][2][3][4][5][6][7]. However, no significant differences with respect to resectability, efficacy of radiation therapy, and overall survival have been established between these two variants of CP [8][9][10].…”

Section: Introductionmentioning

confidence: 99%

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Comparative Immunohistochemical Assessment of Craniopharyngioma and Related Lesions

Towfighi

Kapadia

et al. 2007

Endocr Pathol

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Craniopharyngiomas (CP), Rathke's cleft cysts (RCC), and sellar xanthogranulomas (XG) are closely related lesions. As expression of cytokeratins 8 (CK8) and 20 (CK20) was reported in RCC but not in CP, the present study investigates the reproducibility of immunohistochemical distinction between CP and RCC, attempting to identify the relationship of XG to these lesions. A comparative study of 55 patient specimens (25 CP, 28 RCC, and 2 XG) was analyzed for the histological features of xanthomatous changes and squamous metaplasia, and expression of CK8 and CK20. In the 25 CP cases, xanthomatous changes were seen in 5 (20%), with CK8 reactivity demonstrated in all 25 cases. A prominent xanthomatous component was identified in 13 of 28 RCC (46%), and squamous metaplasia was seen in 11 (39%), 9 of which also contained xanthomatous features. CK8 reactivity was demonstrated in all 28 RCC cases, whereas CK20 was seen only in 9 cases (32%). Of the two cases diagnosed as XG, none contained epithelium, and immunohistochemistry for cytokeratins was not observed. Overall, differential expression of cytokeratins cannot reliably distinguish CP from RCC. Furthermore, expression of CK20 in RCC is generally seen within a background of prominent squamous metaplasia and reactive xanthomatous changes.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Comparative Immunohistochemical Assessment of Craniopharyngioma and Related Lesions

Towfighi

Kapadia

et al. 2007

Endocr Pathol

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“…Craniopharyngioma was not listed on the intraoperative differential diagnosis for any of the 13 specimens. Cytologically, craniopharyngiomas are distinct from pituicytomas in that they show tissue fragments with peripheral palisading and calcifications . Additionally, in adamantinomatous craniopharyngiomas wet keratin may be observed.…”

Section: Discussionmentioning

confidence: 99%

“…On SP, pituitary adenomas spread freely forming a sheet of monotonous cells with round nuclei and little cytoplasm. 16,23 TPs of pituitary adenomas are often highly cellular (due to their discohesive nature) whereas TPs from pituicytomas generally contain scant tumor cells. 24 It is important to note that non-tumoral neurohypophysis is also on the differential for pituicytomas.…”

Section: Atypical Pituicytomasmentioning

confidence: 99%

Intraoperative cytology of pituicytomas

Viaene

Lee

Nasrallah

2019

Diagnostic Cytopathology

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Background Pituicytoma is a rare tumor of the sella and suprasellar region. It is common for these tumors to be misdiagnosed radiographically as pituitary adenomas, meningiomas, and craniopharyngiomas. Histologically, pituicytomas are also known to show variable morphology. These factors often complicate intraoperative consultation, especially when tissue is limited. Methods A database search (January 1990‐June 2019) identified 13 surgically resected pituicytomas that were sent for intraoperative consultation. The intraoperative cytology was reviewed by two pathologists, and both squash preparations/smears and touch preparations were included. Results The cytological features of pituicytomas were variable. The cytoplasm ranged from fibrillary to fine and wispy. The nuclei were round to ovoid with occasional tumors showing spindled morphology. Small nucleoli were seen in all tumors, and chromatin was fine to vesicular. While squash preparations were cellular and revealed cohesive groups of tumor cells, touch preparations were often paucicellular with the exception of one tumor. The cytological features of pituicytomas are compared to those of other tumors with similar radiographic appearances. Conclusions Our findings illustrate the range of cytological features of these rare tumors and highlight the difficulty in making a definitive intraoperative diagnosis. Pituicytomas should be considered in the differential of a sellar/suprasellar lesion with glial and meningioma‐like cytological features.

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“…5 Intraoperative diagnosis for pituitary adenomas is readily achievable on smear preparations alone, which can achieve a high degree of diagnostic accuracy. [13][14][15] Smear preparations have several advantages in that they require the use of only small (1 mm 3 ) portions of tissue, they can be prepared and stained rapidly using a variety of stains (of which the most common are toluidine blue and haematoxylin and eosin), and their preparation requires no specialised facilities or equipment other than access to a class 1 hood in which to handle the unfixed tissue. 5 The preparation of smears from pituitary adenomas is relatively easy, because they usually have a soft consistency that readily allows a monolayer preparation to be made, which is ideal for cytological examination (fig 1).…”

Section: Intraoperative Diagnosis and Specimen Handlingmentioning

confidence: 99%

Winds of change

Rajalakshmi¹

2003

Journal of Clinical Pathology

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Intraoperative cytologic diagnosis of suprasellar and sellar cystic lesions

Cited by 26 publications

References 38 publications

Comparative Immunohistochemical Assessment of Craniopharyngioma and Related Lesions

Comparative Immunohistochemical Assessment of Craniopharyngioma and Related Lesions

Intraoperative cytology of pituicytomas

Winds of change

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