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- Title
Xanthomatous hypophysitis associated with ruptured Rathke's cleft cyst.
- Authors
Kai Duan; Gentili, Fred; Gelareh, Zadeh; Asa, Sylvia L.; Mete, Ozgur
- Abstract
Objective: Xanthomatous hypophysitis is an exceptionally rare form of hypophysitis with unclear pathogenesis and clinicopathological features. We reviewed our institution's experience with xanthomatous hypophysitis and its relation to ruptured Rathke's cleft cyst. Method(s): We retrospectively reviewed all cases of xanthomatous hypophysitis diagnosed at the University Health Network from 2002-2015. Clinical, biochemical, radiological and pathology data were retrieved from the electronic health records. Data and results: Five cases of xanthomatous hypophysitis were reported during the study period, in a 32-year-old woman, a 60-year-old man, a 74 year-old woman, a 23 year-old woman, and a 56 year-old man. Biochemical evidence of pituitary dysfunction and radiological evidence of a pituitary mass were noted in four cases that had complete clinical information. In all cases, the pituitary mass was resected through an endoscopic transsphenoidal approach. Morphologic examination revealed the presence of lipid-rich foamy histiocytes, multinucleated giant cells, cholesterol clefts, and chronic inflammatory cells, confirming the diagnosis of xanthomatous hypophysitis. Additionally, all cases presented with concurrent findings of a ruptured Rathke's cleft cyst with the exception of the last patient who had previous surgery for a Rathke's cleft cyst, followed by recurrence and the diagnosis of xanthomatous hypophysitis. Conclusion: Our study provides further insight into the pathogenesis of xanthomatous hypophysitis and identifies Rathke's cleft cyst rupture as a frequent concurrent finding and potential etiology.
- Publication
Canadian Journal of Pathology, 2016, Vol 8, p38
- ISSN
1918-915X
- Publication type
Article