J Korean Soc Radiol.  2011 Nov;65(5):451-454.

A Rathke's Cleft Cyst with Chronic Inflammation Mimicking a Pituitary Macroadenoma

• Choo KY
• Choi HS
• Jung SL
• Kim BS
• Jeun SS
• Hong YK
• Ahn KJ

Abstract

Rathke's cleft cyst is a benign cystic lesion arising in the sellar or suprasellar region. Most cases of Rathke's cleft cysts are thin-walled cystic lesions, but in rare cases, can cause a pituitary abscess by inflammation or infection. We report on a case of Rathke's cleft cyst with chronic inflammation mimicking a pituitary macroadenoma seen as a thick-walled irregular cystic lesion on brain CT and MRI.

MeSH Terms

Abscess
Brain
Central Nervous System Cysts
Inflammation

Figure

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  Fig. 1 CT on admission. A, B. Contrast enhanced CT images show well defined cystic mass (arrow) in the sellar and suprasellar areas with asymmetric thick rim enhancement.

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  Fig. 2 MRI on admission. A. T1-weighted sagittal image shows cystic mass (arrow) in the sellar and suprasellar area. Normal or compressed pituitary gland is not detected. B. T2-weighted coronal image shows intermediate signal intensity mass (arrow) with internal cystic component, similar signal to the CSF. D. Contrast enhanced T1-weighted axial and coronal images show thick rim enhancement of the peripheral solid portion of the mass (arrow). Note.-CSF = cerebrospinal fluid

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  Fig. 3 Microscopic finding shows lining epithelium consisting of cuboidal or flat cells with subepithelial inflammatory cell infiltration including lymphocytes and histiocytes.

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