|
FIG 1. Images obtained in a 28-year-old woman who presented with left-sided frontotemporal headache lasting 6 wk.
A, Axial CT scan of the skull base shows a lytic lesion in the clivus, with no cortical break (arrows). No calcification is seen within the lesion.
B, Sagittal T1-weighted (500/14) image of the brain shows a mass (arrow) in the clivus that is hyperintense relative to the gray matter. The pituitary (arrowhead) is separate from the lesion.
C, Axial T2-weighted (6000/98) obtained at the level of the skull base shows that the lesion (arrow) is isointense to the gray matter.
D, Photomicrographs show the cyst lining composed of a pseudostratified (arrowheads) ciliated columnar epithelium (right image; hematoxylin-eosin, original magnification x100) and cytoplasmic mucin and Goblet cells (arrows in left image; PASD, original magnification x100).
E, Photomicrograph shows strong positive immunohistochemical staining within the lining epithelium (EMA, original magnification x200).
F, Photomicrograph shows focal positive immunohistochemical staining within the lining epithelium (monoclonal CEA, original magnification x200).
G, Sagittal contrast-enhanced T1-weighted brain MR (615/12) image obtained at 1-y follow-up shows a typical surgical defect in the anterior wall of the clivus (arrow), with no recurrence of the cyst.
H, Sagittal view through the clivus at approximately 3 wk of embryonic development shows the notochord (arrows), which obliquely traverses the occipital plate.
|