啊，终于有人发表评论了，不容易啊，谢谢，太感谢了。

当时也考虑颅咽管瘤，但是我们领导和临床的专家都说发生在第四脑室的很少，领导说是囊肿，可怎么看都不像囊肿。

最终我还是报颅咽管瘤。

你的领导和临床专家的意见是准确的，必须要听的！

根据神经解剖的知识，告诉我们颅咽管瘤不会发生在四脑室内。

请做Synaptophysin, S100, Vimentin, D2-40, GFAP免疫组化。

本例是典型的脉络丛囊肿。

谢谢！

The location in the fourth ventricle is indeed incompatible with the diagnosis of cranipharyngioma. The calcification and collection of cholesterol crystals in the fibrotic stroma are seen in choroin plexus lesions such as cyst or xanthagranuloma, but the epithelial lining is more of the stratifiesquamous type than cuboidal epithelial type. Therefore one has to consider the possibility of epidermoid cyst. The unlikely possibility of cystic metastatic sqamous cell carcinoma is not supported by the young patient's age or the lack of cytologic atypia.

 xuexila