Ultrastructure of Pericystic or Intracystic Blood Vessels in Epidermoid Cysts.--A Transmission Electron Microscopy Study: Laboratory Investigation

• Published in: World neurosurgery Vol. 103; pp. 484 - 492
• Main Authors: Ren, Xiao-hui, M.D, Ma, Jun, M.D, Zeng, Chun, M.D, Sun, Yi-lin, M.D, Lin, Song, M.D
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.07.2017
• Subjects: Adolescent; Adult; Adventitia - ultrastructure; Apoptosis; Astrocytes - ultrastructure; Basement Membrane - ultrastructure; Blood vessel; Blood Vessels - ultrastructure; Brain Diseases - surgery; Brain Neoplasms - blood supply; Brain Neoplasms - ultrastructure; Collagen - ultrastructure; Electron microscope; Endothelial Cells - ultrastructure; Endothelium, Vascular - ultrastructure; Epidermal Cyst - blood supply; Epidermal Cyst - surgery; Female; Glioma - blood supply; Glioma - ultrastructure; Humans; Intracranial epidermoid cyst; Intracystic; Male; Microscopy, Electron, Transmission; Middle Aged; Muscle, Smooth, Vascular - ultrastructure; Myocytes, Smooth Muscle - ultrastructure; Necrosis; Neurosurgery; Neurosurgical Procedures; Pericystic; Pericytes - ultrastructure; Postoperative Hemorrhage; Tunica Intima - ultrastructure; Ultrastructure; Vacuoles - ultrastructure; Young Adult; intracranial epidermoid cyst; intracystic; delayed post-operative hemorrhage; blood vessel; epidermoid cyst; electron microscope; DPOH; pericystic; ultrastructure; TEM; EC; transmission electron microscope; Electron microscope; Intracranial epidermoid cyst; Ultrastructure; Blood vessel; Intracystic; Pericystic
• ISSN: 1878-8750; 1878-8769
• DOI: 10.1016/j.wneu.2017.04.027

Abstract Objectives Recently, we reported the tendency towards the spontaneous hemorrhage in both pre- and post-operative periods of patients with intracranial epidermoid cyst (EC). According to our experience this tendency of spontaneous hemorrhage was partly due to the pathologic blood vessels adjacent to the EC. This article was designed to testify this hypothesis. Materials & methods 23 removable pericystic or intracystic blood vessels from 17 EC patients were collected during surgery, and then were examined by transmission electron microscope. The microvascular structure in gliomas was chosen as the control. Results Under electron microscopy, variant pathological changes of vessels were found in all EC patients. In the tunicae intima, we found vacuolization, apoptosis, necrosis, intralumenal protrusion of endothelial cells, as well as swollen basement and highly flexed and discontinued elastic plate. In the tunicae media, vacuolization, swollen mitochondria was found in muscular cells. In the tunicae adventitia, extravascular erythrocytes, edema or apoptosis of pericytes, collagen predominance, and inflammatory cells infiltration and destruction were found. Neuron denature and necrosis was found in the peripheral brain tissue. In the microvascular structure of five glioma specimens we found enlargement and hyperplasia of endothelial cells, swollen basement membrane, swollen pericytes, and astrocytic hyperplasia and neuron denature in adjacent brain tissues. Conclusion Our findings provided a strong evidence for the hypothesis that intracystic or pericystic vascular degeneration or destruction accounts for the spontaneous hemorrhage tendency before and after surgical resection of the ECs.