Clinical history: 50 year old female, sellar/suprasellar lesion.
What is the diagnosis, and features that support the diagnosis?
Rathke cleft cyst
Rathke cleft cyst is a non-neoplastic remnant of Rathke’s pouch. The structure normally involutes, but persists asymptomatically in 2 to 20% of the population, and twice as likely in females than males. It is located in the pars intermedia (between the anterior and posterior pituitary). Histologically it forms thin walled cleft like or microcystic spaces lined by mucus producing and ciliated epithelium, with occasional squamoid metaplasia, and occasional presence of adenohydophyseal secretory cells. There may be associated xanthomatous reaction in surrounding tissue. The lining cells should be positive for cytokeratins and EMA.