Cysts of the ligamentum flavum are often linked to ischemic conditions: A morphological study.

IF 2.5 4区医学 Q2 PATHOLOGY

Pathology International Pub Date : 2024-08-01 Epub Date: 2024-07-12 DOI:10.1111/pin.13465

Ayano Matsunaga, Mariko Saito, Kaya Ijiri, Motohiro Tsuchiya, Akimasa Yasuda, Kazuya Kitamura, Sho Ogata, Kazuhiro Chiba, Susumu Matsukuma

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Abstract

"Cysts of the ligamentum flavum (cysts-LF)" is the term for non-neoplastic cystic lesion involving LF. The aim of the present study was to elucidate the histopathological characteristics and pathogenesis of "cysts-LF". Herein, we defined cysts-LF as spinal cysts containing degenerative LF components. From archival cases, we investigated 18 symptomatic cysts-LF surgically removed from 18 patients (13 males and five females; median age 68.5 years [range, 42-86 years]). The elastic fibers of LF components in the wall were separated and/or torn, and cyst walls were accompanied by chondroid metaplasia (17 cases), myxoid changes (13 cases), ossification (11 cases), amyloid deposits (14 cases), hemosiderosis (six cases), granular/smudgy calcification (four cases), synovial cell linings (three cases), and severe inflammatory infiltrates (one case). These histologic features of our cysts-LF were shared by previously reported "cysts-LF." Fourteen cysts-LF demonstrated vascular stenosis/occlusion, and eight showed thick hyalinized vessels, suggesting local circulatory insufficiency. Eight cases (44%) exhibited lipomembranous fat necrosis, accompanied by hyalinized vascular changes (p = 0.003). Ischemic conditions were observed in nearly half of the present cysts-LF, and may be one of the main contributing factors for the formation of cysts-LF, via degeneration and cystic changes in the LF.

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黄韧带囊肿通常与缺血性疾病有关：形态学研究。

"黄韧带囊肿（cysts-LF）"是涉及黄韧带的非肿瘤性囊性病变的总称。本研究旨在阐明 "黄韧带囊肿 "的组织病理学特征和发病机制。在此，我们将 "LF囊肿 "定义为含有退行性LF成分的脊髓囊肿。我们从存档病例中研究了从 18 名患者（13 名男性和 5 名女性；中位年龄 68.5 岁 [范围 42-86 岁]）身上手术切除的 18 个有症状的 LF 囊肿。囊壁中 LF 成分的弹力纤维分离和/或撕裂，囊壁伴有软骨变性（17 例）、肌样变（13 例）、骨化（11 例）、淀粉样沉积（14 例）、血丝沉积（6 例）、颗粒状/混浊钙化（4 例）、滑膜细胞内衬（3 例）和严重炎症浸润（1 例）。这些囊肿-LF 的组织学特征与之前报道的 "囊肿-LF "相同。14例LF囊肿表现为血管狭窄/闭塞，8例表现为血管肥厚透明化，提示局部循环不足。8例（44%）表现为脂膜性脂肪坏死，伴有透明化血管变化（p = 0.003）。在近一半的LF囊肿中观察到缺血情况，这可能是通过LF的变性和囊变形成LF囊肿的主要因素之一。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pathology International 医学-病理学

CiteScore

4.50

自引率

4.50%

发文量

102

审稿时长

12 months

期刊介绍： Pathology International is the official English journal of the Japanese Society of Pathology, publishing articles of excellence in human and experimental pathology. The Journal focuses on the morphological study of the disease process and/or mechanisms. For human pathology, morphological investigation receives priority but manuscripts describing the result of any ancillary methods (cellular, chemical, immunological and molecular biological) that complement the morphology are accepted. Manuscript on experimental pathology that approach pathologenesis or mechanisms of disease processes are expected to report on the data obtained from models using cellular, biochemical, molecular biological, animal, immunological or other methods in conjunction with morphology. Manuscripts that report data on laboratory medicine (clinical pathology) without significant morphological contribution are not accepted.

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