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Primary pulmonary malignant meningioma.

R A Prayson1, C F Farver

  • 1Department of Anatomic Pathology, Cleveland Clinic Foundation, Ohio 44195, USA.

The American Journal of Surgical Pathology
|June 12, 1999
PubMed
Summary
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This study details a rare case of malignant primary pulmonary meningioma, a typically benign lung tumor. The aggressive tumor recurred rapidly with widespread metastases, highlighting its malignant potential.

Area of Science:

  • Pathology
  • Oncology
  • Pulmonology

Background:

  • Primary pulmonary meningiomas are rare tumors, with fewer than 20 reported cases.
  • Most documented pulmonary meningiomas exhibit benign histological and clinical characteristics.

Observation:

  • A unique case of primary pulmonary meningioma with atypical histological features and malignant behavior is presented.
  • Computed tomography scan of the head ruled out intracranial meningioma.
  • A right upper lobe mass was resected, revealing atypical meningioma features.

Findings:

  • Histological analysis showed loss of architectural pattern, mild nuclear pleomorphism, increased mitotic activity (15/hpf), and rhabdoid cells.
  • Immunohistochemical and ultrastructural profiles confirmed meningioma origin.

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  • The tumor was negative for estrogen receptors and focally positive for progesterone receptors, with a MIB-1 labeling index of 9.2%.

    • Implications:

    • This case underscores that primary pulmonary meningiomas can rarely present as high-grade malignant lesions.
    • The tumor demonstrated aggressive behavior with rapid recurrence and widespread metastasis within 5 months post-resection.
    • This highlights the importance of considering malignant potential in the differential diagnosis of pulmonary meningiomas.