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Cytology of microcystic meningioma in crush preparation
K Fukuoka1, M Hirokawa, T Kanahara
1Department of Pathology, Kawasaki Medical School, Kurashiki, Japan.
Abstract:
Microcystic meningioma is a rare variant of meningioma, showing microcystic formations throughout the tumor. To the best of our knowledge, there have been no reports describing cytologic findings of microcystic meningioma. Our case was a 66-yr-old woman with a tumor mass adhered to the dura matter. The crush preparations of a small tissue fragment resected from the mass showed medium- to large-sized, well-cohesive clusters or sheets of uniform tumor cells. The tumor cells did not show a feathering-off pattern. Various-sized cystic spaces were observed within the clusters and sheets. The cytoplasm was relatively abundant, and the nuclear:cytoplasmic ratio was lower than that of classic meningioma. We believe that the cystic spaces within the cell clusters or sheets are characteristic of microcystic meningioma. The cytology of microcystic meningioma seen in our case was similar to that of metastatic adenocarcinoma, but relatively monotonous bland cells, smooth nuclear outline, and inconspicuous nucleoli led us to the diagnosis of meningioma rather than adenocarcinoma.
Insights
This study describes the cytologic findings of microcystic meningioma, a rare brain tumor variant. Characteristic microcystic spaces within tumor cell clusters aid in its diagnosis.
Area of Science:
- Neuropathology
- Cytopathology
Background:
- Microcystic meningioma is a rare meningioma variant characterized by microcystic formations.
- Cytologic findings of microcystic meningioma have not been previously reported.
Observation:
- A case of microcystic meningioma in a 66-year-old woman is presented.
- Crush preparations revealed well-cohesive clusters of uniform tumor cells with variable-sized cystic spaces.
- Tumor cells exhibited abundant cytoplasm and a lower nuclear:cytoplasmic ratio compared to classic meningioma.
Findings:
- The presence of cystic spaces within cell clusters is a characteristic feature.
- Cytology was initially similar to metastatic adenocarcinoma.
- Distinctive features included monotonous bland cells, smooth nuclear outlines, and inconspicuous nucleoli, leading to a meningioma diagnosis.
Implications:
- This report establishes the cytologic diagnostic criteria for microcystic meningioma.
- Understanding these features is crucial for differentiating it from other tumors, particularly metastatic adenocarcinoma.
- Provides valuable insights for cytopathologists and neurosurgeons managing meningioma cases.