Rhabdoid meningioma: intraoperative diagnosis using smear preparation

Tumors with rhabdoid morphology were first described by Beckwith and Palmer in 1978 as aggressive renal tumors in very young children. Subsequently, rhabdoid tumors and tumors with rhabdoid features have been described in many other organ systems and all tend to have a poor outcome no matter what the histogenesis of the original tumor. Rhabdoid cells are plump, with abundant eosinophilic fibrillary to hyaline cytoplasm and peripheral, vesicular, variably pleomorphic nuclei. Nucleoli are invariably present. While their morphology is well recognized in processed biopsy material, their presence on a smear preparation can be quite startling. A case is presented to highlight the appearance of rhabdoid cells on an intraoperative smear preparation of a rhabdoid meningioma. An accompanying secretory component added to the complex picture.