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Primary chordoid meningioma of lung
Corwyn Rowsell1, Jane Sirbovan, Marc K Rosenblum
1Department of Pathology, University Health Network, Princess Margaret Hospital, 610 University Avenue, Toronto, Ontario M4N 3M5, Canada.
Abstract:
Primary meningiomas of the lung are rare. Most pulmonary meningiomas are typical syncytial or transitional meningiomas with smaller numbers of fibrous-type tumors. Herein, we report an unusual pulmonary tumor with the microscopic, immunohistochemical, and ultrastructural characteristics of a chordoid meningioma. The tumor was composed of cords and fascicles of small- to medium-sized spindle and epithelioid cells with eosinophilic cytoplasm and round nuclei with finely dispersed chromatin. The tumor cells were surrounded by an abundant mucoid, vacuolated stroma. The periphery of the tumor was enveloped by a significant lymphoplasmacytic infiltrate. The neoplastic cells were positive for vimentin and epithelial membrane antigen only. The unusual morphology of the tumor caused significant diagnostic difficulties. The differential diagnosis included inflammatory myofibroblastic tumor, spindle cell myoepithelioma, and extraskeletal myxoid chondrosarcoma. To the best of our knowledge, this is possibly the first description of an extracranial or intrapulmonary chordoid meningioma.
Insights
This study describes a rare intrapulmonary chordoid meningioma, a unique lung tumor. Its unusual features presented diagnostic challenges, highlighting the need for careful pathological evaluation of lung neoplasms.
Area of Science:
- Oncology
- Pathology
- Pulmonology
Background:
- Primary meningiomas of the lung are exceptionally rare.
- Typical pulmonary meningiomas include syncytial, transitional, and fibrous types.
Observation:
- This report details an unusual pulmonary tumor exhibiting characteristics of a chordoid meningioma.
- The tumor displayed cords of spindle/epithelioid cells in a mucoid stroma, with peripheral lymphoplasmacytic infiltrate.
- Immunohistochemistry revealed positivity for vimentin and epithelial membrane antigen.
Findings:
- The tumor's unique morphology mimicked other spindle cell neoplasms, including inflammatory myofibroblastic tumor and extraskeletal myxoid chondrosarcoma.
- Diagnostic difficulty arose from the atypical presentation of a chordoid meningioma within the lung.
- This case represents a potential first description of an intrapulmonary chordoid meningioma.
Implications:
- Accurate diagnosis of rare pulmonary tumors requires comprehensive histopathological and immunohistochemical analysis.
- Recognition of chordoid meningioma in the lung broadens the differential diagnosis for pulmonary spindle cell lesions.
- This finding contributes to the understanding of meningioma diversity and extraneural occurrences.
