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Cystic meningioma with unusual histopathological features
H D Mennel1, D Arndt, K H Plate
1Department of Neuropathology, Medical Center of Pathology, Federal Republic of Germany.
Abstract:
A parasagittal meningioma of an eighty year old female patient showed by light and electron microscopy cystic architecture (forme humide) as well as nuclear vacuoles (indentations) and cytoplasmic inclusions. The latter are the known pseudopsammoma bodies or hyaline inclusions as demonstrated by light and electron microscopy. Light microcopy on paraffin sections and cytological smear preparations revealed, in addition to the cells of endotheliomatous meningioma and those containing the inclusions a third type with small granular cytoplasmic content. Electron microscopy showed characteristic features of meningioma such as folded double membranes, desmosomes and filaments and thus gave evidence of the meningiomatous nature of the tumor. By immunohistochemistry tumor cells in slightly focal distribution contained vimentin, whereas small clusters of cells with hyaline inclusions were strongly positive for cytokeratin. The dispersed cells of granular cytoplasmic content were positive for fibronectin. These findings, especially of the inclusion containing cytokeratin positive cell clusters may shed new light upon the concept of histogenesis and classification.
Insights
This study details a parasagittal meningioma in an elderly patient, revealing cystic structures and unique cellular inclusions. Findings suggest new insights into meningioma histogenesis and classification.
Area of Science:
- Neuropathology
- Oncology
- Cell Biology
Background:
- Meningiomas are tumors arising from the meninges.
- Understanding meningioma subtypes is crucial for diagnosis and treatment.
Observation:
- A parasagittal meningioma exhibited cystic architecture (forme humide) and distinct cellular features.
- Microscopic examination revealed nuclear vacuoles and cytoplasmic inclusions, identified as pseudopsammoma bodies or hyaline inclusions.
Findings:
- Three cell types were identified: endotheliomatous cells, cells with inclusions, and cells with granular cytoplasm.
- Immunohistochemistry showed vimentin in tumor cells, cytokeratin in inclusion-containing cells, and fibronectin in granular cells.
- Electron microscopy confirmed meningioma features like desmosomes and filaments.
Implications:
- The presence of cytokeratin-positive cell clusters with hyaline inclusions may alter current concepts of meningioma histogenesis.
- These findings could lead to revised meningioma classification systems.
- Further research into these distinct cellular components is warranted.