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Updated: Mar 29, 2026
Author Spotlight: Assessing the Potential of Circulating Tumor Cells in Leptomeningeal Disease Research
Published on: March 29, 2024
Crush Cytology of Secretory Meningioma: A Case Report
Na Rae Kim1, Gie-Taek Yee2, Hyun Yee Cho1
1Department of Pathology, Gachon University Gil Medical Center, Incheon, Korea.
Abstract:
Secretory meningioma, a histologic subtype of meningioma of World Health Organization grade 1, is clinically significant because it is frequently accompanied by peritumoral brain edema. The patient was a 53-year-old woman suffering from dysarthria and motor weakness of the right arm. Enhanced magnetic resonance images showed an enhancing mass measuring 2.5 cm in size located in the right parietal convexity. Intraoperative squash cytology showed moderately cellular smears composed mainly of clusters of ovoid cells with scattered whorl formations. The cells had round nuclei and a moderate amount of eosinophilic cytoplasm with ill-defined cell borders. Neither atypia nor mitosis was observed. Some scattered round shaped eosinophilic refractile hyaline globules, measuring from 5 to 25 µm, were observed, and a periglobular halo was occasionally observed. The diagnosis of secretory meningioma should be made as early as possible so that neurosurgeons can prevent postoperative aggravation of peritumoral edema. We emphasize that cytologic findings including eosinophilic, non-fibrillary cytoplasm with eosinophilic refractile hyaline globules are helpful in differentiating secretory meningioma from other subtypes of meningioma, primary and metastatic brain tumors.
Insights
Secretory meningioma, a WHO grade 1 tumor, often causes brain swelling. Early cytologic diagnosis is key to prevent worsening edema after surgery.
Area of Science:
- Neuropathology
- Neurosurgery
- Cytopathology
Background:
- Secretory meningioma is a World Health Organization grade 1 subtype.
- This tumor type is frequently associated with peritumoral brain edema.
- Edema can lead to significant patient morbidity.
Purpose of the Study:
- To highlight the importance of early diagnosis of secretory meningioma.
- To describe the key cytologic features of secretory meningioma.
- To differentiate secretory meningioma from other brain tumors.
Main Methods:
- Case presentation of a 53-year-old woman with dysarthria and right arm weakness.
- Magnetic resonance imaging revealed a right parietal convexity mass.
- Intraoperative squash cytology was performed for diagnosis.
Main Results:
- Cytology revealed moderately cellular smears with ovoid cells, whorl formations, round nuclei, and eosinophilic cytoplasm.
- Distinctive findings included eosinophilic refractile hyaline globules (5-25 µm) and occasional periglobular halos.
- No cellular atypia or mitosis was observed.
Conclusions:
- Early diagnosis of secretory meningioma is crucial for preventing postoperative edema aggravation.
- Cytologic findings, particularly eosinophilic cytoplasm and hyaline globules, aid in differentiating secretory meningioma.
- Distinguishing secretory meningioma from other meningioma subtypes and primary/metastatic brain tumors is vital.
