Lymphoplasmacyte-rich meningioma with hematologic signs and PD-L1 over-expression

Gabriele Gaggero1, Michela Campora2, Davide Taietti3

  • 1IRCCS Ospedale Policlinico San Martino, Pathology Unit, Genoa, Italy.

Autopsy & Case Reports
|August 23, 2022
PubMed

Insights

Lymphoplasmacyte-rich meningioma (LPRM) is a rare grade I tumor. This case highlights its association with anemia and cognitive decline, offering insights into its immune microenvironment.

Area of Science:

  • Neuropathology
  • Oncology
  • Immunology

Background:

  • Lymphoplasmacyte-rich meningioma (LPRM) is an exceptionally rare variant of grade I meningioma.
  • LPRM can present with significant peripheral blood abnormalities, including anemia and gammopathy, often resolving post-surgery.
  • The rarity of LPRM limits understanding of its origins and behavior.

Purpose of the Study:

  • To document a case of right frontal LPRM in an elderly male presenting with cognitive decline and mild anemia.
  • To investigate the immunomorphological characteristics of LPRM, focusing on PD-L1 expression.
  • To explore the role of the inflammatory tumor microenvironment and immune checkpoints in LPRM.

Main Methods:

  • Case report of a 72-year-old male with right frontal LPRM.
  • Clinical assessment including evaluation of cognitive function and peripheral blood counts.
  • Immunohistochemical analysis to determine the tumor's cellular composition and PD-L1 expression profile.

Main Results:

  • The patient presented with general cognitive decadence and mild anemia.
  • Immunohistochemistry revealed prominent PD-L1 expression in the LPRM.
  • The findings suggest a potential link between the inflammatory microenvironment, PD-L1 expression, and immune checkpoint activity in LPRM.

Conclusions:

  • LPRM, though rare, can be associated with systemic effects like anemia and neurological symptoms.
  • Prominent PD-L1 expression in LPRM warrants further investigation into its immunobiology.
  • Understanding the immune microenvironment of LPRM may offer new therapeutic avenues.

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