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Updated: Oct 8, 2025
Author Spotlight: Unveiling Cellular Functions and Potential Clinical Implications of Leptomeningeal Lymphatic Endothelial Cells
Published on: September 8, 2023
Lymphoplasmacyte-rich meningioma in the central nervous system: An unusual case report
Han Wang1,2, Bin He3, Yuelong Wang1
1Department of Neurosurgery, West China Hospital, West China Medical School, Sichuan University, Chengdu, PR China.
Insights
This study reports a rare case of lymphoplasmacyte-rich meningioma (LPRM) extending from the skull base to the cervical spine. While surgery is standard, immunotherapy may offer new treatment options for this aggressive tumor.
Area of Science:
- Neuro-oncology
- Pathology
- Neurosurgery
Background:
- Lymphoplasmacyte-rich meningioma (LPRM) is a rare WHO grade I central nervous system tumor.
- LPRM is characterized by significant infiltration of plasma cells and lymphocytes.
- This variant presents unique challenges due to its cellular composition and potential for extensive dural involvement.
Observation:
- A 44-year-old male presented with progressive limb weakness, hand numbness, sensory disturbances, and incontinence.
- MRI revealed an extensive extramedullary mass encasing the clivus and cervical spinal meninges.
- Histopathology confirmed LPRM with significant lymphoplasmacytic infiltration.
Findings:
- Surgical resection via suboccipital craniotomy and extensive spinal decompression was performed.
- Despite treatment, the patient succumbed to complications of pneumonia two weeks post-surgery.
Implications:
- This case highlights an exceptionally extensive LPRM involving both intracranial and spinal meninges.
- The lymphoplasmacytic nature of LPRM suggests potential efficacy of immunotherapy as a future treatment strategy.
Rationale:
Lymphoplasmacyte-rich meningioma (LPRM) is a rare meningioma characterized by significant infiltration of plasma cells and lymphocytes, and changes in the ratio of meningeal epithelial components. According to the World Health Organization, tumors of the central nervous system are classified as grade I tumors.
Patient Concerns:
A 44-year-old man presented to our department with complaints of limb weakness accompanied by hand numbness. Half a month before admission, the patient's limb weakness worsened and he could not walk and raise his hands, with limb sensory disturbance and incontinence.
Diagnosis:
Magnetic resonance imaging of the head and cervical spinal cord showed a diffuse extramedullary mass creeping on the tentorium and skull base meninges along the clivus down to the sixth cervical spinal meninges. The cervical spinal cord was enveloped and pressed (Fig. 1A-C). Postoperative histopathological examination showed meningothelial areas admixed with lymphocytes and plasma cells (Fig. 2D-H), indicating that the mass was a LPRM.
Intervention:
Suboccipital craniotomy, C1 laminectomy, and C2-C6 laminoplasty were performed for this patient, and postsurgical pathology showed that the tumor was a LPRM with large amounts of lymphocytes and plasma cells.
Outcome:
After 2 weeks of active treatment, the patient died of worsening pneumonia.
Lessons:
LPRM is a rare variant of meningioma, and it is more unusual that the lesions involve the intracranial dura mater and the entire cervical spinal meninges. So far, surgical resection has been the main treatment for LPRM, but according to its own characteristics of lymphoplasmacyte-rich, immunotherapy may become a new treatment option.
