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Presented by Pedram Argani, M.D. and prepared by Aatur Singhi, M.D., Ph.D.
Case 2: This is a 47 female with a dural mass.
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Question 1 of 1
1. Question
Week 425: Case 2
This is a 47 female with a dural mass.images/1Alex/02222010case2image1.jpg
images/1Alex/02222010case2image2.jpg
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images/1Alex/02222010case2image4.jpgCorrect
Answer: Meningioma, secretory type
Histology: This is a solid lesion composed of epithelioid cells which form whorls. The cells have nuclei with fine chromatin which often demonstrate intranuclear inclusions, which are the typical features of meningioma. Scattered within the lesion are similar cells surrounding eosinophilic inclusion bodies. These cells surrounding the inclusion bodies specifically label for cytokeratin and CEA. These are the typical features of a secretory meningioma.
Discussion: A transitional meningioma demonstrates both meningothelial (syncytial) and fibrous areas. Angiomatous meningiomas have prominent blood vessels, and must be distinguished from hemangioblastoma and hemangiopericytoma. Microcystic meningiomas have myxoid intercellular spaces, vacuolated neoplastic cells with hyperchromatic nuclei, and hyalinized blood vessels.
Among meningiomas, several subtypes have prognostic significance. Chordoid and clear cell meningiomas are considered grade 2 (atypical), while rhabdoid or papillary meningiomas are grade 3 (malignant).
Incorrect
Answer: Meningioma, secretory type
Histology: This is a solid lesion composed of epithelioid cells which form whorls. The cells have nuclei with fine chromatin which often demonstrate intranuclear inclusions, which are the typical features of meningioma. Scattered within the lesion are similar cells surrounding eosinophilic inclusion bodies. These cells surrounding the inclusion bodies specifically label for cytokeratin and CEA. These are the typical features of a secretory meningioma.
Discussion: A transitional meningioma demonstrates both meningothelial (syncytial) and fibrous areas. Angiomatous meningiomas have prominent blood vessels, and must be distinguished from hemangioblastoma and hemangiopericytoma. Microcystic meningiomas have myxoid intercellular spaces, vacuolated neoplastic cells with hyperchromatic nuclei, and hyalinized blood vessels.
Among meningiomas, several subtypes have prognostic significance. Chordoid and clear cell meningiomas are considered grade 2 (atypical), while rhabdoid or papillary meningiomas are grade 3 (malignant).
