Ultrastructural examination is essential for diagnosis of papillary meningioma

Histopathology
S Al-SarrajP L Lantos

Abstract

Papillary meningioma is a rare meningeal tumour. To date only a few cases have been reported and their immunohistochemical features have not been fully documented. A 49-year-old woman presented with a 2-month history of headaches and memory disturbance. CT and MRI imaging showed an enhancing pineal mass with extension into the occipital lobes and invasion of the splenium. At surgery, the tumour was found to be tough and vascular with a well-defined capsule. No recurrence was noted 19 months after the operation. In another case a 44-year-old woman was admitted with 1-month history of headaches, poor memory, imbalance and diplopia. CT scan showed a large hyperdense, uniformly, enhancing mass within the middle cranial fossa at the petrous ridge. The tumour recurred 19 and 25 months after first resection. The histology of both tumours was similar. The neoplasms contained polygonal cells with a moderate amount of cytoplasm, rounded regular nuclei and distinct cell borders. The cells were arranged radially around the blood vessels (perivascular pattern) and a papillary pattern was seen only focally. Mitotic figures were moderately frequent. Immunohistochemistry showed that both tumours were immunoreactive to vimentin and NSE, whereas...Continue Reading

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