They make up 20% to 30% of intracranial tumors with a slight female predominance. They are also referred to as minute pulmonary meningotheliallike nodules abbreviated mpmn and minute pulmonary chemodectoma. Nestor, arie perry, ozlem kurtkaya, patrice abellaleff, aldo m. They are a nonglial neoplasm that originates from the arachnoid cap cells of the meninges. To better understand all the types of cystic meningiomas with magnetic resonance imaging mri, diffusionweighted imaging dwi and histopathology, we attempted to correlate the mri and dwi features of cystic meningiomas with the. Cystic meningiomas are quite rare, accounting for between 2% and 4% of all intracranial meningiomas. All patients were explored ct, mri, preoperative selective angiography and in all cases the who 2000 classification criteria were used to define atypical meningioma results. The present study, analyzing 729 meningiomas, in a age group of 872 years, revealed table 3 different sites of origin for who grade i benign 89. Some meningiomas can cause problems despite their benign nature, because they are difficult to remove when they are located in. Treatment of meningioma typically consists of surgery alone, but radiation therapy can be used in cases of surgically inaccessible, residual, or recurrent tumors, as well as in patients with an unacceptably high surgical risk. Perfusion values were the greatest for angiomatous meningioma and lowest for.
We report a case of meningothelial variant of meningioma. Case report meningothelial meningioma component in a prepubertal testicular teratoma ruchi sinha,1 madhu kumari,2 ranwir kumar sinha,2 and bindey kumar3 1department of pathology, aiims, patna, india 2department of pathology, aiims, patna, india 3department of paediatric surgery, aiims, patna, india correspondence should be addressed to madhu kumari. Histopathology of meningiomas and gliomas of the optic nerve. Apr 21, 2014 meningioma comprises about one fourth of all primary tumors of the central nervous system cns. Meningothelial meningioma radiology reference article. Who classification of meningiomas adapted after louis et al. For benign meningiomas, clinically relevant recurrences are common during the patients lifetimes.
All patients treated for a primary meningioma over a ten year period, from 1. Extracranial metastases developed in only 11% of these tumors. Firm tumors composed of spindle cells with indistinct cell boundaries. A few histological features and variants are associated with aggressive behavior and high risk of recurrence. Within the lobules, epithelioid tumour cells have fuzzy illde. Meningioma pathology, genetics, and biology journal of. Pdf the histological appearance of a meningioma is an important predictor of tumor behavior and is frequently a factor in decisions concerning therapy. Meningothelial meningioma mri scan shows an extradural mass with dural tail extending above and below it results in marked compression of the upper thoracic cord sections studied show meningothelial meningioma displaying a more relaxed fascicular and syncytial arrangements. Women are more likely to develop a meningioma, with a femalemale ratio of approximately 2. Histologicalsubtypes and anatomical location correlated in. One relatively common intracranial subtype, fibrous meningioma, was not encountered.
Pathology of meningioma of the middle ear dr sampurna roy md. All other mesenchymal tumours examined were negative for muc4. After gross total resection, benign meningiomas are associated with 5year recurrence rates of only 5%. Interestingly, most non nf2 meningioma family members develop meningothelial meningiomas, which is in line with the observation that this variant seems to arise independently of nf2 inactivation. An associated cholesteatoma may identified in some cases. Meningiomas occurring outside the cerebrospinal axis can be primary at an extracranial site nasal cavity, paranasal sinuses, and nasopharynx or secondary extending from an intracranial lesion. It invokes a wide clinical differential diagnosis, but diagnosis is based on characteristic histologic and cytologic findings. Meningothelial meningiomas are the most common extraaxial tumors of the central nervous system. Special emphasis is given to distinguishing between arachnoidal hyperplasia and meningioma, identifying the origin of meningioma, and distinguishing between the following tumors. Between 20062011 we operated 6 atypical meningioma of 63 benign meningiomas 9,52%. Media in category histopathology of meningioma the following 51 files are in this category, out of 51 total.
Malignant transformation of teratoma in the testis is well known. Disease bioinformatics research of meningothelial meningioma has been linked to meningioma, neoplasms, meningeal neoplasms, brain neoplasms, malignant paraganglionic neoplasm. The study of meningothelial meningioma has been mentioned in research publications which can be found using our bioinformatics tool below. Olavs hospital, university hospital trondheim 680,110 habitants in 2011. Meningiomas are duralbased, slowgrowing tumors that are derived from meningothelial arachnoid cap cells. Meningothelial cells are wrapped around small blood vessels. Meningiomas, as defined by the world health organization who, are meningothelial arachnoid cell neoplasms. Mrs study of meningeal hemangiopericytoma and edema. Metaplastic bone was present within the whorls or in their immediate vicinity in 10 of 17 cases. Meningothelial meningioma was most common variant in the study by nath et al accounting for 32% of cases. A radiologypathological correlation of spinal meningioma. Histopathology of meningiomas and gliomas of the optic.
Meningothelial meningiomas are histologically composed of characteristic uniform tumour cells that form lobules surrounded by thin collagenous septae. Immunohistochemistry was positive for epithelial membrane antigen and vimentin. A detailed clinicopathologic, immunohistochemical and genetic study of 11 cases article in brain pathology 152. Meningioma showed the highest frequency of loss of heterozygosity with major events seen at 22q 60%, 14q 42. We report a case of meningothelial variant of meningioma arising in a pure and mature teratoma. The origin, histologic features, and problems in the histopathologic diagnosis of orbital meningiomas and gliomas are discussed. Doctors use many tests to find, or diagnose, a tumor and learn if it is cancerous. The percentage of who grade ii tumors in the orbit 8% is similar to that reported for intracranial tumors using the current grading scheme. Meningothelial meningioma with abundant edema radiology. In addition, the meningothelial cap cells may also exhibit monocytelike functions. Pulmonary meningotheliallike nodule libre pathology. The cut surface appearance of meningioma can be quite variable and correlates with the histologic features of the tumor. Primary extracranial meningioma of the sinonasal tract.
Teratomas are nonseminomatous germ cell tumors composed of elements derived from more than one germinal layers endoderm, mesoderm, and ectoderm. Daniel zedek, md n cutaneous meningioma is a rare tumor that most commonly occurs on the scalp and occurs in both congenital and acquired forms. Magnetic resonance imaging and diffusionweighted images. Meningothelial meningioma information including symptoms, causes, diseases, symptoms, treatments, and other medical and health issues. The median survival of patients with tumors considered malignant on the basis of anaplasia or excessive mitotic cells was 1. Meningothelial meningiomas also known as syncytial or endothelial meningiomas are the most common histological subtype of meningioma, found in 60% of all meningiomas, most frequently combined with fibrous meningioma 40% or in isolation 17% 1 their epidemiology, clinical presentation, radiographic features, treatment, prognosis, and differential diagnosis are. We report a case of meningothelial variant of meningioma arising in a pure and mature teratoma of the testis in a 5yearold boy. Perfusion imaging of meningioma by using continuous. The histologic variants most commonly diagnosed in pathology specimens are meningothelial, fibrous, and transitional meningioma. Histologically, the tumours demonstrated features similar to those of intracranial meningiomas, including meningothelial, psammomatous, fibroblastic and atypical meningioma. Seemingly complete removal is achieved in 64% to 97% of operated patients 1 5 but is curative only in 68% to 80%. Muc4 expression was constant and almost diffuse in meningothelial and angiomatous subtypes, whereas it was limited in 5% or fewer tumour cells or absent in 26 of 28 fibrous meningiomas. Histologicalsubtypes and anatomical location correlated. Neurosurgical care in midnorway, which includes three counties, is centralised at st.
Oct 14, 2015 dural tail sign has high specificity but low sensitivity to detect intracranial meningioma level 1 likely reliable evidencebased on diagnostic cohort study 110 patients aged 680 years with an intracranial mass were evaluated with mri with and without contrast followed by resection and histopathology of mass reference standard 98. Histomorphological spectrum of meningioma with variants. Thus, accurate histopathological diagnosis and grading of these tumors are essential. Recurrence of meningiomas and its management clinical gate. The meningothelial also called syncytial or endothelial type is characterized by broad sheets or mediumsize lobules of fairly uniform cells with round or oval nuclei, ample light pink cytoplasm, and indistinct cytoplasmic borders.
Some tumors, particularly those with numerous psammoma bodies or extensive osseous metaplasia, may be quite firm and in fact require a decalcification or. Highgrade meningiomas are more commonly seen in males. Thus, a continuous revision of the histopathology of meningiomas is necessary to improve the accuracy and reproducibility of the histopathological diagnosis and grading of these tumours. The most common histology is represented by meningothelial meningioma, followed by fibrous and transitional subtypes. The consistency of the lesion may range from soft to quite firm. Aug 15, 2018 muc4 was expressed in meningiomas 92. The vast majority of meningiomas arise in the meninges from arachnoidal cap cells that are normally present in small nests. A radiologypathological correlation of spinal meningioma in. Harvey cushing first introduced the term meningioma in 1922 to designate a group of tumors, which arose from the meninges of the brain and spinal cord 1. The majority are grade i meningioma with meningothelial meningioma as the commonest variant and are curable by surgical resection.
Meningothelial meningioma article about meningothelial. Meningothelial meningiomas also known as syncytial or endothelial meningiomas are the most common histological subtype of meningioma, found in 60% of all meningiomas, most frequently combined with fibrous meningioma 40% or in isolation 17% 1. They may also do tests to learn which treatments could work best. Webpathology is a free educational resource with 10328 high quality pathology images of benign and malignant neoplasms and related entities. Magnetic resonance imaging mri, in vivo localized single voxel 1hmrs was also performed on the same patients prior to surgery and the in vivo and ex vivo mrs spectra were compared. The most common form of meningioma in the middle ear is of meningothelial type. Meningothelial meningioma definition of meningothelial. Meningothelial meningioma component in a prepubertal. Perfusion imaging of meningioma by using continuous arterial spinlabeling. Histopathological and ultrastructural findings with immunohistochemical and genetic correlation.
Psammomatous calcifications can be appreciated in the center of the image. Mean ki67 index is 2% do not recur if entirely resected am j surg pathol 2004. Pulmonary meningotheliallike nodule, abbreviated mln, is a common benign finding in the lung. Most meningiomas are benign classic, grade i, wellcircumscribed, slow. Melanocytic colonization of a meningothelial meningioma. These lesions can occur in people of any age but commonly present in middle age. A sphenoid ridge meningioma is found along the ridge of bone behind the eyes and nose. Common sense holds that the risk of recurrence depends on the extent of removal. The distance between the tibia plafond and the tip of the fibula were observed as 29 2. M eningiomas are neoplasms derived from arachnoidal meningothelial cells. Mar 25, 2012 the presence of lymphocytes, plasma cells, and macrophages in the meningioma tissue may reflect various immune responses against the tumour 61,62.
Pulmonary meningothelial like nodule, abbreviated mln, is a common benign finding in the lung they are also referred to as minute pulmonary meningothelial like nodules abbreviated mpmn and minute pulmonary chemodectoma. The histopathological spectrum of human meningiomas. The pathology of extracranial scalp and skull masses in young children. To better understand all the types of cystic meningiomas with magnetic resonance imaging mri, diffusionweighted imaging dwi and histopathology, we attempted to correlate the mri and dwi features of cystic meningiomas with the histopathological findings. This case illustrates an important point about garden variety meningothelial meningiomas. Primary meningioma of the nasopharynx primary calvarial ectopic meningiomas primary intraorbital ectopic meningioma primary ectopic meningioma of the neck. Meningiomas usually arise from the arachnoidal cap cells of the leptomeninges. Petrulionis m, valeviciene n, paulauskiene i, bruzaite j. It is the most common primary intracranial neoplasm and the most diversified in histologic patterns among all primary tumors of the cns. Histomorphological spectrum of meningioma with variants and. You will find a list of common tests, procedures, and scans that doctors use to find the cause of a medical problem. In another multiple meningioma kindred, immunoreactivity for merlin was detected, implying that the nf2 gene was not inactivated.
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