Papillary meningioma

Abstract

Objective To investigate the clinicopathological features of papillary meningioma. Methods The clinical manifestations, imaging, histopathological features and immunophenotype were analysed in one case of papillary meningioma, with review of related literatures. Results The patient was a 43 year⁃old woman. Magnetic resonance imaging (MRI) examination revealed a parenchyma mass at left frontotemporal with asymmetrical signal, low signal of cystoid area with distinct enhance. Histologically, the presence of a perivascular pseudopapillary pattern comprised the majority of the tumor on the background of necrosis and hemorrhage. The other area consisted of dispersed cells and some lobules. Most tumor cells were atypical and anaplasia, obvious malignant cytology resembling carcinoma, melanoma or high grade sarcoma. Abundant mitotic figures were present. In the same case, tumor cells appeared to form a whorl in the lobules with oval nuclei with delicate chromatin. Immunohistochemical analysis showed intense immunoreactivity of the cells to vimentin (Vem) antigens. The cells showed a negative reaction for S⁃100 protein (S ⁃ 100), epithelial membrane antigen (EMA), keratin, human chorionic gonadotropin (hCG), placental alkaline phosphatase (PLAP), glial fibrillary acidic protein (GFAP), CD31 and desmin (Des). The Ki⁃67 positive rate was 3.13%. Conclusion Papillary meningioma is a rare tumor. The image features can offer certain diagnostic cues. The diagnosis may be made on histological and immunohistochemical features.

DOI：10.3969/j.issn.1672-6731.2010.06.018