Goel Deepa, Babu Sasidhara, Prayaga Aruna K, Sundaram Challa
Department of Pathology, Nizam's Institute of Medical Sciences, Hyderabad, India.
Acta Cytol. 2008 May-Jun;52(3):344-6. doi: 10.1159/000325519.
Meningeal hemangiopericytoma (HPC) is a rare neoplasm. It is closely related to hemangiopericytomas in systemic tissues, with a tendency to recur and metastasize outside the CNS. Only a few case reports describe the cytomorphologic appearance of these metastasizing lesions, most having primary tumor in deep soft tissues. We report a case of recurrent meningeal HPC metastasizing to lungs.
A 48-year-old woman presented with a history of headache. She underwent primary surgery 10 years previously for left parietal tumor. Histopathologic diagnosis was HPC. Radiotherapy was given postoperatively. Brain magnetic resonance imaging (MRI) at admission suggested local recurrence. She also complained of dry cough and shortness of breath. On evaluation, computed tomography (CT) scan lung showed multiple, bilateral, small nodules. Fine needle aspiration cytology (FNAC) of a larger nodule revealed spindle-shaped cells arranged around blood vessels. Immunohistochemistry with CD34 on cell block confirmed metastatic HPC.
FNAC is an easy, accurate, relatively noninvasive procedure for diagnosing metastases, especially in patients with a history of recurrent intracranial HPC. Immunohistochemistry on cell block material collected at the time of FNAC may aid in distinguishing HPC from other tumors that are close mimics cytologically.
脑膜血管外皮细胞瘤（HPC）是一种罕见的肿瘤。它与全身组织中的血管外皮细胞瘤密切相关，有在中枢神经系统外复发和转移的倾向。仅有少数病例报告描述了这些转移病灶的细胞形态学表现，大多数原发肿瘤位于深部软组织。我们报告一例复发性脑膜HPC转移至肺部的病例。
一名48岁女性，有头痛病史。她10年前因左顶叶肿瘤接受了初次手术。组织病理学诊断为HPC。术后给予了放疗。入院时脑部磁共振成像（MRI）提示局部复发。她还主诉干咳和气短。经评估，胸部计算机断层扫描（CT）显示双侧多发小结节。对一个较大结节进行细针穿刺抽吸细胞学检查（FNAC），发现梭形细胞围绕血管排列。细胞块上CD34免疫组化证实为转移性HPC。
FNAC是一种简便、准确、相对无创的诊断转移瘤的方法，尤其适用于有复发性颅内HPC病史的患者。FNAC时收集的细胞块材料进行免疫组化有助于将HPC与其他细胞学表现相似的肿瘤区分开来。
