Ida C M, Rodríguez F J, Scheithauer B W, Kois N, Vanefsky M, Andersen B J, Erickson B
Division of Anatomic Pathology, Hospital das Clinicas Sao Paulo University School of Medicine, Sao Paolo, Brazil.
Clin Neuropathol. 2007 May-Jun;26(3):111-8. doi: 10.5414/npp26111.
Meningiomas involving the pineal region are rare. Herein we describe two cases of chordoid meningioma with histologic evidence of pineal gland infiltration.
Clinical histories were abstracted from chart review and consultation letters. HE-stained slides were reviewed in both cases. Selected immunohistochemical stains were performed.
the patients included a 44-year-old male and a 37-year-old female who presented with symptoms of intracranial tumor referable to the pineal region. On magnetic resonance imaging (MRI), both lesions demonstrated heterogeneous contrast enhancement. Histologically, the tumors were characterized by strands and cords ofmeningothelial cells arranged in a mucinous stroma. In addition, obvious meningothelial cytology as well as focal osseous metaplasia (Case 1), and transitional histology (Case 2) were also noted. Tumor cells demonstrated EMA and focal S100 protein immunoreactivity, but lacked cytokeratin AE1/AE3 and glial fibrillary acidic protein (GFAP) staining. Synaptophysin and neurofilament protein highlighted the overrun pineal gland parenchyma. MIB1-proliferative index was 8.4 and 20.1%, respectively.
Chordoid meningioma, although rare, may occur in the pineal region. The differential diagnosis of this meningioma subtype in this location is discussed.
累及松果体区的脑膜瘤较为罕见。在此我们描述两例具有松果体浸润组织学证据的脊索样脑膜瘤病例。
从病历回顾和会诊信件中提取临床病史。对两例病例的苏木精-伊红（HE）染色切片进行了复查，并进行了选定的免疫组化染色。
患者包括一名44岁男性和一名37岁女性，均表现出与松果体区相关的颅内肿瘤症状。在磁共振成像（MRI）上，两个病灶均表现为不均匀强化。组织学上，肿瘤的特征是脑膜内皮细胞条索排列于黏液样基质中。此外，还观察到明显的脑膜内皮细胞形态以及局灶性骨化生（病例1）和移行性组织学表现（病例2）。肿瘤细胞显示上皮膜抗原（EMA）和局灶性S100蛋白免疫反应性，但细胞角蛋白AE1/AE3和胶质纤维酸性蛋白（GFAP）染色阴性。突触素和神经丝蛋白突出显示了受累的松果体实质。MIB1增殖指数分别为8.4%和20.1%。
脊索样脑膜瘤虽罕见，但可发生于松果体区。本文讨论了该部位这种脑膜瘤亚型的鉴别诊断。
