Rogerio F, de Araújo Zanardi V, Ribeiro de Menezes Netto J, de Souza Queiroz L
Department of Pathology and Department of Radiology, Faculty of Medical Sciences, University of Campinas - Unicamp, Campinas, SP, Brazil.
Clin Neuropathol. 2011 Nov-Dec;30(6):291-6. doi: 10.5414/np300408.
Meningiomas are common central nervous system tumors with a wide range of morphological variants, assigned World Health Organization (WHO) Grades I - III. We report an extremely rare rhabdoid, papillary and clear cell meningioma (WHO Grade III) in a 29-year-old female, who presented with diplopia and headache over a few days, 2 years ago. Magnetic resonance imaging showed a well-circumscribed, lobulated, predominantly solid and contrast-enhancing lesion in the right temporal, parietal and occipital lobes. On routine staining, the tumor did not display classical meningioma features. A wide immunohistochemical panel ruled out metastasis and endorsed the meningothelial nature of the lesion (positivity for epithelial membrane antigen and vimentin). Electron microscopy did not show usual hallmarks of meningioma but was helpful in excluding other tumors. Even though the three variants are associated with aggressive behavior, the patient is currently asymptomatic. The concurrent use of different techniques was essential for diagnosis.
脑膜瘤是常见的中枢神经系统肿瘤,具有多种形态学变异,世界卫生组织(WHO)将其分为I - III级。我们报告了一例极为罕见的横纹肌样、乳头状及透明细胞型脑膜瘤(WHO III级),患者为一名29岁女性,2年前曾在数天内出现复视和头痛症状。磁共振成像显示,右侧颞叶、顶叶和枕叶有一个边界清晰、分叶状、主要为实性且有强化的病变。常规染色显示,该肿瘤未表现出典型的脑膜瘤特征。广泛的免疫组化检查排除了转移,并证实了病变的脑膜上皮性质(上皮膜抗原和波形蛋白呈阳性)。电子显微镜检查未显示脑膜瘤的常见特征,但有助于排除其他肿瘤。尽管这三种变异型都与侵袭性行为相关,但该患者目前无症状。同时使用不同技术对于诊断至关重要。