Sen Rajeev, Sethi Divya, Goyal Vandana, Duhan Amrita, Modi Shilpi
Department of Pathology, Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India.
Asian J Neurosurg. 2011 Jul;6(2):110-2. doi: 10.4103/1793-5482.92176.
Primary melanotic meningeal neoplasms are extremely rare lesions and benign forms are even rarer though with better prognosis than the malignant ones. We describe a 40-year-old male with a history of gradually progressive weakness of both lower limbs with normal bowel, bladder control, and an intradural mass measuring 1.5×1.0 cm on radiologic investigations. The lesion was surgically excised. Histopathologic examination revealed heavily melanin-pigmented cells, nuclei with reticulogranular chromatin and small nucleoli, moderate amount of eosinophillic cytoplasm with indistinct cell boundaries, and symplasmic appearance. A probable diagnosis of meningeal melanocytoma was made. The diagnosis was confirmed on immunohistochemical analysis which revealed strongly positive expression of HMB-45 in the tumor cells. Vimentin and S-100 were also diffusely positive while neuron specific enolase showed focal and patchy positivity; however, epithelial membrane antigen was distinctly negative.
原发性黑色素性脑膜肿瘤极为罕见，良性形式更为罕见，不过其预后比恶性者更好。我们报道一名40岁男性，有双下肢进行性无力病史，大小便控制正常，影像学检查发现硬膜内有一大小为1.5×1.0 cm的肿块。该病变经手术切除。组织病理学检查显示大量黑色素沉着细胞，细胞核有网状颗粒状染色质和小核仁，中等量嗜酸性细胞质，细胞边界不清，呈合体细胞外观。初步诊断为脑膜黑色素细胞瘤。免疫组织化学分析确诊，结果显示肿瘤细胞中HMB-45呈强阳性表达。波形蛋白和S-100也呈弥漫性阳性，而神经元特异性烯醇化酶呈局灶性和斑片状阳性；然而，上皮膜抗原明显阴性。
