Department of Neurosurgery, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami, Sagamihara, Kanagawa 252-0374, Japan.
Brain Tumor Pathol. 2013 Jan;30(1):57-60. doi: 10.1007/s10014-012-0091-3. Epub 2012 Mar 2.
A 55-year old female was referred to the Department of Neurosurgery, Kitasato Hospital, because of a hearing impairment. Neuroimaging revealed a typical meningioma attached to the falx in the right frontal region. During surgery, an encapsulated, circumscribed, reddish-gray, slightly hard tumor attached to the falx was completely removed by an interhemispheric approach. On light microscopy, many of the tumor cells contained eosinophilic inclusions with single or multiple vacuoles that displaced the cytoplasm. The nuclei of the tumor cells were eccentric. There were no signs of malignancy in the specimen. Electron microscopy revealed that most of the eosinophilic inclusions were composed of filaments measuring 12 nm in diameter. There have been several reports of benign meningiomas with eosinophilic inclusions composed of intermediate filaments. The microscopic differences between these types of tumor and rhabdoid meningiomas are very subtle, and it is important the two types of tumors are not confused. Benign meningiomas with eosinophilic inclusions comprising intermediate filaments, for example the tumor described in this report, have been diagnosed as granulofilamentous meningiomas, which is a subtype of benign meningioma.
一位 55 岁女性因听力障碍被转诊到甲南医院神经外科。神经影像学显示右额叶镰旁有一个典型的脑膜瘤。在手术中，采用大脑纵裂入路完全切除了一个包膜完整、界限清楚、红灰色、稍硬的肿瘤，与镰状窦相连。光镜下，许多肿瘤细胞含有嗜酸性包涵体，其内有单个或多个空泡，使细胞质移位。肿瘤细胞的核偏位。标本无恶性征象。电镜显示，大多数嗜酸性包涵体由直径 12nm 的细丝组成。已经有几例报道了含有中间丝的嗜酸性包涵体的良性脑膜瘤。这两种肿瘤与横纹肌样脑膜瘤之间的显微镜下差异非常细微，重要的是不要将这两种肿瘤混淆。例如本报告中描述的肿瘤，含有中间丝的嗜酸性包涵体的良性脑膜瘤被诊断为颗粒丝膜脑膜瘤，这是良性脑膜瘤的一个亚型。
