Schollenberg Erica, Easton Alexander S
Dalhousie University, Halifax, Nova Scotia, Canada.
Int J Surg Pathol. 2013 Aug;21(4):411-2. doi: 10.1177/1066896912470165. Epub 2012 Dec 17.
We present a case of clear cell meningioma with unusual clinical and pathologic features. The patient was a 54-year-old man who underwent laminectomy and durotomy for an intradural tumor in the lumbar spinal canal. Sections showed a predominance of dense collagenous tissue with irregularly shaped and irregularly sized magenta-colored extracellular deposits. On electron microscopy, these deposits were osmiophilic and "petaloid." The final diagnosis of clear cell meningioma rested on relatively inconspicuous intervening nests of glycogen-containing clear cells that were positive for epithelial membrane antigen. The unusual extracellular deposits seen in this case have previously been characterized as tyrosine-rich crystals of the type most commonly seen in salivary gland tumors. Recognition of this tumor as a clear cell meningioma, despite misleading clinical features and initially challenging histologic findings, is not only a matter of diagnostic accuracy but also imparts important prognostic information.
我们报告一例具有不寻常临床和病理特征的透明细胞型脑膜瘤。患者为一名54岁男性，因腰椎管内硬膜下肿瘤接受了椎板切除术和硬脑膜切开术。切片显示以致密胶原组织为主，伴有形状不规则、大小不一的品红色细胞外沉积物。电子显微镜下，这些沉积物呈嗜锇性且为“花瓣状”。透明细胞型脑膜瘤的最终诊断基于相对不明显的含糖原透明细胞的中间巢状结构，这些细胞上皮膜抗原呈阳性。该病例中所见的不寻常细胞外沉积物先前已被鉴定为富含酪氨酸的晶体，这种晶体最常见于涎腺肿瘤。尽管有误导性的临床特征和最初具有挑战性的组织学表现，但将该肿瘤识别为透明细胞型脑膜瘤不仅关乎诊断准确性，还能提供重要的预后信息。
