Kim Na Rae, Yee Gie-Taek, Cho Hyun Yee
Department of Pathology, Gachon University Gil Medical Center, Incheon, Korea.
Department of Neurosurgery, Gachon University Gil Medical Center, Incheon, Korea.
Brain Tumor Res Treat. 2015 Oct;3(2):147-50. doi: 10.14791/btrt.2015.3.2.147. Epub 2015 Oct 30.
Secretory meningioma, a histologic subtype of meningioma of World Health Organization grade 1, is clinically significant because it is frequently accompanied by peritumoral brain edema. The patient was a 53-year-old woman suffering from dysarthria and motor weakness of the right arm. Enhanced magnetic resonance images showed an enhancing mass measuring 2.5 cm in size located in the right parietal convexity. Intraoperative squash cytology showed moderately cellular smears composed mainly of clusters of ovoid cells with scattered whorl formations. The cells had round nuclei and a moderate amount of eosinophilic cytoplasm with ill-defined cell borders. Neither atypia nor mitosis was observed. Some scattered round shaped eosinophilic refractile hyaline globules, measuring from 5 to 25 µm, were observed, and a periglobular halo was occasionally observed. The diagnosis of secretory meningioma should be made as early as possible so that neurosurgeons can prevent postoperative aggravation of peritumoral edema. We emphasize that cytologic findings including eosinophilic, non-fibrillary cytoplasm with eosinophilic refractile hyaline globules are helpful in differentiating secretory meningioma from other subtypes of meningioma, primary and metastatic brain tumors.
分泌型脑膜瘤是世界卫生组织1级脑膜瘤的一种组织学亚型，具有临床意义，因为它常伴有瘤周脑水肿。患者为一名53岁女性，患有构音障碍和右臂运动无力。增强磁共振成像显示，在右侧顶叶凸面有一个大小为2.5 cm的强化肿块。术中压片细胞学显示，涂片细胞中等丰富，主要由卵圆形细胞簇组成，伴有散在的漩涡状结构。细胞具有圆形核，中等量嗜酸性细胞质，细胞边界不清晰。未观察到异型性和有丝分裂。观察到一些散在的圆形嗜酸性折光性透明小球，大小为5至25 µm，偶尔可见小球周围有晕。应尽早诊断分泌型脑膜瘤，以便神经外科医生预防术后瘤周水肿加重。我们强调，包括嗜酸性、无纤维的细胞质以及嗜酸性折光性透明小球在内的细胞学表现，有助于将分泌型脑膜瘤与脑膜瘤的其他亚型、原发性和转移性脑肿瘤相鉴别。
