Pitfalls in the Histopathologic Diagnosis of Meningioma: Report of Three Rare Variants of Meningioma and Literature Review
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Abstract
Meningioma is a common primary tumor of the central nervous system and one of the most encountered brain tumors. Although classic histopathologic features of meningioma are relatively common and make its diagnosis straightforward, certain variants possess unusual histologic features causing diagnostic challenges. We reported three cases of clear cell meningioma, microcytic meningioma, and angiomatous meningioma report, variants with potential deceptive morphologies, and discuss their distinguishing morphologic features.
[1] Perry A, Louis DN, Budka H, von Deimling A, Sahm F, Mawrin C, et al, Meningioma variants In: WHO classification of tumours of the central nervous system. Lyon, France: International Agen- cy for Research on Cancer; 2016. https://books.google.com/ books/about/WHO_Classification_of_Tumours_of_the_Cen. html?id=JWXWjwEACAAJ
[2] Kamenova M, Guzman R, Guzman J. Demographics and outcome of histologically confirmed intracranial meningi- omas. Clinical and Translational Neuroscience. 2019; 3(2):1-6. [DOI:10.1177/2514183x19894945]
[3] Shibuya M. Pathology and molecular genetics of meningioma: Re- cent advances. Neurologia Medico-Chirurgica. 2015; 55(1):14-27. [DOI:10.2176/nmc.ra.2014-0233] [PMID] [PMCID]
[4] Kunimatsu A, Kunimatsu N, Kamiya K, Katsura M, Mori H, Ohto- mo K. Variants of meningiomas: A review of imaging findings and clinical features. Japanese Journal of Radiology. 2016; 34(7):459-69. [DOI:10.1007/s11604-016-0550-6] [PMID]
[5] Walke V, Sisodia SM, Bijwe S, Patil P. Clear-cell meningioma: Intra- operative diagnosis by squash cytology: Case report and review of the literature. Asian Journal of Neurosurgery. 2017; 12(2):293-5. [DOI:10.4103/1793-5482.146392] [PMID] [PMCID]
[6] Cho JH, Yang KH, Zhang HY, Kie JH. Microcystic meningioma- Un- usual variant of meningiomas. Journal of Korean Neurosurgical Society. 2003; 34(4):382-5. https://www.jkns.or.kr/journal/view. php?number=2434
[7] Kelly A, Dube N, Lekgwara P. Clear cell meningiomas: A short se- ries of two patients and literature review. Journal of Neurology and Clinical Neuroscience. 2018; 1(1):13-6. https://www.pulsus.com/ scholarly-articles/clear-cell-meningiomas-a-short-series-of-two- patients-and-literature-review-4728.html
[8] Jain D, Sharma MC, Sarkar C, Suri V, Garg A, Singh M, et al. Clear cell meningioma, an uncommon variant of meningioma: A clinico- pathologic study of nine cases. Journal of Neuro-Oncology. 2007; 81(3):315-21. [DOI:10.1007/s11060-006-9237-7] [PMID]
[9] Pettry A, Rosenblum MK. Central nervous system. In: Goldblum JR, Lamps LW, Mckenney JK, Myers JL, editors. Rosai and Ackerman’s Surgical Pathology. 11th edition. Amsterdam: Elsevier; 2018. https:// books.google.com/books?id=-7ZEDwAAQBAJ&pg=RA1-PA12&dq
[10] Tao X, Dong J, Hou Z, Hao S, Zhang J, Wu Z, et al. Clinical features, treatment, and prognostic factors of 56 intracranial and intraspinal clear cell meningiomas. World Neurosurgery. 2018; 111:e880-7. [DOI:10.1016/j.wneu.2017.12.173] [PMID]
[11] Harkin JC, Leonard GL. Abnormal amianthoid collagen fib- ers in meningioma. Acta Neuropathologica. 1988; 76(6):638-9. [DOI:10.1007/BF00689605] [PMID]
[12] Kim SH, Kim DG, Kim CY, Choe G, Chang KH, Jung HW. Microcystic meningioma: The characteristic neuroradiologic findings. Journal of Korean Neurosurgical Society. 2003; 35:401-6. https://www.jkns. or.kr/upload/pdf/0042003201.pdf
[13] Love S. Tumors of the meninges. In: Love S, Perry A, Ironside J, Budka H, editors. Greenfield’s Neuropathology. 9th edition. Boca Raton: CRC Press; 2015. https://books.google.com/books?id=O- 9cAQAACAAJ&dq
[14] Haynik DM, Prayson RA. A 37-year-old woman with dural-based intracranial masses. Archives of Pathology & Laboratory Medicine. 2005; 129(7):e173-5. [DOI:10.5858/2005-129-e173-AYWWDI] [PMID]
[15] Liu Z, Wang C, Wang H, Wang Y, Li JY, Liu Y. Clinical characteristics and treatment of angiomatous meningiomas: A report of 27 cases. International Journal of Clinical and Experimental Pathology. 2013; 6(4):695-702. [PMID] [PMCID]
[16] Azizyan A, Eboli P, Drazin D, Mirocha J, Maya MM, Bannykh S. Dif- ferentiation of benign angiomatous and microcystic meningiomas with extensive peritumoral edema from high grade meningiomas with aid of diffusion weighted MRI. BioMed Research International. 2014; 2014:650939. [DOI:10.1155/2014/650939] [PMID] [PMCID]
[17] Abedalthagafi MS, Merrill PH, Bi WL, Jones RT, Listewnik ML, Ramkissoon SH, et al. Angiomatous meningiomas have a distinct genetic profile with multiple chromosomal polysomies including polysomy of chromosome 5. Oncotarget. 2014; 5(21):10596-606. [DOI:10.18632/oncotarget.2517] [PMID] [PMCID]
[18] Boulagnon-Rombi C, Fleury C, Fichel C, Lefour S, Marchal Bres- senot A, Gauchotte G. Immunohistochemical approach to the dif- ferential diagnosis of meningiomas and their mimics. Journal of Neuropathology and Experimental Neurology. 2017; 76(4):289-98. [DOI:10.1093/jnen/nlx008] [PMID]
[2] Kamenova M, Guzman R, Guzman J. Demographics and outcome of histologically confirmed intracranial meningi- omas. Clinical and Translational Neuroscience. 2019; 3(2):1-6. [DOI:10.1177/2514183x19894945]
[3] Shibuya M. Pathology and molecular genetics of meningioma: Re- cent advances. Neurologia Medico-Chirurgica. 2015; 55(1):14-27. [DOI:10.2176/nmc.ra.2014-0233] [PMID] [PMCID]
[4] Kunimatsu A, Kunimatsu N, Kamiya K, Katsura M, Mori H, Ohto- mo K. Variants of meningiomas: A review of imaging findings and clinical features. Japanese Journal of Radiology. 2016; 34(7):459-69. [DOI:10.1007/s11604-016-0550-6] [PMID]
[5] Walke V, Sisodia SM, Bijwe S, Patil P. Clear-cell meningioma: Intra- operative diagnosis by squash cytology: Case report and review of the literature. Asian Journal of Neurosurgery. 2017; 12(2):293-5. [DOI:10.4103/1793-5482.146392] [PMID] [PMCID]
[6] Cho JH, Yang KH, Zhang HY, Kie JH. Microcystic meningioma- Un- usual variant of meningiomas. Journal of Korean Neurosurgical Society. 2003; 34(4):382-5. https://www.jkns.or.kr/journal/view. php?number=2434
[7] Kelly A, Dube N, Lekgwara P. Clear cell meningiomas: A short se- ries of two patients and literature review. Journal of Neurology and Clinical Neuroscience. 2018; 1(1):13-6. https://www.pulsus.com/ scholarly-articles/clear-cell-meningiomas-a-short-series-of-two- patients-and-literature-review-4728.html
[8] Jain D, Sharma MC, Sarkar C, Suri V, Garg A, Singh M, et al. Clear cell meningioma, an uncommon variant of meningioma: A clinico- pathologic study of nine cases. Journal of Neuro-Oncology. 2007; 81(3):315-21. [DOI:10.1007/s11060-006-9237-7] [PMID]
[9] Pettry A, Rosenblum MK. Central nervous system. In: Goldblum JR, Lamps LW, Mckenney JK, Myers JL, editors. Rosai and Ackerman’s Surgical Pathology. 11th edition. Amsterdam: Elsevier; 2018. https:// books.google.com/books?id=-7ZEDwAAQBAJ&pg=RA1-PA12&dq
[10] Tao X, Dong J, Hou Z, Hao S, Zhang J, Wu Z, et al. Clinical features, treatment, and prognostic factors of 56 intracranial and intraspinal clear cell meningiomas. World Neurosurgery. 2018; 111:e880-7. [DOI:10.1016/j.wneu.2017.12.173] [PMID]
[11] Harkin JC, Leonard GL. Abnormal amianthoid collagen fib- ers in meningioma. Acta Neuropathologica. 1988; 76(6):638-9. [DOI:10.1007/BF00689605] [PMID]
[12] Kim SH, Kim DG, Kim CY, Choe G, Chang KH, Jung HW. Microcystic meningioma: The characteristic neuroradiologic findings. Journal of Korean Neurosurgical Society. 2003; 35:401-6. https://www.jkns. or.kr/upload/pdf/0042003201.pdf
[13] Love S. Tumors of the meninges. In: Love S, Perry A, Ironside J, Budka H, editors. Greenfield’s Neuropathology. 9th edition. Boca Raton: CRC Press; 2015. https://books.google.com/books?id=O- 9cAQAACAAJ&dq
[14] Haynik DM, Prayson RA. A 37-year-old woman with dural-based intracranial masses. Archives of Pathology & Laboratory Medicine. 2005; 129(7):e173-5. [DOI:10.5858/2005-129-e173-AYWWDI] [PMID]
[15] Liu Z, Wang C, Wang H, Wang Y, Li JY, Liu Y. Clinical characteristics and treatment of angiomatous meningiomas: A report of 27 cases. International Journal of Clinical and Experimental Pathology. 2013; 6(4):695-702. [PMID] [PMCID]
[16] Azizyan A, Eboli P, Drazin D, Mirocha J, Maya MM, Bannykh S. Dif- ferentiation of benign angiomatous and microcystic meningiomas with extensive peritumoral edema from high grade meningiomas with aid of diffusion weighted MRI. BioMed Research International. 2014; 2014:650939. [DOI:10.1155/2014/650939] [PMID] [PMCID]
[17] Abedalthagafi MS, Merrill PH, Bi WL, Jones RT, Listewnik ML, Ramkissoon SH, et al. Angiomatous meningiomas have a distinct genetic profile with multiple chromosomal polysomies including polysomy of chromosome 5. Oncotarget. 2014; 5(21):10596-606. [DOI:10.18632/oncotarget.2517] [PMID] [PMCID]
[18] Boulagnon-Rombi C, Fleury C, Fichel C, Lefour S, Marchal Bres- senot A, Gauchotte G. Immunohistochemical approach to the dif- ferential diagnosis of meningiomas and their mimics. Journal of Neuropathology and Experimental Neurology. 2017; 76(4):289-98. [DOI:10.1093/jnen/nlx008] [PMID]
| Files | ||
| Issue | Vol 6 No 4 (2021): July-August | |
| Section | Case Report(s) | |
| DOI | https://doi.org/10.18502/crcp.v6i4.7861 | |
| Keywords | ||
| Clear cell meningioma Microcystic meningioma Angiomatous meningioma Differential diagnosis | ||
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Shaker G, Azmoudeh Ardalan F, Zeinalizadeh M. Pitfalls in the Histopathologic Diagnosis of Meningioma: Report of Three Rare Variants of Meningioma and Literature Review. CRCP. 2021;6(4):173-180.
