Microcystic meningioma mimicking pleomorphic xanthoastrocytoma

Abstract

Microcystic meningioma is a distinct morphological variant of meningioma, characterized by loose texture and microcysts with formation of large extracellular spaces containing edematous fluid. The tumor cells have stellate and vacuolated cytoplasm with long cytoplasmic processes. We report a case of microcystic meningioma occurring in a 60 year-old man. Histological features showed tumor cells with abundant foamy cytoplasm, pleomorphic nucleus with vesicular chromatin and prominent nucleoli which mimicked pleomorphic xanthoastrocytoma. The clinical presentation and histopathological diagnostic dilemma along with immunohistochemistry is discussed. Keywords: MicrocysticMeningioma; Pleomorphic xanthoastrocytoma Immunohistochemistry DOI: http://dx.doi.org/10.3126/jpn.v1i2.5413 JPN 2011; 1(2): 158-160

Crush Cytology of Microcystic Meningioma with Extensive Sclerosis

“…In the current case, pleomorphic cells occasionally found on crush cytology were concordant with its histology. These pleomorphic tumor cells in microcystic meningioma may show xanthomatous changes, mimicking pleomorphic xanthoastrocytoma (PXA) 8. Vacuolated cells, a characteristic cytologic clue for microcystic meningioma, are also found in PXA, hemangioblastoma, and angiomatous meningioma 9,10.…”

“…These pleomorphic tumor cells in microcystic meningioma may show xanthomatous changes, mimicking pleomorphic xanthoastrocytoma (PXA). 8 Vacuolated cells, a characteristic cytologic clue for microcystic meningioma, are also found in PXA, hemangioblastoma, and angiomatous meningioma. 9 , 10 Some pleomorphic cells in PXA may show rare intranuclear inclusions.…”