Rhabdoid meningioma: Cytopathologic findings in cerebrospinal fluid

Abstract

Rhabdoid meningioma is a recently described, rare, WHO Grade III intracranial tumor with an aggressive growth pattern and increased risk of recurrence. We describe the cytopathologic findings on cerebrospinal fluid of one such case in a 26-yr-old female who underwent resection of a left temporo-parietal mass. Cerebrospinal fluid contained abundant malignant cells with a prominent "rhabdoid" phenotype, i.e., large cells, eccentric nuclei, single prominent nucleoli, and dense eosinophilic cytoplasm. Although rhabdoid meningioma has a characteristic cytomorphology, the differential diagnosis of this tumor would involve metastatic adenocarcinoma, metastatic malignant melanoma, and other tumors with "rhabdoid" features (such as an atypical teratoid/rhabdoid tumor).

Cytologic Findings of Rhabdoid Meningioma in Cerebrospinal Fluid

“…1 So far, only 1 case of rhabdoid meningioma with exfoliated neoplastic cells in cerebrospinal fluid (CSF) has been reported, which has been shown to be useful in diagnosis. 2 We present here an additional such case.…”

“…Paragangliomas (PG) of the thyroid are extremely uncommon tumors that are often confused clinically and histologically with more common thyroid neoplasms. [1][2][3][4][5][6] Rarer still are variants of medullary thyroid carcinomas (MTC) that show a PG-like pattern. [7][8][9][10] We describe cytologic, histologic and immunocytologic features in a case of PG-like MTC that was mistaken for PG on fine needle aspiration cytology (FNAC).…”

Rhabdoid meningioma occurring in an unrelated resection cavity with leptomeningeal carcinomatosis

“…Further details on the findings are provided in a separate publication. 14 The autopsy showed extensive residual tumor in the left temporal lobe resection cavity and a diffuse leptomeningeal spread of tumor along the spinal cord and nerve roots (Fig. 4).…”

“…14 Risk factors for rhabdoid transformation of meningiomas are currently unknown. Numerous case-control and observational studies 1,6,7,[16][17][18][19][20] have led investigators to suggest a general association between head trauma and meningioma formation.…”

Extradural Spinal Meningioma as a Source of Plasmacytoid Cells

“…[16][17][18] Plasmacytoid appearance of lesional cells was previously demonstrated in a rhabdoid variant of meningioma. 19 That case shed tumor cells in the cerebrospinal fluid and consisted of loosely cohesive, atypical cells with hyaline, globoid cytoplasmic inclusions, prominent nucleoli on histology and a high proliferation index (~50%). By contrast, the current case had bland cytologic features with no evident cytoplasmic inclusions or prominent nucleoli, and < 4% of the cells were Ki-67 positive.…”