Secretory Meningiomas: Clinical and Immunohistochemical Observations

Abstract

Secretory meningiomas are rare tumors, and they are mainly localized at the frontal convexity and the sphenoid ridge. They are surrounded by more edema than usual. The preponderance of female patients with this presentation is striking. The expression of carcinoembryonic antigen and epithelial membrane antigen is a characteristic feature of secretory meningiomas. These meningiomas are also positive for progesterone receptors, which has been shown to be a good prognostic factor.

Original article Secretory meningiomas: immunohistochemical pattern of lectin and ultrastructure of pseudopsammoma bodies

“…Enhanced expression of the lectin glycoconjugates in the meningioma secretory cells probably reflects the selective changes in tumour cell glycosylation, that may be important for their phenotypic heterogeneity. Expression of CEA, which is a highly Nglycosylated glycoprotein, is also the characteristic finding in secretory meningiomas [1,5,22,36,37]. We demonstrated a similar pattern of the immunoreactivity for CEA and the binding sites for PNA in the pseudopsammoma bodies and the cells surrounding them.…”

“…These inclusions are strongly stained with periodic acidSchiff (PAS) and were immunopositive for some epithelial antigens, including cytokerat ins (CKs), epithelial membrane antigens (EMA) and carcinoembryonic antigen (CEA) [2,5,7,25]. Moreo ver, pseudopsammoma bodies exhibit positivity for various secretory components, as immunoglobulins [4], α1antitripsin (AT) and α1antichymotrypsin (ACT) [7].…”

“…From a clinical point of view, secretory meningiomas appear pre dominantly in women, with the most frequent loca tion at the sphenoid ridge and frontal region. In comparison with other ordinary meningiomas, they are often associated with significant peritumoral oedema [5,12,25,26,36,38,40]. It has been speculat ed that some products of pseudopsammoma bodies might be involved in the development of cerebral oedema [23,26,36].…”

Immunohistochemical study of the extracellular matrix proteins laminin, fibronectin and type IV collagen in secretory meningiomas

“…[6][7][8][9][10][11][12] The incidence of SM ranges from 1.2 to 9.3% of all meningiomas. 6,7 SMs have a strong tendency to undergo epithelial differentiation, reflecting the pluripotential of cap cells, and they accumulate secretory materials in the form of hyaline inclusions and are frequently accompanied by massive peritumoral edema. [6][7][8] The literature contains few reports concerning the expression of ECM proteins in meningiomas.…”

“…6,7 Despite patients with SMs having a good prognosis, SMs may be well vascularized, showing some angiomatous features, pericytic proliferation and perivascular arrangement; SMs are also frequently accompanied by massive peritumoral edema. [6][7][8] The most common subtypes of meningiomas (meningotheliomatous, transitional, psammomatous and anaplastic), have been extensively studied with respect to their pathological characteristics and extracellular matrix proteins. To our knowledge, no previously published research has been specifically aimed at studying the immunohistochemical expression of ECM proteins in SMs.…”