5/13/2008 Case 3: Papillary meningioma

Presented by: Dr. Faust and Dr. Baisre - Columbia University


Clinical History:

This 48 year old woman presented with new onset generalized seizures.  A large posterior medial, dural-based, right fronto-parietal lesion enhanced and produced edema with mass effect.

Sections show a cellular neoplasm of polygonal cells forming sheets and perivascular pseudorosettes with papillary structures.  There is focal necrosis, a few whorls and brain invasion.  There were rhabdoid areas with whorls.  Macronucleoli and mitoses were present.  The tumor was positive for CD56, bcl2, NCAM, synaptophysin, NeuN (cytoplasmic) and neurofilament.  The tumor showed desmosomes and nuclear pseudoinclusions on electron microscopy.

Diagnostic Notes:


The diagnosis was Papillary Meningioma (WHO Grade III).  It was noted that the immunophenotype can be variable and puzzling.

References:        

  • Hojo H, Abe M.  Rhabdoid papillary meningioma.  AJSP 2001;25:964-69.

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