Histiocytic meningioma: A distinctive subtype of meningioma?
Histiocytic meningioma: A distinctive subtype of meningioma?
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DOI：
10.5582/irdr.2014.01007
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发表时间：
2014-05-01
影响因子：
1.3
通讯作者：
Xiong, Zhenggang
中科院分区：
文献类型：
--
作者：
Liu, Liqiong;Stone, Jonathan;Xiong, Zhenggang
脑膜瘤合并广泛的组织细胞改变是罕见的。我们描述了一个组织细胞脑膜瘤的情况下，发生在一个55岁的妇女。患者在过去四年中有进行性头痛和精细运动协调和记忆力下降。磁振造影显示在右侧上上级额顶叶区域有一个边界清楚、以硬脑膜为基础、对比增强的肿块病变。组织学上，肿瘤表现为肿瘤性脑膜炎增生，伴有广泛和多灶性组织细胞浸润。组织细胞成分约占整个肿瘤的一半。免疫组织化学，脑膜炎和组织细胞的上皮膜抗原（EMA）的免疫反应性，而组织细胞也为CD4和CD68阳性。此外，在整个肿瘤中有散在的S100阳性组织细胞。Ki67免疫组化显示的肿瘤指数为1.6%。标本中没有高级别的变化，如频繁的核分裂、坏死或脑实质浸润。结合文献回顾，我们认为这种类型的脑膜瘤应被视为脑膜瘤的一个独立亚型。本文讨论了其生物学基础和鉴别诊断。
Meningioma with extensive histiocytic changes is rare. We describe a case of histiocytic meningioma which occurred in a 55-year-old woman. The patient had a progressive headache and a decline in fine motor coordination and memory for the past four years. Magnetic resonance imaging demonstrated a well-demarcated, dura-based and contrastenhancing mass lesion in the right superior frontoparietal region. Histopathologically, the tumor showed neoplastic meningothelial proliferation with extensive and multifocal histiocytic infiltration. The histiocytic component constituted approximately half of the entire tumor. Immunohistochemically, both meningothelial and histiocytic cells showed immunoreactivity for epithelial membrane antigen (EMA), while the histiocytic cells were also positive for CD4 and CD68. In addition, there were scattered S100-positive histiocytes throughout the tumor. Proliferative index highlighted by Ki67 immunostain was 1.6%. There were no high-grade changes such as frequent mitoses, necrosis, or brain parenchymal invasion in the specimen. With review of the literature, we propose that this type of meningioma should be considered as a separate subtype of meningioma. The biological basis and differential diagnosis are discussed.