Korean J Cytopathol.  2004 May;15(1):52-55.

Cytologic Features of Secretory Meningioma in Squash Preparation: A Case Report

• Kim SH
• Lee KG
• Kim TS

Abstract

Secretory meningioma is a distinct subtype of meningioma. We describe the cytologic features of a secretory meningioma on squash preparations, in comparision with other cytologic mimickers. A 54-year-old woman presented with hearing loss, vertigo, tinnitus, and headache for seven years. A brain MRI study revealed a 4.5 cm sized mass in the cerebellopontine angle, which showed homogenous signal intensity in T2-weighted image. The intraoperative squash smear showed some well-defined, thin rimmed intracytoplasmic inclusions, containing a finely granular eosinophilic core among less cohesive meningiomatous cells. Histologic sections revealed a meningothelial meningioma with scattered inclusions, with periodic acid-Schiff, carcinoembryonic antigen, and cytokeratin positivity. Identification of characteristic intracytoplasmic inclusions is helpful for diagnosing secretory meningiomas. On squash preparations, differential diagnoses included tumors with inclusions or cytoplasmic vacuolizations, such as metastatic mammary infiltrating ductal carcinoma, gastric adenocarcinoma, hepatocellular carcinoma, and clear cell ependymoma, oligodendroglioma, hemangioblastoma, chordoma, and other variants of meningiomas (clear cell, xanthomatous, microcytic, and chordoid variants). In addition, the possibilities of glioma with eosinophilic granular body, and metastatic tumors from mammary infiltrating ductal carcinoma, gastric adenocarcinoma, and hepatocellular carcinoma in meningioma should be considered.

Keyword

Brain; Neoplasm; Secretory meningioma; Cytology; Squash preparation

MeSH Terms

Adenocarcinoma
Brain
Carcinoembryonic Antigen
Carcinoma, Ductal
Carcinoma, Hepatocellular
Cerebellopontine Angle
Chordoma
Cytoplasm
Diagnosis, Differential
Eosinophils
Ependymoma
Female
Glioma
Headache
Hearing Loss
Hemangioblastoma
Humans
Keratins
Magnetic Resonance Imaging
Meningioma*
Middle Aged
Oligodendroglioma
Tinnitus
Vertigo
Carcinoembryonic Antigen
Keratins