Secretory Meningioma: A unique Meningioma variant

The secretory subtype of meningioma (pictured here) is just one of many variants of meningioma, a usually histologically benign tumor that arises from the meninges (i.e. the outer coverings overlying the brain) and often contains concentrically-layered calcifications called psammoma bodies.  The secretory variant can be suspected on imaging by the exuberant edema often seen in the adjacent brain tissue.  Microscopically,... Continue Reading →

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Multiple Schwannomas in Neurofibromatosis Type II (NF2)

Schwannomas are typically sporadic lesions which stem from the Schwann cells that myelinate (or insulate) the peripheral nerves.  Patients with multiple schwannomas are more likely to have an associated familial tumor syndrome, such as Neurofibromatosis Type II (NF2). NF2 is a disorder in which a person inherits a defective gene, called NF2, that affects the merlin tumor suppressor protein thereby permiting... Continue Reading →

Orbital Meningioma with Radiology-Pathology Correlation

Like the brain, the optic nerve is surrounded by meningeal coverings (called the pia, arachnoid and dura) that can infrequently give rise to a meningioma.  Although often histologically benign, intraorbital meningiomas can cause significant morbidity and blindness due to optic nerve compression.  Surgical removal can be curative, as was the case for this patient, whose tumor exhibited the typical... Continue Reading →

Mengioma: Vascular Changes and Prognosis

Meningiomas, like the one pictured here, typically show whorling architectural pattern and nuclear pseduoinclusions.  The vast majority of meningiomas are low grade (WHO Grade 1) dura-based tumors with good prognosis following complete resection.  However, recent studies have suggested that endothelial cell hypertrophy and/or microvascular proliferation in an otherwise typical meningioma are correlated with shorter progression free... Continue Reading →

Atypical Meningioma – Mitoses and Macronucleoli

The vast majority of meningiomas are benign grade I tumors.  Meningiomas can be upgraded to grade II, called atypical meningiomas, if they show increased mitotic activity (4 or more mitoses in 10 high power fields) or other worrisome histopathologic features, such as tumor cells exhibiting a prominent and large nucleolus.  Notice the mitosis in the center-right of the image and... Continue Reading →

Psammoma bodies in a psammomatous variant of meningioma.

Psammoma bodies, lamellated purple concretions composed of calcium and other ions, are commonly found in meningiomas and are particularly numerous in the psammomatous variant of meningioma, pictured here.  Psammomatous meningiomas are low grade (WHO grade I) tumors that often have a gritty texture on gross evaluation due to increased numbers of psammoma bodies and dystrophic calcification often necessitating... Continue Reading →

Intraventricular Meningioma

Although meningiomas are classically dura-based lesions, they can also arise in the choroid plexus and, thus, must be considered in the differential diagnosis for intraventricular lesions.  This intraventricular meningioma, shown here, is growing underneath normal choroid plexus epithelium.

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