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3 "Secretory meningioma"
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Case Reports
Cytologic Features of Secretory Meningioma in Squash Preparation: A Case Report.
Se Hoon Kim, Kwang Gil Lee, Tai Seung Kim
Korean J Cytopathol. 2004;15(1):52-55.
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AbstractAbstract PDF
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.
Secretory Meningioma: Report of 2 cases.
Dong Sug Kim, Eun Hi Lee, Young Ran Shim, Sang Pyo Kim, Oh Ryong Kim
Korean J Pathol. 1995;29(3):361-367.
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  • 35 Download
AbstractAbstract PDF
The secretary meningioma is a distinct variant of meningioma that revealed characteristic light microscopic, immunohistochemical and ultrastructural features of epithelial and secretary differentiation, which was named as a distinct subtype of meningioma by Alguacil-Garcia et al in 1986. We experienced 2 cases of secretary meningioma. One was a 53-year-old female who had suffered from sudden onset of dizziness for I day. The computerized tomography revealed a sharply marginated well enhanced mass in temporal lobe. The other was a 59-year-old female who had suffered from dizziness for 8 years. The computerized tomography revealed a well demarcated lobulated mass in petrosal ridge. In both cases, multiple hyaline inclusions were scattered in the background of meningothelial meningioma. They were PAS positive, diastase resistant, stained yellow with van Gieson, and did not stain with reticulin in contrast to Psammoma bodies. The immunohistochemistry revealed positive reaction for EMA, CEA, a-FP and cytokeratin. T'he electron microscopic study revealed interdigitation with desmosomes and abundant intracellular lumina. They were lined by numerous microvilli and filled with granular material which was composed of electron dense homogenous material, me branous material, and small membrane-bound vesicles. Microvilli were filled with electron dense material identical to the material in the lumina, and some of them were interconnected with electron dense material in the lumina. It was concluded that secretary activity of the meningothelial cells and degenerated microvilli were involved in the pathogenesis of hyaline inclusions.
Secretory Meningioma: A case report.
Na Hye Myung, Je G Chi
Korean J Pathol. 1993;27(1):64-68.
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  • 26 Download
AbstractAbstract PDF
Secretory meningioma is now a distinctive subtype of mostly meningotheliomatous type of meningioma, which was first defined by Alguacil-Garcia et al. It shows characteristic light-microscopic, ultrastructural, and immunohistochemical features of epithelial and secretory differentiation of meningothelial cells with accumulation of secretory material in the from of hyaline inclusions. A 38-year-old female presented with headache for about 5 months. Magnetic resonance imaging revealed a round multilobated mass, measuring 4x4x3 cm, in the right inferior frontal lobe near the skull base, with surrounding brain edema. Histologically, the tumor basically showed a pattern of meningotheliomatous meningioma but tended to deposit eosinophilic homogeneous material both in the intracellular and extracellular spaces. The shape was globular intracellularly and of variable shape and often conglomerated extracellularly. Histochemical stains revealed the material not of psammomatous but of pseudopsammomatous proteinaceous nature. On electron microscopy, there was no intracellular lumen with secretion but granular electron-dense material of variable size accumulated in the degenerated endoplasmic reticulums, suggestive of proteinaceous secretion.

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