We report a unique case of a 4-year-old girl with an intriguing fibrohistiocytic tumour. Magnetic resonance imaging scans showed a dural mass of variegated intensity compressing the left occipital pole and apparently extending toward the superior sagittal sinus. Grossly, the cut surface of the surgical specimen was yellow, pale, and soft with reddish kernel-like crusts. Histologically, the yellow areas resembled cholesterol granulomas with widespread coagulative necrosis, cholesterol clefts, powdery calcification, foreign body-type giant cells, and foamy macrophages, while the scattered red spots contained numerous multinucleated giant cells of foreign-body and Touton types, the former with amphophilic to slightly eosinophilic cytoplasm. Immunoperoxidase reactions confirmed the expression of histiocytic markers and vimentin. As far as we know, no tumour displaying these peculiar morphological features has yet been described.
Citations
Citations to this article as recorded by
Reticulohistiocytoses: a revision of the full spectrum A. Bonometti, E. Berti Journal of the European Academy of Dermatology and Venereology.2020; 34(8): 1684. CrossRef
Alveolar soft part sarcoma, accounting for less than 1% of all soft tissue sarcomas, is known for late metastases to the lung, bone and brain. We have examined a case of metastatic alveolar soft part sarcoma to the brain in a 34-year-old woman. Computed tomography of the brain revealed a well enhancing dura based mass of the left temporal area.
The patient had a previous history of surgery for alveolar soft part sarcoma from the right thigh at the age of 24 years. She underwent total removal of the dural mass under the clinical impression of the meningioma. Grossly, a well-circumscribed, pale tan and solid mass was 3.4 x 3.2 x 2.4 cm and easily detached from the attached dura.
Histologically, the tumor showed typical features of alveolar soft part sarcoma. Immunohistochemically, tumor cells were positive for muscle related antibodies.
Ultrastructural examination showed rod-shaped membrane bound crystals and electron-dense granules in the cytoplasm of tumor cells.
Meningioma of unusual age of onset, location, histogenesis and histologic type is reported. The patient, 4 year-old girl, had an intradural spinal meningioma arising from lumbar nerve root with no dural attachement. The meningioma revealed glycogen-rich, clear cell type with extensive and blocky hyalinization of the stroma. The tumor shared common fibrous sheath with attached lumbar nerve, and nerve fibers were scattered within the tumor. Ultrastructurally, the tumor cells had abundant glycogen particles, intermediate filaments and intercellular desmosomes. Hyalinized material revealed large amianthoid collagen fibers.
Neurosarcoidosis without systemic manifestation is vary unusual condition. Solitary lesion in the spinal dura is exceptional. The diagnosis of the neurosarcoidosis is very difficult, because the efficacy of Kveim test is low in neurosarcoidosis. The histologic examination is considered as confirmative diagnostic tool. The authors reported a case of neurosarcoidosis involving the dura of the cervical spine, in a fifty-nine year old female who had suffered from mid-back pain for six months and paraparesis for two weeks.
There was a dumbbell shaped mass in the D4-5 dura. It showed tan gray color with rubbery consistency. With histological examination, it revealed diffuse non-caseating granuloma.
Occasionally asteroid bodies were observed within the cytoplasm of the multinucleated giant cells. After operation, she was treated with steroid, and she has been well about nine month period.
Fibrous histiocytoma composed of fibroblasts and histiocytes is quite variable in histologic pattern. The biologic behavior is unpredictable by histologic ground. This tumor is well-known in subcutaneous tissue and deep soft tissue, but quite rare in central nervous system. We experienced a case of the fibrous histiocytoma involving the dura mater of spinal cord in a 26 year old female patient. In gross findings, the mass was a well demarcated, ovoid mass attached to the dura matter, and measured 2.5x1.5 cm in diameter. The cut surface was rubbery, solid, gray-white or yellow. Microscopically, the lesion consisted of polyhedral cells with round or oval nuclei and faintly eosinophilic or vaculoated cytoplasm, and multinucleated giant cells. Some giant cells were Touton-type. Composing cells were bland-looking. Mitotic figures were average 3 per 10 high power fields.