Meningioma
Updates to Study Attributes
MRI demonstrates demonstrates markedly high T2 signal, and a CSF cleft sign. The mass enhances vividly and demonstrates prominent surrounding oedema.
Updates to Case Attributes
HiHigh T2 signal is the resultseen in a variety of abundant water in the tumourhistological variants, including microcystic meningiomas, angiomatous meningiomas, secretory meningiomas and to a lesser degree chordoid meningiomas. TheseHigh T2 signal is more often associated with peritumoural oedema. These tumours are usually therefore softer and easier to resect but can be highly vascular, and may therefore benefit from preoperative embolisation.
Although not mentioned in the pathology report (see below), and thus not likely to be the case in this instance, the very high T2 signal and presence of abundant adjacent oedema can suggest that this represents a microcystic variant of meningioma.
Histology
MACROSCOPIC DESCRIPTION: "Frontal tumour": Two pieces of red soft tissue the larger 8mm,smaller 3mm in maximum dimension. Fragments of brown tan coloured firm tissue measuring in aggregate 25x25x7.
MICROSCOPIC DESCRIPTION: Sections show multiple fragments of tumour which has a cellular tumour consisting of spindle cells. The spindle cells have round bland nuclei with prominent intracytoplasmic clearing. No atypical features are seen.
DIAGNOSIS: Meningioma WHO grade 1.
Discussion
This is the sort of case that I find personally infuriating. The histology in this case does not explicitly state the histological subtype, but mentions 'prominent intracytoplasmic clearing' which makes me think that they are seeing a clear cell meningioma. Unfortunately clear cell meningiomas are considered WHO grade II tumours. Thus one is left wondering exactly what the answer is. *sigh*
-<p> </p><p>Hi T2 signal is the result of abundant water in the tumour. These tumours are usually therefore softer and easier to resect but can be highly vascular, and may therefore benefit from preoperative embolisation. </p><p>Although not mentioned in the pathology report (see below), and thus not likely to be the case in this instance, the very high T2 signal and presence of abundant adjacent oedema can suggest that this represents a microcystic variant of meningioma. </p><p><strong>Histology</strong></p><p>MACROSCOPIC DESCRIPTION: "Frontal tumour": Two pieces of red soft tissue the larger 8mm,smaller 3mm in maximum dimension. Fragments of brown tan coloured firm tissue measuring in aggregate 25x25x7. </p><p>MICROSCOPIC DESCRIPTION: Sections show multiple fragments of tumour which has a cellular tumour consisting of spindle cells. The spindle cells have round bland nuclei with prominent intracytoplasmic clearing. No atypical features are seen.</p><p>DIAGNOSIS: Meningioma WHO grade 1.</p>- +<p> </p><p>High T2 signal is seen in a variety of histological variants, including microcystic meningiomas, angiomatous meningiomas, secretory meningiomas and to a lesser degree chordoid meningiomas. High T2 signal is more often associated with peritumoural oedema. These tumours are usually therefore softer and easier to resect but can be highly vascular, and may therefore benefit from preoperative embolisation. </p><p><strong>Histology</strong></p><p>MICROSCOPIC DESCRIPTION: Sections show multiple fragments of tumour which has a cellular tumour consisting of spindle cells. The spindle cells have round bland nuclei with prominent intracytoplasmic clearing. No atypical features are seen.</p><p>DIAGNOSIS: Meningioma WHO grade 1.</p><p><strong>Discussion</strong></p><p>This is the sort of case that I find personally infuriating. The histology in this case does not explicitly state the histological subtype, but mentions 'prominent intracytoplasmic clearing' which makes me think that they are seeing a <a title="Clear cell meningioma" href="/articles/clear-cell-meningioma">clear cell meningioma</a>. Unfortunately clear cell meningiomas are considered WHO grade II tumours. Thus one is left wondering exactly what the answer is. *sigh*</p>