Spinal meningioma (L3/4)

Case contributed by A.Prof Frank Gaillard

Presentation

Sciatica

Patient Data

Age: 50 years
Gender: Female
Modality: MRI

A well circumscribed vividly enhancing eccentric intrathecal extra-medullary mass is present, displacing the cauda equina to the left, and compressing it. On both T1 and T2 weighted images it is isointense to cord. 

Case Discussion

The patient went on to have resection. 

Histology

MICROSCOPIC DESCRIPTION:

The sections show a moderately cellular tumour. The tumour forms sheets and nests in a fibrous background. No whorls are seen. The tumour cells have round hyperchromatic nuclei, inconspicuous nucleoli and moderate amounts of clear cytoplasm. There is no nuclear pleomorphism. Mitoses are inconspicuous. There is no necrosis. The tumour cells are focally PAS positive. They are EMA and progesterone receptor positive. The Ki-67 index is about 8%. They are CAM5.2 and CD10 negative. The features are those of clear cell meningioma, which

is classified as WHO grade II.

DIAGNOSIS:

L3/4 spinal tumour: Clear cell meningioma (WHO Grade II).

Discussion

The signal intensity similar to cord on T2 is helpful in suggesting the diagnosis of meningioma over a schwannoma or myxopapillary ependymoma despite the somewhat atypical location. 

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Case Information

rID: 31238
Case created: 26th Sep 2014
Last edited: 27th Apr 2017
Inclusion in quiz mode: Included

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