A case of xanthomatous meningioma-Usefulness of cytologic preparations in intraoperative diagnosis-

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  • Ｘａｎｔｈｏｍａｔｏｕｓ　ｍｅｎｉｎｇｉｏｍａの１例―術中迅速診断における細胞診の有用性―
  • Usefulness of cytologic preparations in intraoperative diagnosis
  • 術中迅速診断における細胞診の有用性

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Background: Xanthomatous meningioma, a metaplastic meningiomas, is difficult to diagnoes intraoperativly from frozen sections alone. Here, we report its characteristic cytological features.<BR>Case: A 57-year-old Japanese man with a right occipital headache was found in magnetic resonance imaging (MRI) to have an extraaxial tumor on the surface of the motor area. Although meningioma was clinically most likely, intraoperative pathological examination was planned to confirm the diagnosis. Frozen sections showed almost only nuclei on a clear background, making meningioma inconclusive. Cytological preparations showed cohesive clusters and whorl-like cell arrangements, and nuclei were round to oval and uniform, indicating meningioma. Cells had abundant, foamy, or vacuolated cytoplasm. Postoperative paraffin-embedded histological sections showed a proliferation of tumor cells with small round to oval nuclei and abundant foamy cytoplasm, accompanied by abundant vasculature. Together with the results of immunohistochemistry and other special stains, the case was diagnosed as xanthomatous meningioma.<BR>Conclusion: Despite extensive xanthomatous change, meningioma features are evident in cytologic preparations. Diagnosis of this subtype of meningioma is based on careful observation of cytologic preparations.

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