case 9 history: a 24 year-old male presented with a frontal enhancing extra-axial tumor
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Diagnostic Challenge Pathology for Neurosurgery & Neurology Residents Department of Pathology University of Oklahoma Health Sciences Center, Oklahoma City, OK, U.S.A. Case 9 History: A 24 year-old male presented with a frontal enhancing extra-axial tumor. - PowerPoint PPT PresentationTRANSCRIPT
Diagnostic ChallengePathology for Neurosurgery & Neurology
ResidentsDepartment of Pathology
University of Oklahoma Health Sciences Center,Oklahoma City, OK, U.S.A.
Case 9History: A 24 year-old male presented with a frontal enhancing extra-axial tumor.
Contributor: Kar-Ming Fung, M.D., Ph.D., [email protected] Last updated: 1/9/2008
Cytologic Preparation
Frozen Section
Frozen Section
A
B C
Paraffin Section
D
Paraffin SectionParaffin Section
E F
What is your diagnosis?
Arrow points to brain invasion. Arrow points to mitosis.
Diagnosis: Atypical Meningioma (WHO grade II).
Discussion: • The cellular whorls illustrated in Panel A is practically diagnostic of a
meningeal tumor. • A meningothelial pattern is maintained in this tumor (Panel B to F).• Focal brain invasion is illustrated and mitosis are not uncommon. These
features are diagnostic of an atypical meningioma.• It should be emphasized tumor with low-grade histology and well
preserved meningothelial pattern may have mitosis and brain invasion. These features are not, and often not, associated with high grade pleomorphism. A high index of suspicion is always a safe practice.