Microcystic meningioma is a distinct morphological variant of meningioma, characterized by loose texture and microcysts with formation of large extracellular spaces containing edematous fluid. The tumor cells have stellate and vacuolated cytoplasm with long cytoplasmic processes. We experienced a case of typical microcystic meningioma occurring in the falx cerebri adjacent to the left superior parasagittal sinus in a 41-year-old man. The tumor showed the typical histologic features with a few nests of meningothelial whorls. The tumor cells showed diffuse immunoreactivity for vimentin, epithelial membrane antigen (EMA), and S-100 protein. Ultrastructural study confirmed the meningiomatous nature of the tumor.
Adult ; Case Report ; Human ; Magnetic Resonance Imaging ; Male ; Meningeal Neoplasms/metabolism/*pathology ; Meningioma/metabolism/*pathology

Brain Neoplasms ; diagnosis ; metabolism ; pathology ; Child ; Diagnosis, Differential ; Female ; Glioma ; pathology ; Humans ; Immunohistochemistry ; Magnetic Resonance Imaging ; Meningioma ; diagnosis ; metabolism ; pathology ; Mucin-1 ; metabolism ; Occipital Lobe ; Vimentin ; metabolism

Actins ; metabolism ; Adult ; Brain Neoplasms ; metabolism ; pathology ; surgery ; Desmin ; metabolism ; Diagnosis, Differential ; Dura Mater ; chemistry ; pathology ; Female ; Granuloma, Plasma Cell ; metabolism ; pathology ; surgery ; Humans ; Immunohistochemistry ; Meningeal Neoplasms ; pathology ; Meningioma ; pathology ; Neoplasms, Muscle Tissue ; metabolism ; pathology ; surgery ; Vimentin ; metabolism

Diagnosis, Differential ; Ependymoma ; metabolism ; pathology ; Female ; Hemangioblastoma ; metabolism ; pathology ; Humans ; Ki-67 Antigen ; metabolism ; Meningeal Neoplasms ; metabolism ; pathology ; surgery ; Meningioma ; metabolism ; pathology ; surgery ; Middle Aged ; Mucin-1 ; metabolism ; Neoplasm Recurrence, Local ; Vimentin ; metabolism

This study was aimed to explore the value of quantitative proton MR spectroscopy (1H-MRS) in the differentiation of benign and malignant meningioma. 23 cases, including 19 benign (grade I) and 4 malignant (grade II-III) meningiomas, underwent single voxel 1H-MRS (TR/TE = 2000 ms/68, 136, 272 ms). T2 relaxation time of tissue water and choline were estimated by an exponential decay model. Choline concentration was calculated using tissue water as the internal reference, and corrected according to intra-voxel cystic/necrotic parts. Tissue water T2 of benign and malignant meningiomas were (105 +/- 41) ms and (151 +/- 42) ms, respectively. The difference was statistically significant (P = 0.033). While Choline T2 of benign and malignant meningiomas were (242 +/- 73) ms and (316 +/- 102) ms respectively, the difference was not significant (P = 0.105). Choline concentration was (2.86 +/- 0.86) mmol/ kg wet weight in benign meningiomas and (3.53 +/- 0.60) mmol/kg wet weight in malignant ones; after correction they increased to (2.98 +/- 0.93)mmol/kg wet weight and (4.58 +/- 1.22) mmol/kg wet weight, respectively, and the difference was significant (P = 0.019). In conclusion, quantitative 1H-MRS is useful for the differentiation of benign and malignant meningioma by T2 relaxation time and absolute choline concentration.
Adult ; Aged ; Choline ; metabolism ; Diagnosis, Differential ; Female ; Humans ; Magnetic Resonance Spectroscopy ; methods ; Male ; Meningeal Neoplasms ; diagnosis ; metabolism ; pathology ; Meningioma ; diagnosis ; metabolism ; pathology ; Middle Aged ; Protons ; Young Adult

Astrocytoma ; metabolism ; pathology ; Biomarkers, Tumor ; metabolism ; Brain Neoplasms ; metabolism ; pathology ; Cell Proliferation ; Diagnosis, Differential ; Glioblastoma ; metabolism ; pathology ; Humans ; Ki-67 Antigen ; metabolism ; Melanoma ; metabolism ; pathology ; Meningeal Neoplasms ; metabolism ; pathology ; Meningioma ; metabolism ; pathology ; Nevus ; metabolism ; pathology ; Proliferating Cell Nuclear Antigen ; metabolism ; Skin Neoplasms ; metabolism ; pathology

Meningioma is a common intracranial tumor in adults. Pediatric cases account for approximately 1.5% of all intracranial meningiomas, and very few cases show malignant histological features. Primary pediatric malignant meningioma in the cerebellopontine angle is extremely uncommon. Herein, we report a 2-year-old girl with malignant meningioma in the cerebellopontine angle. The clinical features, diagnosis, and treatment protocol are discussed.
Cerebellar Neoplasms ; diagnostic imaging ; metabolism ; pathology ; surgery ; Cerebellopontine Angle ; Child, Preschool ; Female ; Follow-Up Studies ; Humans ; Meningeal Neoplasms ; diagnostic imaging ; metabolism ; pathology ; surgery ; Meningioma ; diagnostic imaging ; metabolism ; pathology ; surgery ; Mucin-1 ; metabolism ; Radiography ; S100 Proteins ; metabolism ; Vimentin ; metabolism

Antigens, CD34 ; metabolism ; Carcinoma, Renal Cell ; metabolism ; pathology ; Central Nervous System Neoplasms ; metabolism ; pathology ; surgery ; ultrastructure ; Diagnosis, Differential ; Ependymoma ; metabolism ; pathology ; Hemangioblastoma ; metabolism ; pathology ; surgery ; ultrastructure ; Humans ; Meningeal Neoplasms ; metabolism ; pathology ; Meningioma ; metabolism ; pathology ; Mutation ; Neoplasm Recurrence, Local ; Prognosis ; Receptor, Epidermal Growth Factor ; metabolism ; Vimentin ; metabolism ; von Hippel-Lindau Disease ; genetics ; metabolism ; pathology ; surgery

OBJECTIVETo investigate the expression of HER2/neu, Ki-67 and TK1 protein in meningiomas in correlation with tumor grades and recurrence.

METHODSTwenty cases of each of the following types of meningiomas were selected for the study, namely: the benign non-recurrent, recurrent benign, atypical and malignant, according to the World Health Organization (WHO) histological classification of nervous system, 2007. Immunohistochemistry study for HER2/neu, Ki-67 and TK1 protein was performed. HER2/neu gene amplification was detected using FISH. Cases with HER2 protein overexpression were studied by immunohistochemistry staining. The results of the biomarker assays were also used to study the correlationship with the tumor grades and tumor recurrency.

RESULTSImmunohistochemistry showed that the positive rates of HER2 expression in non-recurrence benign group, recurrence benign group, atypical group and malignant group were 3 cases (15%), 6 cases (30%), 7 cases (35%), and 10 cases (50%), respectively (P < 0.05). A higher tumor grade was correlated with a higher rate of HER2/neu expression. The Ki-67 and TK1 labeling index (LI) in non-recurrence group were lower than those in the atypical or malignant group (P < 0.05), whereas the atypical group had lower LI than that of the malignant group (P < 0.05). Higher levels of LI of Ki-67 and TK1 were correlated with higher tumor grades and recurrence of the benign meningiomas (P < 0.05). Expression of HER2 was positively correlated with Ki-67 and TK1 (r = 0.445, P < 0.01; r = 0.501, P < 0.01, respectively), and there was a positive correlation between Ki-67 and TK1 (r = 0.450, P < 0.01) as well. HER2/neu gene copy amplification in 7 of 26 cases (26.9%) of HER2 immunopositive meningiomas. The rates of HER2/neu gene amplification were 0 in tumors with 1+ immunopositivity, 4/6 in tumor with 2+ immunopositivity and 3/4 in tumor with 3+ immunopositivity. HER2/neu gene amplification in 3+ and 2+ immunopositive cases had no statistical significance (P > 0.05). Aneuploidy of chromosome 17 existed in 9 of 26 of HER2 immunopositive meningiomas (34.6%). However, the rates of chromosome 17 aneuploidy had no significant difference among tumors with variable HER2/neu imumopositivity (P > 0.05).

CONCLUSIONSHigh levels of HER2 and Ki-67 or TK1 expression correlate with the increase of tumor grades and tumor recurrence. HER2/neu gene amplification is seen in a subset of meningiomas with the protein expression (26.9%). A combination of biomarker study including HER2/neu, Ki-67 and TK1 may be useful in predicting the biological behavior of meningiomas.

Aneuploidy ; Chromosomes, Human, Pair 17 ; Female ; Gene Amplification ; Humans ; Immunohistochemistry ; In Situ Hybridization, Fluorescence ; Ki-67 Antigen ; metabolism ; Male ; Meningeal Neoplasms ; genetics ; metabolism ; pathology ; Meningioma ; genetics ; metabolism ; pathology ; Middle Aged ; Neoplasm Recurrence, Local ; Receptor, ErbB-2 ; genetics ; metabolism ; Thymidine Kinase ; metabolism

OBJECTIVETo analyze the expressions of BAG-1 in meningioma for further understanding of biological behaviors of meningiomas.

METHODSThe specimens included in this study were collected from 158 meningioma cases. Streptavidin-peroxidase were used in immunohistochemical staining. The results of immunohistochemical score were depending on the positive ratio and intensity of the immunoreactivity. The expressions of BAG-1 in meningioma were analyzed in relationship with histopathologic grading, postoperative recurrence.

RESULTSThe difference in the expression degree of BAG-1 between each subtype in the same histopathologic grade and various subtypes between the grade of II to III were not statically significant (P > 0.05). The expression degree of BAG-1 between each subtype in the pathological grade I to the each subtype pathological grade I or III was different, the difference had statistical significance (P < 0.05 or P < 0.01). The immunohistochemical score of the expression of BAG-1 was decreased gradually with the pathologic grading of WHO increased, and the result was statistically significant (chi2 = 141.49, P < 0.01). As the immunohistochemical score of the expression of BAG-1 decreased the postoperative meningioma was easy to recur, the result was statistically significant (x2 = 55.13, P < 0.01).

CONCLUSIONThe expression degree of BAG-1 is in close correlations with the WHO pathologic grading of meningioma. The lower the expressions of BAG-1, the more recurrent with postoperation of meningiomas will be.

Adolescent ; Adult ; Aged ; Apoptosis ; DNA-Binding Proteins ; metabolism ; Female ; Humans ; Meningeal Neoplasms ; metabolism ; pathology ; Meningioma ; metabolism ; pathology ; Middle Aged ; Neoplasm Grading ; Neoplasm Recurrence, Local ; Prognosis ; Transcription Factors ; metabolism ; Young Adult