Unusual clear cell, lymphoplasmacyte-rich, dural-based tumor with divergent differentiation: a tricky case mimicking a meningioma

• Published in: Human pathology 2015-07, Vol.46 (7), p.1050-1056
• Main Authors: Miracco, Clelia, MD, Toscano, Marzia, PhD, Butorano, Marie Aimée Gloria Munezero, MD, Baldino, Gennaro, MD, Tacchini, Damiana, MD, Barone, Aurora, MD, Cerase, Alfonso, MD
• Format: Article
• Language: English
• Subjects: Biomarkers, Tumor - analysis; Cell Differentiation; Clear cell tumor; Cloning; Diagnosis, Differential; Dura Mater - chemistry; Dura Mater - pathology; Dura Mater - surgery; Dural neoplasms; Female; Histology; Humans; Immunoglobulins; Immunohistochemistry; Magnetic Resonance Imaging; Medical imaging; Meningeal Neoplasms - chemistry; Meningeal Neoplasms - pathology; Meningeal Neoplasms - surgery; Meningioma; Meningioma - pathology; Middle Aged; Morphology; Neoplasm Recurrence, Local; Neurosurgery; NMR; Nuclear magnetic resonance; Pathology; Predictive Value of Tests; Tumors
• ISSN: 0046-8177; 1532-8392
• DOI: 10.1016/j.humpath.2015.03.006

Summary We describe an unusual case of a recurrent dural neoplasm, previously diagnosed as meningioma. Histopathologically, the tumor is characterized by aggregates of divergently differentiated clear cells embedded in an abundant lymphoplasmacyte-rich stroma, mimicking a lymphoplasmacyte-rich meningioma. This study focuses on the histologic and immunohistochemical characterization of a unique dural-based tumor and provides useful guidelines for differentiating meningioma from other uncommon dural-based neoplasms. We propose that this recurrent dural neoplasm is a distinctive entity and, therefore, enlarges the spectrum of dural-based neoplasms that enter the differential diagnosis with meningiomas. Awareness of this tumor entity could prove useful for appropriate patient management.