Author(s): Salinero E, Beltran L, Costa JR
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Abstract BACKGROUND: Chordoid meningioma is an uncommon supratentorial tumor in which a cordonal pattern on a mucofibrillar background covers areas of classic meningioma with a diffuse, meningeal, immunohistochemically reactive pattern. Its cytology has not been described before. CASE: A 45-year-old woman with headaches and a poorly defined, nondiplopic vision alteration underwent magnetic resonance imaging, which showed a tumor in the upper part of the left orbital cavity. An intraoperative squash smear showed closely knit, pseudosyncytial plates composed of medium-sized cells with homogeneous nuclei and nuclear pseudoinclusions. There were some physaliferouslike, loose cells without cytoplasmic vacuolation and a fairly abundant, metachromatic, pink to light purple background that was absent inside the plates. A diagnosis of meningioma with a possible chordoid pattern was made. No frozen intraoperative section was prepared. Histology showed 90\% chordoid meningioma merging with areas of classic meningothelial meningioma and overall positivity for epithelial membrane antigen and vimentin. S-100 was negative. CONCLUSION: A reliable intraoperative cytologic diagnosis of chordoid meningioma can be made because the morphology is highly characteristic. Close cellular association and the cells' nuclear traits are expected in a meningioma. The metachromatic background can cause a false diagnosis of chordoma. However, there are some clear differences in the cells and their relation to the mucofibrillar matrix that make the diagnosis definitive.
This article was published in Acta Cytol
and referenced in Journal of Addiction Research & Therapy