Sclerosing meningioma: immunohistochemical analysis of five cases

• Published in: Neuropathology and applied neurobiology Vol. 30; no. 2; pp. 126 - 135
• Main Authors: Kim, N. R., Im, S.-H., Chung, C. K., Suh, Y.-L., Choe, G., Chi, J. G.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Science Ltd 01.04.2004; Blackwell Science
• Subjects: Adolescent; Adult; Biological and medical sciences; Biomarkers, Tumor - analysis; Diagnosis, Differential; Female; Humans; Immunohistochemistry; Magnetic Resonance Imaging; Male; Medical sciences; Meningeal Neoplasms - metabolism; Meningeal Neoplasms - pathology; Meningeal Neoplasms - ultrastructure; meningioma; Meningioma - metabolism; Meningioma - pathology; Meningioma - ultrastructure; Microscopy, Electron; Middle Aged; Neurology; sclerosing; Sclerosis - pathology; Immunohistochemistry; Anatomic pathology; Nervous system diseases; Benign neoplasm; Meningioma
• ISSN: 0305-1846; 1365-2990
• DOI: 10.1046/j.0305-1846.2003.00517.x

Sclerosing meningioma is a rare morphologic subtype of meningioma and may be mistaken for atypical or malignant meningioma and astrocytoma or schwannoma because of marked collagen deposits and a sparse population of cells with little resemblance to meningothelial cells. Authors describe the histopathologic and immunophenotypic features of five cases of sclerosing meningioma. Histologically, all the cases consisted of paucicellular collagenous tissue containing spindle cells with or without small foci of meningothelial cell proliferation. The morphology and immunohistochemical profile of the spindle cells were different from those of conventional meningothelial cells. The meningothelial cells showed a typical immunoreactivity of conventional meningiomas, while the spindle cells displayed a strong expression of vimentin. The Ki‐67 labelling index was uniformly low in all cases, and none of cases expressed p53 protein. In summary, the recognition of meningothelial cells in massively sclerotic lesions is helpful for a correct diagnosis. In the cases with a total absence of meningothelial cells, however, the vague collagenous whorls are more diagnostic rather than immunohistochemistry. Considering association with clear cell meningioma, prospective and retrospective long‐term follow‐up is necessary for deciding whether reminiscent clear cell meningiomas should be separated from sclerosing meningioma or not.