Background: Chordoid meningioma is a rare meningioma variant characterised by epithelioid cord-like tumour cells in a myxoid stroma. It is classified as grade II (World Health Organization) tumours, as they have a tendency to behave more aggressively than traditional meningiomas and have a greater likelihood of recurrence. Aims: To report the features of intraoperative imprint smears of five cases of chordoid meningioma. Methods: The intraoperative squash smears were reviewed for cellularity, cellular atypia, mitotic figure, cytoplasmic vacuolation, intranuclear inclusion, presence of a cohesive cord of tumour cells, whorl-like structure, psammoma bodies, chronic inflammatory cells (lymphocytes and plasma cells), background mucin and necrosis. Results: All cases were of moderate to high cellularity, with cohesive cords of bland tumour cells possessing uniformly round nuclei with smooth nuclear outline, stippled chromatin and small nucleoli, with cytoplasmic vacuolation and chronic inflammatory cells in the background. Intranuclear inclusions (80%) and whorl-like structures (60%) were also common. Necrotic background, psammoma bodies or mitotic figures were consistently absent. Conclusions: The cytological features of chordoid mengiomas are distinctive, and intraoperative imprint diagnosis is feasible. C hordoid meningioma is a rare variant of meningioma characterised by epithelioid cord-like tumour cells in a myxoid stroma. It is classified as grade II (World Health Organization (WHO)) tumours, as they have a tendency to behave more aggressively than traditional meningiomas and have a greater likelihood of recurrence. Five cases of chordoid meningiomas were retrieved. The clinical features, intraoperative imprint smears and subsequent histological sections showed distinctive and characteristic findings.
MATERIALS AND METHODSFive cases with chordoid meningioma with intraoperative squash smears and confirmed by subsequent formalin-fixed paraffin-wax-embedded sections were identified from the archives of the Department of Pathology, Kwong Wah Hospital, Kowloon, Hong Kong (n = 2); Princess Margaret Hospital, Kwai Chung, Hong Kong (n = 2); and Prince of Wales Hospital, Shatin, Hong Kong (n = 1) over a period of 5 years. The clinical information, presentation, treatment and follow-up were retrieved.Squash smears were made from the intraoperative frozen section material and stained with H&E stain. The remaining materials and the follow-up specimens were fixed in formalin and embedded in paraffin wax.In all cases, the following components were assessed from the smear: cellularity, cellular atypia, mitotic figure, cytoplasmic vacuolation, intranuclear inclusion, presence of a cohesive cord of tumour cells, whorl-like structure, psammoma bodies, chronic inflammatory cells (lymphocytes and plasma cells), background mucin and necrosis. Cellular atypia was defined as tumour cells with high nucleocytoplasmic ratio, with or without prominent nucleoli. All the other cytomorphological parameters were taken as present or absent i...