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...

A total of 144 gastric biopsies colonized by Helicobacter-like organisms were studied under light and differential interference contrast microscopy for the modes of bacterial colonization. Biopsies were also graded for the degree of epithelial damage (epithelial-damage-grade: 0 to 6, in ascending order of severity) and density of Helicobacter-like organism (Helicobacter-grade: 0 to 6, in ascending order of bacterial density). Three modes of colonization were identified: free-in-mucus, surface-adhesion and intercellular colonization. Because light microscopy cannot definitely prove the presence of intracellular colonization, bacteria located between cells and below the apical cell border were counted together as intercellular colonization. Bacteria free-in-mucus were seen in all biopsies. Surface adhesion was seen in 50-87.9% of biopsies, without obvious correlation with the epithelial-damage- and Helicobacter-grades. The incidences of intercellular and intracellular colonization were directly proportional to the epithelial-damage- and Helicobacter-grades. Free-in-mucus as the predominant mode of colonization was mainly seen in biopsies with lower (1-3) epithelial-damage- and Helicobacter-grades. Conversely, biopsies with intercellular colonization as the predominant mode of colonization were mainly cases with higher (4-6) epithelial-damage- and Helicobacter-grades. In cases showing predominantly bacteria between cells, 69.2% had a gastric ulcer whereas only 38.8% of cases showing predominantly bacteria free-in-mucus showed ulceration (P < 0.01). These results indicate that Helicobacter-like organisms can invade and penetrate between epithelial cells. When free-in-mucus, Helicobacter-like organisms are less likely to induce epithelial damage. However, the more invasive modes of colonization (intercellular) were associated with severe epithelial damage and high Helicobacter density.(ABSTRACT TRUNCATED AT 250 WORDS)

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