Meningioma presenting as temporal region swelling: Diagnosis by cytopathology and immunohistochemical confirmation on cell block preparation

Abstract

Meningiomas are common intracranial neoplasms. Meningomas are rarely subjected to fine-needle aspiration (FNA) studies. However, intraoperative squash preparations are commonly done. FNA of meningiomas are usually performed incidentally for cases with a clinical suspicion of some other disease such as metastatic carcinoma. We are reporting two cases, which were referred to our center with a diagnosis of metastatic carcinoma on FNA from swelling of the temporal region. We are discussing the characteristic cytomorphological features, which help in diagnosing meningiomas, the common cytological differentials, and the utility of immunohistochemistry (IHC) on cell block preparations in confirming the diagnosis, especially when there is a clinical differential diagnosis.

Cytological features of ectopic nasal meningioma. Report of a case diagnosed using FNAC

“…The presence of nuclear grooves, intranuclear inclusions, and psammoma bodies can raise the possibility of metastatic thyroid carcinoma. 8 Accordingly, cell block preparation along with the application of IHC can help confirm the diagnosis, which shows the presence of EMA, S100, vimentin, and progesterone receptor positivity. 8 In a cytological study of 158 lesions from the sinonasal region, Gupta et al found many infective, inflammatory, benign, and malignant lesions with just one case of meningioma occurring in the nasal region.…”

“…8 Accordingly, cell block preparation along with the application of IHC can help confirm the diagnosis, which shows the presence of EMA, S100, vimentin, and progesterone receptor positivity. 8 In a cytological study of 158 lesions from the sinonasal region, Gupta et al found many infective, inflammatory, benign, and malignant lesions with just one case of meningioma occurring in the nasal region. They concluded that FNAC can help in the diagnosis of various non-neoplastic and neoplastic conditions especially when a clinical-radiological correlation is possible.…”

“…It can also resemble benign soft tissue lesions like fibromatosis or nodular fasciitis and other mesenchymal neoplasms. The presence of nuclear grooves, intranuclear inclusions, and psammoma bodies can raise the possibility of metastatic thyroid carcinoma 8 …”

“…Accordingly, cell block preparation along with the application of IHC can help confirm the diagnosis, which shows the presence of EMA, S100, vimentin, and progesterone receptor positivity 8 …”