Department of Pathology, University of Oklahoma Health Sciences Center

NeuroTest Sample Question #49 Next question Previous question

Answer: B (Secretory Meningioma)  Level of difficulty: 3 NeuroTest NeuroLearn NeuroHelp

Discussion: 

• Pathology of the case: In this cytologic preparation, there are many bubble like structure with a centrally located eosinophilic globules (Þ). These structures are several times the size of the nuclei that is present in this photo. The morphology of the nuclei is bland overall. In addition, some nuclei have pseudonuclear inclusions (Þ). The cytoplasm of these cells are amphophilic and granular. These features are highly suggestive of a secretory meningioma. [Click here to see a case]
• Metastatic adenocarcinoma: Although metastatic adenocarcinoma cells tend to have intracytoplasmic inclusions and those in mucin producing ones and signet ring cell adenocarcinoma can be large, the bubbly structures here are several times the size of a nuclei. This is too large for metastatic adenocarcinoma. In addition, the blend nuclear morphology and the pseudonuclear inclusions are more compatible with a meningioma.
• Metastatic melanoma: The large bubbly globules and the bland nuclei go against metastatic melanoma. Psuedonuclear inclusion, however, can be seen in metastatic melanoma.
• Glioblastoma and oligodendroglioma: The large bubbly globules go against a diagnosis of glial neoplasm including glioblastoma and oligodendroglioma.

Comment: KarMing-Fung@ouhsc.edu