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Best Cases from the AFIP

Involuted Sclerotic Meningioma¹

¹ From the Department of Diagnostic Radiology, Division of Neuroradiology, Wayne State University School of Medicine, DRH 3L8, 4201 St Antoine, Detroit, MI 48201 (M.A.S., I.T.Z.); and the Department of Pathology, Wayne State University School of Medicine, Harper University Hospital, Detroit, Mich (W.J.K.). Received July 11, 2002; revision requested August 9 and received September 17; accepted September 18. Address correspondence to M.A.S. (e-mail: mshaman@med.wayne.edu).

View larger version (125K): [in a new window]   Figure 1a.  (a) Axial CT scan (window width = 80 HU, window level = 45 HU; 120 kV, 300 mAs) of the brain demonstrates a densely calcified, peripherally located 3-cm mass in the posterior aspect of the left temporal lobe. (b) Axial CT scan (window width = 3,500 HU, window level = 900 HU) demonstrates no erosion, hyperostosis, or scalloping of the overlying calvaria.

View larger version (95K): [in a new window]   Figure 1b.  (a) Axial CT scan (window width = 80 HU, window level = 45 HU; 120 kV, 300 mAs) of the brain demonstrates a densely calcified, peripherally located 3-cm mass in the posterior aspect of the left temporal lobe. (b) Axial CT scan (window width = 3,500 HU, window level = 900 HU) demonstrates no erosion, hyperostosis, or scalloping of the overlying calvaria.

View larger version (135K): [in a new window]   Figure 2a.  (a) Axial unenhanced T1-weighted MR image (repetition time [TR] msec/echo time [TE] msec = 570/17) demonstrates an extraaxial mass over the posterosuperior aspect of the left temporal lobe. The mass measured 3 x 3 x 4 cm and demonstrated low signal intensity with all sequences. (b) Axial T2-weighted MR image (3,700/90) demonstrates a thin margin of hyperintensity anterior to the tumor in the adjacent brain parenchyma. (c, d) Axial (c) and coronal (d) contrast-enhanced MR images (570/17) show mild focal enhancement along the anterior margin of the mass. There is no evidence of a dural tail.

View larger version (103K): [in a new window]   Figure 2b.  (a) Axial unenhanced T1-weighted MR image (repetition time [TR] msec/echo time [TE] msec = 570/17) demonstrates an extraaxial mass over the posterosuperior aspect of the left temporal lobe. The mass measured 3 x 3 x 4 cm and demonstrated low signal intensity with all sequences. (b) Axial T2-weighted MR image (3,700/90) demonstrates a thin margin of hyperintensity anterior to the tumor in the adjacent brain parenchyma. (c, d) Axial (c) and coronal (d) contrast-enhanced MR images (570/17) show mild focal enhancement along the anterior margin of the mass. There is no evidence of a dural tail.

View larger version (121K): [in a new window]   Figure 2c.  (a) Axial unenhanced T1-weighted MR image (repetition time [TR] msec/echo time [TE] msec = 570/17) demonstrates an extraaxial mass over the posterosuperior aspect of the left temporal lobe. The mass measured 3 x 3 x 4 cm and demonstrated low signal intensity with all sequences. (b) Axial T2-weighted MR image (3,700/90) demonstrates a thin margin of hyperintensity anterior to the tumor in the adjacent brain parenchyma. (c, d) Axial (c) and coronal (d) contrast-enhanced MR images (570/17) show mild focal enhancement along the anterior margin of the mass. There is no evidence of a dural tail.

View larger version (130K): [in a new window]   Figure 2d.  (a) Axial unenhanced T1-weighted MR image (repetition time [TR] msec/echo time [TE] msec = 570/17) demonstrates an extraaxial mass over the posterosuperior aspect of the left temporal lobe. The mass measured 3 x 3 x 4 cm and demonstrated low signal intensity with all sequences. (b) Axial T2-weighted MR image (3,700/90) demonstrates a thin margin of hyperintensity anterior to the tumor in the adjacent brain parenchyma. (c, d) Axial (c) and coronal (d) contrast-enhanced MR images (570/17) show mild focal enhancement along the anterior margin of the mass. There is no evidence of a dural tail.

View larger version (109K): [in a new window]   Figure 3a.  (a) Photograph of the resected specimen demonstrates a smooth-surface nodule that is attached to the dural membrane. (b) Photograph shows the bisected nodule to be partially calcified, with a white-tan fibrous appearance. The nodule does not appear to penetrate the dural membrane.

View larger version (85K): [in a new window]   Figure 3b.  (a) Photograph of the resected specimen demonstrates a smooth-surface nodule that is attached to the dural membrane. (b) Photograph shows the bisected nodule to be partially calcified, with a white-tan fibrous appearance. The nodule does not appear to penetrate the dural membrane.

View larger version (174K): [in a new window]   Figure 4a.  (a) Low-power photomicrograph (original magnification, x20; H-E stain) shows bundles of densely packed, cellular hyalinized collagen with a homogeneous appearance. Arrow indicates small nests of residual tumor cells. (b) High-power photomicrograph (original magnification, x1,000; H-E stain) of the cell nests shows uniform meningothelial cells embedded in collagen. No atypical features are seen.

View larger version (181K): [in a new window]   Figure 4b.  (a) Low-power photomicrograph (original magnification, x20; H-E stain) shows bundles of densely packed, cellular hyalinized collagen with a homogeneous appearance. Arrow indicates small nests of residual tumor cells. (b) High-power photomicrograph (original magnification, x1,000; H-E stain) of the cell nests shows uniform meningothelial cells embedded in collagen. No atypical features are seen.