CNS & pituitary tumors
Meningeal tumors
Secretory meningioma
Last author update: 1 April 2014
Last staff update: 28 September 2020
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PubMed Search: "Secretory meningioma"
Table of Contents
Definition / general | Radiology description | Radiology images | Case reports | Gross description | Microscopic (histologic) description | Microscopic (histologic) images | Cytology description | Cytology images | Positive stains | Negative stains | Electron microscopy description | Molecular / cytogenetics description | Differential diagnosisCite this page: Kresak JL, Yachnis AT. Secretory meningioma. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/cnstumorsecretorymeningioma.html. Accessed March 24th, 2023.
Definition / general
- 1 - 3% of all meningiomas (Int J Clin Exp Pathol 2013;6:358)
- WHO grade I
- Female predominance
- May have elevated serum CEA
Radiology description
- May have increased peritumoral edema on MRI (Int J Clin Exp Pathol 2013;6:358)
Radiology images
Images hosted on other servers:
Cystic changes
Heterogeneous strong enhancement
Axial T1 weighted
Typical "xenon light"
Peritumoral brain edema
Axial Gd-DTPA enhanced images
High resolution CT
Postcontrast T1 WI MRI
Case reports
- 46 year old woman (Arch Pathol Lab Med 2000;124:787)
- 48 year old woman with metastasis into secretory meningioma (Br J Neurosurg 2002;16:66)
- 56 year old woman with primary temporal bone secretory meningioma presenting as chronic otitis media (Eur Arch Otorhinolaryngol 2008;265:843)
- 66 year old woman with frontoparietal brain mass (Case #325)
- Lipomatous component (Brain Tumor Pathol 1999;16:77, Neuroradiology 1998;40:656)
- Secretory meningiomas of the orbit (Orbit 2009;28:408)
Gross description
- Dural based of variable size
Microscopic (histologic) description
- Intracellular lumina with eosinophilic, granular or hyalinized secretions referred to as "pseudopsammoma bodies"
- Secretions are PAS+ and CEA+
- Additional areas have classic meningioma histology
- May have abundant mast cells (Neurosurg Rev 2006;29:41)
Microscopic (histologic) images
Case #325
H&E
PASD
EMA
NSE
Cytology description
- Hypercellular cohesive clusters of uniformly dense cells with eosinophilic cytoplasm, smooth nuclear outlines and even chromatin
- Also cells with syncytial arrangements, whorls and nuclear pseudoinclusions (Acta Cytol 1999;43:121)
Cytology images
Images hosted on other servers:
Various images
Positive stains
- Secretions positive for PAS and CEA
- Tumor cells surrounding secretions are positive for CEA and sometimes cytokeratin
- EMA, PR
Negative stains
Electron microscopy description
- Hyaline inclusions are intracellular and within intercellular lumina lined by microvilli; inclusions contain granular material forming a dense core
- Also microvesicles, dense bodies and lamellar structures
Molecular / cytogenetics description
- Secretory meningiomas are defined by combined KLF4 K409Q and TRAF7 mutations (Acta Neuropathol 2013;125:351)
Differential diagnosis
- Metastatic carcinoma: usually CK7-, CK20+ (Adv Clin Path 1999;3:47)
- Microcystic, clear cell or chordoid meningioma
