Background: Both rhabdoid and papillary meningioma are rare variants of meningioma categorized as WHO grade III. Here, we report a rare case of combined rhabdoid papillary meningioma with discussion of its differential intraoperative cytologic diagnoses. Case: The patient was a 72-year-old female who presented with a huge mass at the cervical spine on MRI. The crush smears showed a radially arranged pattern of elongated tumor cells centered around the vessels, which formed a pseudorosette-like papillary structure, as well as singly scattered large gemistocyte-like rhabdoid cells with distinct cell borders. Rhabdoid cells had eccentrically placed vesicular nuclei with plump, fibrillary-to-hyaline cytoplasm with short broad processes. Nuclei had occasional nuclear inclusions with no nuclear grooves. Conclusion: Rhabdoid papillary meningiomas, encountered less often, should be distinguished from metastatic tumors of rhabdoid or papillary configuration, astrocytomas, ependymomas and atypical teratoid/rhabdoid tumor. Search for eosinophilic hyaline cytoplasm, rather than a fibrillary one, is critical for distinguishing it from other commonly encountered spinal cord tumors in the total absence of meningothelial whorls, like the present case. We also emphasize that the present case is the first case of rhabdoid papillary meningioma with primary manifestation in the spinal cord.

Keywords:
Meningioma, Rhabdoid, Papillary, Crush cytology, Spinal cord
1.
Perry A, Louis DN, Scheithauer BW, Budka H, von Deimling A: Meningiomas; in Louis DN, Ohaki H, Wiestler OD, Cavenee WK (eds): WHO Classification of Tumours of the Central Nervous System, ed 4. Lyon, IARC, 2007, pp 164-186.
2.
Perry A, Scheithauer BW, Stafford SL, Abell-Aleff PC, Meyer FB: ‘Rhabdoid' meningioma: an aggressive variant. Am J Surg Pathol 1998;22:1482-1490.
3.
Kepes JJ, Moral LA, Wilkinson SB, Abdullah A, Llena JF: Rhabdoid transformation of tumor cells in meningiomas: a histologic indication of increased proliferative activity: report of four cases. Am J Surg Pathol 1998;22:231-238.
4.
Hojo H, Abe M: Rhabdoid papillary meningioma. Am J Surg Pathol 2001;25:964-969.
5.
Saito A, Nakazato Y, Yoshii Y, Hyodo A, Harakuni T, Toita T, Ogawa K, Horikawa K, Terada Y, Kinjo S, Minei S: Anaplastic meningioma with papillary, rhabdoid, and epithelial features: a case report. Brain Tumor Pathol 2001;18:155-159.
6.
Al-Habib A, Lach B, Al Khani A: Intracerebral rhabdoid and papillary meningioma with leptomeningeal spread and rapid clinical progression. Clin Neuropathol 2005;24:1-7.
7.
Wakabayashi K, Suzuki N, Mori F, Kamada M, Hatanaka M: Rhabdoid cystic papillary meningioma with diffuse subarachnoid dissemination. Acta Neuropathol 2005;110:196-198.
8.
Santhosh K, Kesavadas C, Radhakrishnan VV, Thomas B, Kapilamoorthy TR, Gupta AK: Rhabdoid and papillary meningioma with leptomeningeal dissemination. J Neuroradiol 2008;35:236-239.
9.
Eom KS, Kim DW, Kim TY: Diffuse craniospinal metastases of intraventricular rhabdoid papillary meningioma with glial fibrillary acidic protein expression: a case report. Clin Neurol Neurosurg 2009;111:619-623.
10.
Wu YT, Ho JT, Lin YJ, Lin JW: Rhabdoid papillary meningioma: a clinicopathologic case series study. Neuropathology 2011;31:599-605.
11.
Rogerio F, de Araújo Zanardi V, Ribeiro de Menezes Netto J, de Souza Queiroz L: Meningioma with rhabdoid, papillary and clear cell features: case report and review of association of rare meningioma variants. Clin Neuropathol 2011;30:291-296.
12.
Martinez-Saez E, Malik I, Connor S, King A: Combined rhabdoid, papillary and adenocarcinomatous-like elements in a malignant meningioma - potential diagnostic problem. Clin Neuropathol 2012;31:51-53.
13.
Endo K, Tanaka S, Komagata M, Ikegami H, Kosaka T, Imakiire A, Serizawa H: Rhabdoid transformation of recurrent meningioma in the cervical cord: a case report. J Orthop Sci 2004;9:323-326.
14.
Batoroev YK, Nguyen GK: Rhabdoid meningioma diagnosed by imprint cytology. Acta Cytol 2005;49:464-465.
15.
Wyatt-Ashmead J, Kleinschmidt-DeMasters BK, Hill DA, Mierau GW, McGavran L, Thompson SJ, Foreman NK: Rhabdoid glioblastoma. Clin Neuropathol 2001;20:248-255.
16.
Tena-Suck ML, Gómez-Amador JL, Ortiz-Plata A, Salina-Lara C, Rembao-Bojórquez D, Vega-Orozco R: Rhabdoid choroid plexus carcinoma: a rare histological type. Arq Neuropsiquiatr 2007;65:705-709.
17.
Endo S, Terasaka S, Yamaguchi S, Ikeda H, Kato T, Kobayashi H, Tanaka S, Houkin K: Primary rhabdoid tumor with low grade glioma component of the central nervous system in a young adult. Neuropathology 2013;33:185-191.
18.
Bannykh SI, Perry A, Powell HC, Hill A, Hansen LA: Malignant rhabdoid meningioma arising in the setting of preexisting ganglioglioma: a diagnosis supported by fluorescence in situ hybridization: case report. J Neurosurg 2002;97:1450-1455.
19.
Gadd S, Sredni ST, Huang CC, Perlman EJ, Renal Tumor Committee of the Children's Oncology Group: Rhabdoid tumor: gene expression clues to pathogenesis and potential therapeutic targets. Lab Invest 2010;90:724-738.
20.
Wang Z, Kong M, Li J, Xiao W, Zheng S: Intraspinal rhabdoid meningioma metastasis to the liver. J Clin Neurosci 2011;18:714-716.
21.
Fukuoka K, Hirokawa M, Kanahara T, Ishii N, Ishii R, Shirabe T: Cytology of microcystic meningioma in crush preparation. Diagn Cytopathol 2000;23:275-278.
22.
Meinsma van der Tuin M, Molenaar WM, Mooij JJ: Spinal papillary meningioma: a case report and review of the literature. Acta Neurochir (Wien) 2000;142:703-708.
23.
Kirby PA: Rhabdoid meningioma: intraoperative diagnosis using smear preparation. Diagn Cytopathol 2003;29:292-296.
24.
Manasa PL, Uppin MS, Sundaram C: Analysis of squash smear cytology of ependymomas. Acta Cytol 2012;56:183-188.
25.
Fu YJ, Taniguchi Y, Takeuchi S, Shiga A, Okamoto K, Hirato J, Nobusawa S, Nakazato Y, Kakita A, Takahashi H: Cerebral astroblastoma in an adult: an immunohistochemical, ultrastructural and genetic study. Neuropathology 2013;33:312-319.
26.
Kumar PV: Nuclear grooves in ependymoma: cytologic study of 21 cases. Acta Cytol 1997;41:1726-1731.
27.
Raisanen J, Hatanpaa KJ, Mickey BE, White CL 3rd: Atypical teratoid/rhabdoid tumor: cytology and differential diagnosis in adults. Diagn Cytol 2004;31:60-63.
28.
Jovanović I, Ugrenović S, Vasović L, Petrović D, Cekić S: Psammoma bodies - friends or foes of the aging choroid plexus. Med Hypotheses 2010;74:1017-1020.
29.
Kim NR, Suh YL, Shin HJ, Park IS: Gliofibroma with extensive calcified deposits. Clin Neuropathol 2003;22:14-22.
30.
Kim NR, Chung DH, Lee SK, Ha SY: Intramedullary clear cell ependymoma in the thoracic spinal cord: a case with its crush smear and ultrastructural findings. J Korean Med Sci 2007;22(suppl):S149-S153.
31.
Kim JP, Park BJ, Lim YJ: Papillary meningioma with leptomeningeal seeding. J Korean Neurosurg Soc 2011;49:124-127.
32.
Savage NM, Crosby JH, Reid-Nicholson MD: The cytologic findings in choroid plexus carcinoma: report of a case with differential diagnosis. Diagn Cytopathol 2010;40:1-6.
© 2013 S. Karger AG, Basel
2013
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.