Histopathological Investigation in Meningioangiomatosis

A case of meningioangiomatosis without association with von Recklinghausen’s disease is reported. A 39-year-old man was admitted because of head injury. Computed tomography (CT) scan show-ed right acute epidural hematoma, left intracerebral hematoma, and a mass with calcification in the right parietal region. Craniotomy, evacuation of epidural hematoma, and external decompression were performed. Enhanced CT scan revealed that the mass was slightly enhanced around calcifica-tion. Angiography demonstrated an avascular mass. Cranioplasty and partial removal of the mass were carried out. Microscopically, irregularly-branched thick-walled blood vessels extended into the gray matter from the meningeal surface, and proliferated blood vessels were surrounded by wavy or concentric arrangement of spindle-form cells in association with intervening neural tissue. A diag-nosis of meningioangiomatosis was made. Spindle-form cells were not found to contain S-100 pro-tein. Electron microscopic findings demonstrated that the proliferating cells were composed of spindle-form nuclei rich in heterochromatin and slender cytoplasm containing micro filaments, in association with desmosomal junctions and basal lamina-like structure on occasion. These findings disclosed that spindle-form cells were not derived from Schwann cells but that they may be menin-gothelial cells in origin.