Cytology of chordoid meningioma: a series of five cases with emphasis on differential diagnoses.

BACKGROUND: Chordoid meningioma is a rare meningioma variant characterised by epithelioid cord-like tumour cells in a myxoid stroma. It is classified as grade II (World Health Organization) tumours, as they have a tendency to behave more aggressively than traditional meningiomas and have a greater likelihood of recurrence. AIMS: To report the features of intraoperative imprint smears of five cases of chordoid meningioma. METHODS: The intraoperative squash smears were reviewed for cellularity, cellular atypia, mitotic figure, cytoplasmic vacuolation, intranuclear inclusion, presence of a cohesive cord of tumour cells, whorl-like structure, psammoma bodies, chronic inflammatory cells (lymphocytes and plasma cells), background mucin and necrosis. RESULTS: All cases were of moderate to high cellularity, with cohesive cords of bland tumour cells possessing uniformly round nuclei with smooth nuclear outline, stippled chromatin and small nucleoli, with cytoplasmic vacuolation and chronic inflammatory cells in the background. Intranuclear inclusions (80%) and whorl-like structures (60%) were also common. Necrotic background, psammoma bodies or mitotic figures were consistently absent. CONCLUSIONS: The cytological features of chordoid mengiomas are distinctive, and intraoperative imprint diagnosis is feasible.

Fine needle aspiration cytology of invasive micropapillary carcinoma of the breast.

AIM: To determine the pathognomonic diagnostic cytological features of invasive micropapillary carcinoma of the breast which is a poor prognostic subtype of infiltrating ductal carcinoma. METHODS: A series of 20 histologically proven tumours were reviewed retrospectively to evaluate the various cytological features, including tumour morules, isolated malignant cells, staghorn epithelial structures, mucinous background and apocrine metaplasia. RESULTS: Tumour morules formation and isolated malignant cells were the two most reliable and constant cytological features, being present in 75% (15/20 cases) of cases. Staghorn epithelial structures were present in 35% (7 cases). Mucinous background (2 cases, 10%) and apocrine metaplasia (4 cases, 20%) of the tumour cells were seen in a few cases only and did not appear very helpful. CONCLUSION: Tumour morules formation, isolated malignant cells and staghorn epithelial structures are the most reliable cytological features, and the presence of these should raise suspicion of invasive micropapillary carcinoma.

Intracranial chloroma in hypereosinophilic myelofibrosis.

BACKGROUND: Chloroma, also called granulocytic sarcoma, is a localized extramedullary tumor composed of leukemic myeloid cells. It is a rare tumor that can occur in various locations. The association of chloroma with leukemic disease or myeloproliferative disorders is limited to isolated case reports. CASE DESCRIPTION: We report a case of intracranial chloroma in an elderly man with myelofibrosis and progressive hypereosinophilia. The presence of leukemic cells within his pleural aspirate suggested an incipient acute leukemic state. CONCLUSION: We report the first case of intracranial chloroma associated with hypereosinophilia developing in the course of myelofibrosis. The significance of hypereosinophilia in predicting the likelihood of development of central nervous system chloroma and acute leukemia in a patient with myelofibrosis needs further evaluation.