Crush intraoperatory analysis in craniopharyngioma.

Intraoperative smear cytology provides a rapid and reliable intraoperative diagnosis and guidance to the neurosurgeon during surgical resection and lesion targeting. It also helps the surgeon to monitor and modify the approach at surgery. The aim of this article was a clinicopathological and cytomorphological intraoperative crush smear correlation in craniopharyngioma. Thirty craniopharyngiomas were included in this study. Twenty-seven cases were adaCP and only three cases were papCP. This series included 16 (53%) males and 14 (47%) females adult patients, aged from 15 to 86 years (median, 49 year). Two cases were frank errors, 12 cases showed partial correlation, 5 cases showed incomplete typing of the cell type, and 7 cases discrepancy in type of tumors. The percent error was 14%. Correlations with clinical details and radiological findings were helpful in improving the accuracy rate. Smear technique is a fairly accurate, relatively safe, rapid, simple, easily reproducible, and cost-effective tool to diagnose brain tumors. Smear cytology is of great value in intraoperative consultation of central nervous system pathology. The cytological aspects and smear patterns disclose important complementary diagnostic information for the histopathological examination.

Chordoid meningioma: a report of ten cases.

Chordoid meningioma is a rare variant of meningioma with histological features resembling those of chordoma. This tumor has a great risk of recurrence and aggressive growth (WHO grade II). This study was done to document the clinical and pathological features of ten patients with chordoid meningioma who submitted to surgery at the National Institute of Neurology and Neurosurgery in Mexico City. Clinical, histological and immunohistochemical features were examined. The age range was from 30 to 67 years old (mean, 34.2 years). Seven patients were female and three male. The duration of symptoms varied from 3.5 months to 5 years (mean, 14.1 months). No systemic symptoms were noted. The tumor was localized in eight cases in the supratentorial compartments. Histologically, the tumors were characterized by strands and cords of meningothelial cells arranged in a mucinous stroma. Two of the ten tumors showed metaplasic changes, and seven showed brain invasion. Tumor cells demonstrated CK7, EMA and focal S-100 protein and Ep-CAM. Cytokeratin AE1/AE3, GFAP and synaptophysin were negative. The MIB-1 proliferative index was from 6 to 9% (mean 7.8). PCNA Li was 6 to 20% (mean, 14), and microvascular density was 6-16 (mean, 14.5). The mean rate of the MIB-1 labeling index in recurrences was 7.1% versus 6.33% for no tumor recurrence. Chordoid meningioma, World Health Organization grade II, is an uncommon variant of meningioma with a propensity for aggressive behavior and increased likelihood of recurrence. Chordoid meningiomas are predominantly tumors of young adults with a predilection for the supratentorial location. Intraventricular location and absence of systemic manifestations, despite the presence of abundant B-lymphocytes, mast cells and low MIB-1 LI, are some of the interesting findings in the present series that need further study. Hence, a larger number of cases with adequate follow-up data need to be studied further to establish the clinical relevance of this variant.