ABSTRACT
The posterior thoracic midline location is an unusual site for a congenital hemangiopericytoma. The authors report such a case that caused near fatal exsanguination of a newborn after vaginal delivery. Magnetic resonance imaging (MRI) studies of the mass were completed after hemostasis. These studies showed a well-defined border between the tumor and underlying trapezius muscle. The mass was removed successfully surgically and presumed initially to be a teratoma. Pathological diagnosis of the tumor was hemangiopericytoma with low malignant potential. After a 9-day hospital course, the patient was discharged with recovering hepatic and renal function.
Subject(s)
Hemangiopericytoma/congenital , Thoracic Neoplasms/congenital , Back , Hemangiopericytoma/diagnosis , Humans , Infant, Newborn , Male , Thoracic Neoplasms/diagnosisABSTRACT
The relationship between meningeal hemangiopericytoma (angioblastic meningioma), meningiomas of meningothelial derivation, and peripheral hemangiopericytoma is controversial; and immunohistochemical studies have yielded conflicting results. Likewise, immunohistochemistry has been touted as a reliable means of differentiating fibrous meningioma from acoustic schwannoma. By the immunoperoxidase method, we studied 40 meningiomas (11 meningotheliomatous, four transitional, 11 fibrous, three secretory, four metaplastic, one xanthomatous, one papillary, four atypical, one malignant), five arachnoid granulations, 13 angioblastic meningiomas, nine peripheral hemangiopericytomas, and seven acoustic schwannomas. Antisera to vimentin, epithelial membrane antigen (EMA), keratin, S-100 protein, carcinoembryonic antigen (CEA), desmin, factor VIII, Ulex europeaus, and glial fibrillary acidic protein (GFAP) were utilized. All meningiomas and arachnoid granulations stained for vimentin and EMA; 15% and 12% of meningiomas were S-100 and keratin positive, respectively. The latter was noted primarily in areas of secretory (pseudopsammomatous) differentiation. In contrast, all angioblastic meningiomas stained for only vimentin. This profile of immunoreactivity was also seen in the peripheral hemangiopericytomas, with the exception of single cases that stained focally for EMA and S-100 protein, respectively. Acoustic schwannomas all stained positively for S-100 protein, vimentin, and were variably reactive for EMA, a pattern not distinct from meningioma. We conclude that (a) meningiomas express both epithelial and mesenchymal markers as do arachnoid granulations, (b) that angioblastic meningiomas demonstrate only mesenchymal markers, (c) that angioblastic meningiomas express identical markers to peripheral hemangiopericytoma and should thus be considered a variant thereof, (d) among meningiomas, CEA and keratin appear to be relatively specific markers for the "secretory" variant, and (e) because of overlap in S-100 and EMA reactivity, these markers are unreliable in differentiating meningioma from acoustic schwannoma.
Subject(s)
Hemangiopericytoma/diagnosis , Meningeal Neoplasms/diagnosis , Meningioma/diagnosis , Neurilemmoma/diagnosis , Antibodies, Neoplasm/analysis , Diagnosis, Differential , Hemangiopericytoma/analysis , Hemangiopericytoma/pathology , Humans , Immunoenzyme Techniques , Meningeal Neoplasms/analysis , Meningeal Neoplasms/pathology , Meningioma/analysis , Meningioma/pathology , Neurilemmoma/analysis , Neurilemmoma/pathologyABSTRACT
A case is presented of hemopericardium and sudden death due to rupture of a solitary myocardial abscess in an elderly woman with cirrhosis and mild urosepsis. If suspected clinically, such myocardial abscesses may be detectable by noninvasive tomographic cardiac imaging.
