[Atypical meningioma with xanthogranulomatous stromal reaction].

A case of atypical meningioma with xanthogranulomatous stromal reaction was described in a 37 year-old man. At the age of 18, the patient started to have seizures. He became aware of disturbances in gait since 27 years of age. At the age of 37 he came to the hospital for detailed examinations and adequate treatment. EEG showed focal spikes at right temporal area and the CT scan disclosed abnormalities indicating the presence of a right posterior temporal mass. At craniotomy, a tumor was found located over the surface of right temporal lobe. It was well-circumscribed, firm in consistency and was attached to the dura, measuring 3cm in its greatest diameter. Gross total removal was accomplished. On cut section, the tumor was greyish in color mottled variously with yellow or rustbrown tint. It contained a cyst. Microscopically, the tumor was made up of compact masses of spindle-shaped or polygonal cells. The cells were arranged in areas in interlacing fascicles or forming whorles. In many places the tumor showed pleomorphic cytology. Mitotic figures were found few in number. The cytoplasm of the neoplastic cells appeared groundglass-like. Some of them contained hyaline globules. The globules were found to react positive with P.A.S. technique, and this procedure was resistant against diastase digestion. They were also stained positive with P.T.A.H. stain. In some areas foamy xanthomatous cells were found in groups. A large number of lymphocytes, plasma cells, eosinophiles and macrophages ingesting brownish pigments were found infiltrating around vascular vessels.(ABSTRACT TRUNCATED AT 250 WORDS)