Objective Meningoma has a wide range of histopathological characteristics, some rare variants give a real challenge to the neuropathologist. The aim of this study was to gain a deeper insight into the tu(m)or by exploring the clinical and pathological features of meningioma with a Zellhallen growth pattetn. Methods We analyzed the clinical data of 4 cases of meningioma with a Zellballen growth pattern in the brain or vertebral canal, and studied their histochemical characteristics, immunophenotypes and ultramicrostructures. Results Histologically, this type of meningioma was found to have a trabecular or nestlike architecture with many blood sinuses, resembling that of paraganglioma. Immunohistochemically, the tumor cells were positive for EMA and Vimentin, but negative for synaptophysin and chromogranin A. Electron microscopy showed zonula occludens and desmosome between the cells, butno ultrastructural evidence of neuroendocrine differentiation. Conclusion Meningioma with a Zellballen growth pattem has the histological characteristics of paraganglioma-like meningioma, and resembles typical meningioma in immunophenotype and ultramicrostructure. However, the biological behavior of this type of meningioma remains to be clarified by further studies of more cases.%目的 脑膜瘤的组织学类型比较多,人们对有些罕见类型的脑膜瘤通常认识不足,文中通过对伴有副神经节瘤样结构脑膜瘤临床和病理的研究,提高对该肿瘤的认识.方法 分析4例发生于颅内及椎管内的伴有副神经节瘤样结构脑膜瘤的临床资料,对其组织学特征、免疫表型及超微结构进行观察研究.结果 脑膜瘤组织形态上具有副神经结瘤样的结构,上皮样肿瘤细胞排列成巢状,间质血管丰富,但瘤细胞表达EMA、Vimetin,而不表达Syn、CgA.电镜下瘤细胞表面有较多不规则的胞质突起,细胞间有桥粒样结构,胞质内有丰富的中间丝,而未见神经分泌颗粒.结论 伴有副神经节瘤样结构的脑膜瘤具有副神经节细胞瘤的组织学特征,而免疫表型及超微结构与经典脑膜瘤一致.由于病例数的限制,其生物学行为尚不清楚.
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