Presentation on theme: "Extramedullary hematopoiesis as a potential pitfall for meningeal mass in patients with myelofibrosis Ghimenton C1, Eccher A1, Brunelli M2, Gobbo S2,"— Presentation transcript:
1 Extramedullary hematopoiesis as a potential pitfall for meningeal mass in patients with myelofibrosisGhimenton C1, Eccher A1, Brunelli M2, Gobbo S2, Parisi A1, Martignoni G2, Turazzi S3, Chilosi M2, Menestrina F2.1 Anatomia Patologica, Ospedale Civile Maggiore, Verona2 Dipartimento di Patologia, Università di Verona3 Neurochirurgia, Ospedale Civile Maggiore, Verona
2 Introduction Myelofibrosis leads to ineffective erythropoiesis Extramedullary hematopoiesis characteristicallydevelops predominantly in the spleen and liverThe central nervous system is rarely affected and thespinal canal and the meninges are preferred locations
3 Case report 63 yrs woman with history of worsening headaches and documented bone marrow fibrosis.MR imaging revealed a bilateral, frontal-solid-lesion,attached to the dura, that was hyperintense to contrast.The patient underwent a frontal craniotomyfor suspected meningioma and the lesion was removedwith its dural implant.Grossly the tumor resection measured inaggregate cm 4,5x3,5x3.
5 Histological examination revealed multiple foci of hematopoietic cells of erythroid, myeloid and megakaryocytic lineages confirmedwith stains for glycophorin, myeloperoxidase and Factor VIII.
6 AE1/AE3 GFAP The hematopoietic cells were of course immunonegative for pankeratin and glial fibrillary acidic protein.The diagnosis was meningeal EH.AE1/AE3GFAP
7 Discussion The presence of EH loci in primary brain tumors is fairly rareExtramedullary myeloid metaplasia should be ruled outin patients experiencing idiopathic myelofibrosis andconsidered as a differential diagnosis in brain lesions
8 ReferencesA meningioma with islets of extramedullary myeloid metaplasia:case report.Zona G. et al, Neurosurgery 2007.2. Intracranial extramedullary hematopoiesis associated withpilocytic astrocytoma: a case reportBeckner E. et al, Acta Neuropathology 2003.