Comparison of imaging and pathological findings of intracranial anaplastichemangiopericytoma and anaplastic meningioma
ZHANG Jing1, ZHOU Jun-lin2, LIU Jian-li2, DONG Chi2
1. Department of Radiology, General Hospital of Lanzhou Petrochemical Company, Lanzhou 730060, China;2. Department of Radiology, the Second Hospital of Lanzhou University, Lanzhou 730030, China
Abstract：Objective: To compare and analyze imaging features of intracranial anaplastic hemangiopericytoma(HPC) and anaplastic meningioma. Methods: Nineteen patients of anaplastic HPC and twenty patients of anaplastic meningioma proved by operation and pathology were analyzed retrospectively. Both plain and enhanced MR scans were performed and the results were compared with pathology in all cases. Results: All the intracranial tumors were located outside the brain. Sixteen cases were lobulated, 9 cases extended into adjacent lobe in 19 anaplastic HPC. On MRI, the lesions showed mixed iso-low signal(n=15) or iso-signal(n=5) on plain T1WI, while mixed high-low signal(n=13) or high signal(n=6) on plain T2WI. After contrast injection, heterogeneous enhancement was seen in 13 cases. Significant necrotic and cystic areas were seen in 12 cases, “dural tail sign” in 4 cases. Seven cases appeared to have bony destruction. Significant mass effect in all cases. Sixteen cases showed significant peritumoral edema. Postoperative tumor histology revealed that the tumor cells were densely aggregated, apparent cellular atypia, mitosis common. Reticular fiber staining showed a large number of slit-like vascular spaces within the interstitial tissue. Sixteen cases of the 20 anaplastic meningiomas were lobulated or irregular in shape. On MRI, the lesions showed mixed iso-low signal(n=12) or iso-high signal(n=3); iso-signal(n=5) on plain T1WI, mixed slight iso-high signal(n=17) or mixed high-low signal(n=3) on plain T2WI, moderate heterogeneous enhancement in 16 cases, obvious cystic necrosis in 13 cases, “dural tail sign” in 14 cases, the skull destruction in 9 cases, peritumoral edema in 16 cases. The pathology showed a poorly differentiated tumor cells, mitosis rich, cell densely aggregated, nucleus enlarged, deep dyeing, significant atypia, mitotic common. Conclusion: Imaging findings of intracranial anaplastic HPC and anaplastic meningioma are different, the former has a more cross-lobe growth tendency, significantly higher signal on plain T2WI, significant enhancement, subdural connected with a narrow base, “dural tail sign” rare, etc, with these characteristics can be identified with the latter.
2014, Vol. 25 
