[en] We report the case of a meningeal inflammatory pseudotumour occurring in a 23-year-old male presenting with focal seizures and headaches. Brain imaging techniques showed a 3.5 cm left parietal meningeal tumour. Histology of the surgical specimen showed a dense lymphoid infiltrate permeating the dura mater and leptomeninges, consisting of a predominant polyclonal B cell population as confirmed by immunophenotyping and genotyping. Cultures of serum, CSF, and surgical specimen were negative and there was no serological evidence of a systemic dysimmune disease. The postoperative course was complicated by an episode of brain oedema resolving under steroid therapy. The patient, free from all medication, is asymptomatic at 3 years of follow-up. We discuss previously published cases and the nosology of intracranial inflammatory pseudotumours.
Disciplines :
Neurology
Author, co-author :
Gollogly, L.; Centre Hospitalier Universitaire de Liège - CHU > Department of Neurology
Sadzot, Bernard ; Centre Hospitalier Universitaire de Liège - CHU > Neurologie Sart Tilman
Lejeune, Jean-Luc ; Centre Hospitalier Universitaire de Liège - CHU > Urgences
Deprez, Manuel ; Université de Liège - ULiège > Département des sciences biomédicales et précliniques > Anatomie et cytologie pathologiques
Language :
English
Title :
Meningeal inflammatory pseudotumour: a case report.
ALGARA P., SORIA C., MARTINEZ P., SANCHEZ L., VILLUENDAS R. et al. Value of PCR detection of TCR gamma gene rearrangement in the diagnosis of cutaneous lymphocytic infiltrate. Diagn. Mol. Pathol., 1994, 3: 275-282.
ASTROM K. E., LIDHOLM S. O. Extensive intracranial lesions in a case of orbital non-specific granuloma combined with polyarteritis nodosa. J. Clin. Pathol., 1963, 16 : 137-143.
BREGIGEON M., BROSSET C., DANO P. Cranial pachymeningitis of unknown origin. Rev. Neurol. (Paris), 1998, 154 : 419-422.
CALLEBAUT J., DORMONT D., DUBOIS B., CHIRAS I., BORIES J. Contrast-enhanced MR imaging of tuberculous pachymeningitis cranialis hypertrophica : case report. AJNR, 1990, 11 : 821-822.
CANELLA D. M., PREZYNA A. P., KAPP J. P. Primary intracranial plasma-cell granuloma. Case report. J. Neurosurg., 1988, 69 : 785-788.
CASTELL C., MORATO J., FERRER I., LUCAS T., SARMIENTO J. et al. Granuloma hipotalamico de celulas plamaticas como cause de panhipopituitarismo. Rev. Clin. Esp., 1983, 170 : 141-144.
DEPREZ M., BORN J., HAUWAERT C., OTTO B., REZNIK M. Idiopathic hypertrophic cranial pachymeningitis mimicking multiple meningiomas : case report and review of the literature. Acta Neuropathol. (Berl.), 1997, 94 : 385-389.
EIMOTO T., YANAKA M., KUROSAWA M., IKEYA F. Plasma cell granuloma (inflammatory pseudotumor) of the spinal cord meninges. Report of a case. Cancer, 1978, 41 : 1929-1936.
ESSOP M. F., BLACKOLMER K., CLOSE P. M., MANUEL Y. E., CORNELIUS S. Analysis of High and Low Grade B-Cell Lymphoma Subtypes Using Semi-Nested PCR and Two Primers. Eur. J. Haematol., 1997, 59: 136-141.
FERINGA E. R., WEATHERBEE L. Hypertrophic granulomatous cranial-pachymeningitis causing progressive blindness in a chronic dialysis patient. J. Neurol. Neurosurg. Psychiatry, 1975, 38 : 1170-1176.
FIGAREELA-BRANGER D., GAMBARELLI D., PEREZ-CASTILLO M., GARBE M., GRISOLI F. Primary intracerebral plasma cell granuloma a light, immunocytochemical, and ultrastructural study of one case. Neurosurgery, 1990, 27 : 142-147.
GHILAIN S., DELREUX V., KEVERS L., SINDIC C. J. M., MATHURIN P. et al. Atteinte multiple des paires crâniennes associée à une pachyméningite tentorielle à caractère granulomateux. Acta Neurol Belg., 1988, 88 : 91-100.
GORELL J. M., PALUTKE W. A., CHASON J. L. Candida pachymeningitis with multiple cranial nerve paresis. Arch. Neurol., 1979, 36 : 719-720.
HSIANG J., MOORHOUSE D., BARBA D. Multiple plasma cell granulomas of the central nervous system : case report. Neurosurgery, 1994, 35 : 744-747.
HORTON B. C., URICH H., STEFOSKI D. Meningiomas with conspicuous plasma cell-lymphocytic components. Cancer, 1979, 43 : 258-264.
KEPES J. J., DUNLAP M. D., BOYNICK P. O., TERREROS D. Meningioma with multiple rhumatoid nodules. A case report. Acta Neuropathol., 1986, 70 : 314-319.
KLEIHUES P., BURGER P. C., SCHEITHAUER B. W. Histological Typing of Tumours of the Central Nervous System. In : KLEIHUES P., BURGER P. C., SCHEITAUER B. W. (eds.). Berlin, Springer-Verlag, 1993, 33-37.
LE MARCHADOUR F., FRANSEN P., LABAT-MOLEUR F., PASSAGIA J. G., PASQUIER B. Intracranial plasma cell granuloma : a report of four cases. Surg. Neurol., 1994, 42 : 481-488.
LLENA J. F., CHUNG H. D., HIRANO A., FEIRING E., ZIMMERMAN H. Intracellular "fibroma". Case report. J. Neurosurg., 1975, 43 : 98-101 (Abstract).
MAEDA Y., TANI E., NAKANO M., MATSUMOTO T. Plasma cell granuloma of the fourth ventricle. J. Neurosurg., 1984, 60 : 1291-1296 (Abstract).
MICHEL D., GIRARD D. F., TOMMASI M., MASSON R., TRILLET M. et al. Les pachyméningites granulomateuses intracrâniennes à symptomatologie pseudo-tumorale. J. Med. Lyon, 1969, 50 : 545-577.
MIRRA S. S., TINDALL S. C., CHECK L. T. Inflammatory meningeal masses of unexplained origin. An ultrastructural and immunological study. J. Neuropathol. Exp. Neurol., 1984, 42 : 453-468.
MOORE A. P., ROLFE E. B., JONES E. L. Pachymeningitis cranialis hypertrophica. J. Neurol. Neurosurg. Psychiatry, 1985, 48 : 942-944.
MURAI H., KIRA J., KOBAYASHI T., GOTO I., INOUE H. et al. Hypertrophic cranial pachymeningitis due to Aspergillus flavus. Clin. Neurol. Neurosurg., 1992, 94 : 247-250.
NAZEK M., MANDYBUR T. I., SAWAYA R. Hyalinizing plasmacytic granulomatosis of the falx. Am. J. Surg. Pathol., 1988, 12 : 308-313.
NISHINO H., RUBLNO F. A., PARISI J. E. The spectrum of neurology involvement in Wegener's granulomatosis. Neurology, 1993, 43 : 1334-1337.
NISHIO S., MORIOKA T., TOGAWA A., YANASE T, NAWATA H. et al. Spontaneous resolution of hypertrophic cranial pachymeningitis. Neurosurg. Rev., 1995, 18 : 201-204.
RANOUX D., DEVAUX B., LAMY C., MEAR J. Y., ROUX F. X. et al. Meningeal sarcoidosis, pseudo-meningioma, and pachymeningitis of the convexity. J. Neurol. Neurosurg. Psychiatry, 1992, 55 : 300-303.
SCHIESS R. J., GOSEIA M. F., MC CLELLAN G. A. Petriellidium boydii pachymeningitis treated with miconazole and ketoconazole. Neurosurgery, 1984, 14 : 220-224.
SPURLOCK R. G., RICHMAN A. V. Rheumatoid meningitis. Arch. Pathol. Lab. Med., 1983, 107 : 129-131.
TANAKA M., SUDA M., ISHIKAWA Y., FUJITAKE J., FUJII H. et al. Idiopathic hypertrophic cranial pachymeningitis associated with hydrocephalus and myocarditis : remarkable steroid-induced remission of hypertrophic dura mater. Neurology, 1996, 46 : 554-556.
WEINSTEIN G. W., POWELL S. R., TRUSH W. P. Chiasmal neuropathy secondary to rheumatoid pachymeningitis. Am. J. Ophtalmol., 1987, 104 : 439-440.
WEST S. G., PITTMAN D. L., COGGIN J. T. Intracranial Plasma Cell Granuloma. Cancer, 1980, 46 : 330-335.
YAMAKI T., IKEDA T., SAKAMOTO Y., OHTAKI M., HASHI K. Lymphoplasmacyte-rich meningioma with clinical resemblance to inflammatory pseudotumor. J. Neurosurg., 1997, 86 : 898-904.
