可能是恶性脑膜瘤

好好计数核分裂，标记Ki67

Yes, I believe this is a case of meningioma. Suboptimal histology suggest chordoid meningioma, but I think most of the spaces between cells are artifacts rather than true intercellular mucin-rich spaces seen in chordoid meningioma. There appears to be multifocal tumor necrosis and, at least in a few better preserved areas, prominent nucleoli. These suggest that this may not be a grade I benign meningioma. One has to search and count mitotic figures carefully in better preserved areas, and look for the other atypical features - hypercellularity, small cells with high nucleocytoplasmic ratios, patternless growth, and brain parenchymal invasion. IMC for EMA, PR and MIB-1 may be very helpful.

liguoxia译：我认为该例是脑膜瘤。组织学图片欠佳，似在提示脊索样脑膜瘤，但是细胞之间的区域多数是人工假象，而不是真正的脊索样脑膜瘤中见到的细胞间富于粘液区域。图片显示了多灶性肿瘤坏死，核仁突出（至少在几个保存好一些的区域中能见到）。这些提示不会是良性脑膜瘤。应该在保存好的区域仔细寻找计数核分裂，寻找其它非典型特征：细胞密集、核浆比高的小细胞、无序生长方式、脑实质浸润。免疫组化EMA、PR、MIB－1会有帮助。