PMC6417304_01
Chest X-ray of metastatic pulmonary meningioma
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F1
The following day, a formal CXR was performed [Figure 1], the patient was back to his baseline and the surgery was postponed.
Computed tomography chest axial image of metastatic pulmonary meningioma
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F2
A subsequent chest computed tomography (CT) was arranged and confirmed the presence of a 19-mm left upper lobe nodule and a total of five other smaller bilateral pulmonary nodules ranging from 4 to 13 mm, giving a cannonball appearance [Figures 2 and 3].
Computed tomography chest coronal image of metastatic pulmonary meningioma
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F3
A subsequent chest computed tomography (CT) was arranged and confirmed the presence of a 19-mm left upper lobe nodule and a total of five other smaller bilateral pulmonary nodules ranging from 4 to 13 mm, giving a cannonball appearance [Figures 2 and 3].
Hematoxylin and eosin stain - Atypical meningioma invading the brain
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F4
Histopathology again showed features consistent with atypical WHO Grade II meningioma [Figure 4]; however, although it did not fulfill criteria for anaplastic WHO Grade III meningioma, the higher Ki-67 proliferation index suggested that it may behave more aggressively than the conventional WHO Grade II meningioma.
Hematoxylin and eosin stain - Metastatic pulmonary meningioma
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F5
This confirmed histopathological features consistent with metastatic meningioma [Figure 5].