PMC4168745_01
MRI and CT scanning of the original meninigioma intra-cerebral and at distance metastasis intra-pleural.. 
A: T1 weighted image after administration of Gadolinium based contrast fluid shows a large extra-axial enhancing lesion in the left parieto-occipital region with local mass effect. Note that the sagittal sinus seems to be invaded.
B: Contrast enhanced T1 weighted image after administration of Gadolinium based contrast fluid showing a large resection cavity after the second operation and recurrent disease at the most upper margin of the resection plane with enhancing areas surrounding the sagittal sinus.
C: Midthoracal CT slice in the transverse plane. Scan performed after i.v. administration of iodine contrast. The lesion is easily distinguished at the left ventral thoracal intrapleural space, slightly enhanced suggesting solid tissue. Some pleural fluid is also present.
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One year later an asymptomatic re-recurrence was diagnosed ( Figure 1A and B), for which conservative follow-up was performed without further surgical intervention.
Histology staining of a biopsy of the solid intrathoracal lesion showing the same morphology as the intracranial meningioma.. 
A: A specimen (HE-stained, 40x) showing histological resemblance between the intrathoracal lesion and the intracranial meningioma.
B: Specimen (focal plus and focal weak) showed high expression in the EMA-staining and also in the AE1/AE3-staining.
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Histopathology was consistent with malignant meningioma (WHO grade-III, Figure 2A), there was a high expression in the EMA staining, also in the AE1/AE3 staining ( Figure 2B).