A 60-year-old man undergoes resection of a convexity dural-based mass. Histology shows spindle cells arranged in whorls with concentric lamellated calcifications. Immunohistochemistry is positive for EMA. The most likely diagnosis is:
- A Schwannoma
- B Meningioma ✓
- C Solitary fibrous tumor
- D Hemangiopericytoma
Correct answer: B. Meningioma
Explanation
Meningioma arises from arachnoid meningothelial cells, is attached to the dura, and shows whorled nests of spindle cells with psammoma bodies (lamellated calcifications). EMA positivity supports meningothelial differentiation. NF2 mutations are common. Schwannoma is S100 positive and lacks whorls, solitary fibrous tumor shows staghorn vessels with STAT6 positivity, and hemangiopericytoma is now classified within solitary fibrous tumor in the WHO 2021 scheme.
Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.