IJCEM Copyright © 2008-All rights reserved. Published by e-Century Publishing Corporation, Madison, WI 53711
Int J Clin Exp Med 2013;6(7):504-515

Original Article
Lymphoplasmacyte-rich meningioma: our experience with 19 cases and a
systematic literature review

Hong-Da Zhu, Qing Xie, Ye Gong, Ying Mao, Ping Zhong, Feng-Ping Hang, Hong Chen, Ming-Zhe Zheng, Hai-Liang Tang, Dai-Jun
Wang, Xian-Cheng Chen, Liang-Fu Zhou

Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China; Department of
Neuropathology, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China. Equal contributors.

Received June 12, 2013; Accepted July 15, 2013; Epub August 1, 2013; Published August 15, 2013

Abstract: Objective: To investigate the clinicopathological characteristics, prognosis, pathology, and differential diagnosis of LPM by
analyzing our experience and reviewed relevant literature. We also postulated the necessity of postoperative adjuvant therapy. Methods:
19 patients with LPM underwent surgical treatment from 2007 through 2010 in our department. The clinical charts of the patients,
including surgical, histological, and follow-up records, as well as imaging studies, were analyzed retrospectively. Other 43 cases
searched from the literature were also included, so that 62 LPM cases were summarized and reviewed together. Results: The
summarized 62 patients comprised 30 males and 31 females aged 9 years to 79 years (40.7±18.3 years). The most common
locations were convexity, skull base, para-sagittal and cervical canal. Multiple or diffuse lesions were found in 8 cases. There were 13
patients had peripheral blood abnormalities (21%). One-third of the cases had moderate to severe peritumoral brain edema.
Thirty-eight patients had total resection, 12 patients not specified while 12 received subtotal resection or only biopsy. MIB-1 was
available in 24 cases and a third of them were higher than 3%. Follow-up more than 3 year was only completed in 19/62 cases. Seven
cases suffered recurrence and two of them died after 2 years of operation. Conclusion: LPM is a very rare benign variant of intracranial
meningioma. Both lesions and hematological abnormalities have a predilection for younger individuals. Preoperative diagnosis of this
subtype of meningioma is still difficult. Surgical resection is the primary treatment option, and supportive care for those not totally
removed is very important, because the recurrence rate for this subtype is rather low. However, the massive infiltration of lymphocytes
and plasma cells in LPMs are still controversial and the long-term follow-ups are needed. Radiotherapy is not recommended, and
hormonal or immune-inhibitor therapy might be helpful. (IJCEM1306008).

Keywords: Diagnosis, differential diagnosis, edema, lymphoplasmacyte-rich meningioma, prognosis

Address correspondence to: Dr. Ye Gong, Depart-ment of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan
University, Shanghai, China. Phone: (+86) 021-52888682; Fax: (+86) 021-62490665; E-mail: meningioma@yahoo.cn