510028
research-article2013
IJSXXX10.1177/1066896913510028International Journal of Surgical PathologyStueck and Easton
Images in Pathology
Hematoidin (Crystallized Bilirubin) Crystals in an Atypical Meningioma
International Journal of Surgical Pathology 2014, Vol. 22(1) 68–69 © The Author(s) 2013 Reprints and permissions: sagepub.com/journalsPermissions.nav DOI: 10.1177/1066896913510028 ijs.sagepub.com
Ashley E. Stueck, MD1,2 and Alexander S. Easton, MBBS, PhD, FRCP(C)1,2
Figure 1. A, Coronal T1-weighted magnetic resonance image of the dural-based neoplasm. B and C, Golden starburst crystalline forms near hemorrhage (hematoxylin and eosin; B, 5×; C, 400×). D, Electron micrograph showing amorphous central region with radiating rhomboid crystals at periphery.
Hematoidin, first described by Virchow, results from histiocytic breakdown of extravasated red blood cells into hemosiderin, which is converted to biliverdin, then reduced to iron free crystallized bilirubin, or hematoidin, in a hypoxic environment.1-4 Crystalline structures, typically sunburst or rhomboid, may be found extracellularly or intracellularly.2,4,5 An 82-year-old male presented with a slowly growing mass on the vertex of the head. Neuroimaging demonstrated a dural-based lesion, with lytic bone destruction of the skull and extension into the scalp (Figure 1A). Histology
showed an atypical meningioma. In the subcutaneous tumor, adjacent to hemorrhage, there were intrahistiocytic and extracellular golden crystalline structures in starburst 1
Dalhousie University, Halifax, Nova Scotia, Canada Queen Elizabeth II Health Sciences Centre, Halifax, Nova Scotia, Canada 2
Corresponding Author: Ashley E. Stueck, Division of Anatomical Pathology, Queen Elizabeth II Health Sciences Centre, Dr D. J. Mackenzie Building, 747-5788 University Avenue, Halifax, Nova Scotia, Canada B3H 2Y9. Email: [email protected]
Stueck and Easton configurations (Figures 1B and C). Electron microscopy demonstrated amorphous central regions with rhomboidtype crystals radially arranged at the margins (Figure 1D). In the brain, hematoidin has been reported in traumatic injury and hemorrhage.3 To our knowledge, our report is the first description of hematoidin in a central nervous system neoplasm. The superficial location and predisposition to repeated, minor trauma likely resulted in the prerequisites for hematoidin formation. References 1. Virchow R. Die pathologischen pigmente. Virchows Arch. 1847;1:379-404.
69 2. Brenner DS, Drachenberg CB, Papadimitriou JC. Structural similarities between hematoidin crystals and asteroid bodies: evidence of lipid composition. Exp Mol Pathol. 2001;70: 37-42. 3. Strassmann G. Formation of hemosiderin and hematoidin after traumatic and spontaneous cerebral hemorrhages. Arch Pathol (Chic). 1949;47:205-210. 4. Tate GA, Schumacher HR, Reginato AJ, Algeo SB, Gratwick GM, Di Battista WT. Synovial fluid crystals derived from erythrocyte degradation products. J Rheumatol. 1992;19:1111-1114. 5. Capaldo G, LeGolvan DP, Dramczyk JE. Hematoidin crystals in cervicovaginal smears: review of 27 cases seen in one year. Acta Cytol. 1983;27:237-240.
Copyright of International Journal of Surgical Pathology is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.
research-article2013
IJSXXX10.1177/1066896913510028International Journal of Surgical PathologyStueck and Easton
Images in Pathology
Hematoidin (Crystallized Bilirubin) Crystals in an Atypical Meningioma
International Journal of Surgical Pathology 2014, Vol. 22(1) 68–69 © The Author(s) 2013 Reprints and permissions: sagepub.com/journalsPermissions.nav DOI: 10.1177/1066896913510028 ijs.sagepub.com
Ashley E. Stueck, MD1,2 and Alexander S. Easton, MBBS, PhD, FRCP(C)1,2
Figure 1. A, Coronal T1-weighted magnetic resonance image of the dural-based neoplasm. B and C, Golden starburst crystalline forms near hemorrhage (hematoxylin and eosin; B, 5×; C, 400×). D, Electron micrograph showing amorphous central region with radiating rhomboid crystals at periphery.
Hematoidin, first described by Virchow, results from histiocytic breakdown of extravasated red blood cells into hemosiderin, which is converted to biliverdin, then reduced to iron free crystallized bilirubin, or hematoidin, in a hypoxic environment.1-4 Crystalline structures, typically sunburst or rhomboid, may be found extracellularly or intracellularly.2,4,5 An 82-year-old male presented with a slowly growing mass on the vertex of the head. Neuroimaging demonstrated a dural-based lesion, with lytic bone destruction of the skull and extension into the scalp (Figure 1A). Histology
showed an atypical meningioma. In the subcutaneous tumor, adjacent to hemorrhage, there were intrahistiocytic and extracellular golden crystalline structures in starburst 1
Dalhousie University, Halifax, Nova Scotia, Canada Queen Elizabeth II Health Sciences Centre, Halifax, Nova Scotia, Canada 2
Corresponding Author: Ashley E. Stueck, Division of Anatomical Pathology, Queen Elizabeth II Health Sciences Centre, Dr D. J. Mackenzie Building, 747-5788 University Avenue, Halifax, Nova Scotia, Canada B3H 2Y9. Email: [email protected]
Stueck and Easton configurations (Figures 1B and C). Electron microscopy demonstrated amorphous central regions with rhomboidtype crystals radially arranged at the margins (Figure 1D). In the brain, hematoidin has been reported in traumatic injury and hemorrhage.3 To our knowledge, our report is the first description of hematoidin in a central nervous system neoplasm. The superficial location and predisposition to repeated, minor trauma likely resulted in the prerequisites for hematoidin formation. References 1. Virchow R. Die pathologischen pigmente. Virchows Arch. 1847;1:379-404.
69 2. Brenner DS, Drachenberg CB, Papadimitriou JC. Structural similarities between hematoidin crystals and asteroid bodies: evidence of lipid composition. Exp Mol Pathol. 2001;70: 37-42. 3. Strassmann G. Formation of hemosiderin and hematoidin after traumatic and spontaneous cerebral hemorrhages. Arch Pathol (Chic). 1949;47:205-210. 4. Tate GA, Schumacher HR, Reginato AJ, Algeo SB, Gratwick GM, Di Battista WT. Synovial fluid crystals derived from erythrocyte degradation products. J Rheumatol. 1992;19:1111-1114. 5. Capaldo G, LeGolvan DP, Dramczyk JE. Hematoidin crystals in cervicovaginal smears: review of 27 cases seen in one year. Acta Cytol. 1983;27:237-240.
Copyright of International Journal of Surgical Pathology is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.
