Ultrastructural study of the formation of psammoma bodies in fibroblastic meningioma.

The fine structure of psammoma bodies was examined in four cases of fibroblastic meningioma. In general, large numbers of various-sized calcified bodies (psammoma bodies) were scattered among the interstitial fibers. In these bodies, the smallest calcific site was found in the extracellular membrane-bound matrix vesicles, which measured approximately 0.1 to 0.2 mu in diameter. In addition, extracellular "matrix giant bodies," with or without hydroxyapatite aggregates and measuring up to 3 mu in diameter, were frequently encountered. These bodies were apparently invested with single, double, or multiple concentric walls averaging nearly 0.1 mu thick. The presumably originated from the neoplastic cells as a consequence of cytoplasmic residuals associated with cellular degeneration or necrotic cell processes. Hydroxyapatite crystals precipitated repeatedly within the bodies. The precipitate may gradually aggregate within the bodies, and gather in clusters, resulting in a large psammoma body. Finally, collagen fibers around the calcified giant bodies accrued deposits of apatite crystals to make a huge psammoma body. These findings suggest that both matrix giant bodies and matrix vesicles may serve as initial nidus of calcification of psammoma bodies in fibroblastic meningioma. Consequently, this mineralization process may represent a certain dystrophic calcification of meningocytic cells.