Meningioma pathophysiology: Difference between revisions

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Brain invasion, 4 or more mitosis/10 HPF, [[necrosis]], increased cell count, high [[nucleus]]:[[cytoplasm]] ratio, increased [[nucleoli]] size, presence of sheeting  
Brain invasion, 4 or more mitosis/10 HPF, [[necrosis]], increased cell count, high [[nucleus]]:[[cytoplasm]] ratio, increased [[nucleoli]] size, presence of sheeting  
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[[File:Grade 2 menigioma.jpg|thumb|none|300px|Grade 2 menigioma.jpg]]
[[File:Grade 2 menigioma.jpg|thumb|none|300px|Grade 2 menigioma]]
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<gallery>
<gallery>
Image:Meningeotheliomatous meningeoma 1.jpg|Meningothelial meningioma with syncytial appearance and whorl formations
Image:Meningeotheliomatous meningeoma 1.jpg|A smear showing meningothelial meningioma with syncytial appearance and whorl formation
Image:Meningothelial Meningioma showing 2.jpg|Meningothelial meningioma with psammoma body  
Image:Meningothelial Meningioma showing 2.jpg|A smear showing meningothelial meningioma with [[psammoma]] body  
Image:Meningothelioal Meningioma 3.jpg|Meningothelial meningioma with onion bulb formation in smear
Image:Meningothelioal Meningioma 3.jpg|A smear showing meningothelial meningioma with onion bulb formation
Image:Meningothelial Meningioma 4.jpg|Meningothelial meningioma Meningioma HPS stain
Image:Meningothelial Meningioma 4.jpg|A smear showing meningothelial meningioma [[HPS stain]]
Image:Meningioma fibromatous variant.jpg|Fibrous meingioma with spindle cells in parallel bundles with few to none whorl formations.
Image:Meningioma fibromatous variant.jpg|A smear showing [[fibrous]] meningioma with [[spindle cell]]s in parallel bundles
Image:Meningiom fibrous variant2.JPG|Fibrous meingioma EMA staining
Image:Meningiom fibrous variant2.JPG|A smear showing fibrous meingioma on EMA stain
Image:Miningioma (2) transitional type.jpg|Transitional meingioma with lobular and fasicular growth patterns coexist
Image:Miningioma (2) transitional type.jpg|A smear showing transitional meningioma with coexisting [[lobular]] and fasicular growth patterns
Image:Psammomatous meningioma.jpg|Psammomatous meningioma with numerous psammoma bodies
Image:Psammomatous meningioma.jpg|A smear showing psammomatous meningioma with numerous psammoma bodies
Image:Angiomatous meningioma.jpg|Angiomatous meningioma with hyalinized vessels
Image:Angiomatous meningioma.jpg|A smear showing angiomatous meningioma with hyalinized vessels
Image:Microcystic meningeoma.jpg|Microcystic meningioma with cystic appearance and increased cytologic pleomorphism of the elongated cells
Image:Microcystic meningeoma.jpg|A smear showing microcystic meningioma with [[cystic]] appearance and increased [[pleomorphism]] of the elongated cells
Image:Secretory meningioma.jpg|Secretory meningioma with secretory granules
Image:Secretory meningioma.jpg|A smear showing secretory meningioma with secretory [[granule]]s
Image:Secretory meningioma PAS.jpg|Secretory meningioma with PAS-positive secretory granules
Image:Secretory meningioma PAS.jpg|A smear showing secretory meningioma with [[PAS stain]] positive secretory granules
Image:Chordoid meningoma.jpg|Chordoid meningioma with myxoid appearance.
Image:Chordoid meningoma.jpg|A smear showing chordoid meningioma with myxoid appearance
Image:Papillary meningioma.jpg|Papillary meningiomao with discohesive meningothelial tumour cells around a fibrovascular core
Image:Papillary meningioma.jpg|A smear showing [[papillary]] meningioma with discohesive meningothelial [[tumor]] cells around a fibrovascular core
Image:Rhabdoid meningioma.jpg|Rhabdoid meningiomaon with abundant cytoplasm and cross-striations
Image:Rhabdoid meningioma.jpg|A smear showing rhabdoid meningiomao with abundant [[cytoplasm]] and cross-striations
</gallery>
</gallery>



Revision as of 20:15, 24 September 2015

Meningioma Microchapters

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Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Meningioma from other Diseases

Epidemiology and Demographics

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Natural History, Complications and Prognosis

Diagnosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Haytham Allaham, M.D. [2]

Overview

Pathogenesis

Meningioma arise from arachnoidal cells, most of which are near the vicinity of the venous sinuses, and this is the site of greatest prevalence for meningioma formation. They are most frequently attached to the dura over the superior parasagittal surface of frontal and parietal lobes, along the sphenoid ridge, in the olfactory grooves, the sylvian region, superior cerebellum along the falx cerebri, cerebellopontine angle, and the spinal cord. The tumor is usually gray, well-circumscribed, and takes on the form of space it occupies. They are usually dome-shaped, with the base lying on the dura.

Meningiomas are the most common benign tumors of the brain (95% of benign tumors), rare meningioma can be malignant. It arises from the meninges which surround the brain and spinal cord. A small meningioma causes no significant signs. With the development of the lump, frequent symptoms include changes in vision, for example seeing double or blurriness, headache, hearing loss memory loss, etc. A meningioma doesn't always require immediate treatment. Treatments include surgery, radiation and a combination of them.

Histologically, the cells are relatively uniform, with a tendency to encircle one another, forming whorls and psammoma bodies (laminated calcific concretions). They have a tendency to calcify and are highly vascularized.

Genetics

Gross Pathology

Microscopic Pathology

  • On microscopic histopathological analysis, whorled appearance, calcification, and psammoma bodies are characteristic findings of of meningioma.
  • The table below differentiates between the three main groups of meningioma according to WHO histological classification:
Grade Histologic features Image

Benign (Grade I) meningioma

Less then 4 mitosis/10 HPF, no atypia

Grade 1 Meningioma

Atypical (Grade II) meningioma

Brain invasion, 4 or more mitosis/10 HPF, necrosis, increased cell count, high nucleus:cytoplasm ratio, increased nucleoli size, presence of sheeting

Grade 2 menigioma

Anaplastic (Grade III) meningioma

20 or more mitoses/10 HPF, histology similar to carcinoma or sarcoma

Grade 3 menigioma


  • Shown below is a series of microscopic images featuring specific findings seen in each subtype of meningioma:

References


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