Meningioma classification: Difference between revisions

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Revision as of 17:59, 20 June 2019

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

Overview

Meningioma has been classified into 3 groups by the WHO: benign classic meningioma (WHO grade 1), atypical meningioma (WHO grade 2), and anaplastic malignant meningioma (WHO grade 3). The WHO grade 1 group grow very slowly and consists of about 9 variants. About 3 variants correspond to WHO grade II, their association with malignancy isn't clear but they grow faster than benign meningiomas. About 2 variants correspond to WHO grade III.

Classification

WHO has classified meningiomas into histo- and cytomorphological variants. Nine variants correspond to WHO grade I which are the benign classic meningiomas, three correspond to WHO grade II which are atypical meningiomas, and three in WHO grade III and are anaplastic malignant meningiomas.^[1]

The table below lists the subtypes of meningioma according to the WHO grades:^[1]^[2]


WHO grade	Subtypes

Benign classic meningioma (WHO grade 1)	Meningothelial, fibrous, transitional, psammomatous, angiomatous, micrcystic, secretory, lymphoplasmacyte-rich, and metaplastic meningioma They are low-grade tumors that grow very slowly and rarely invade the surrounding tissues
Atypical meningioma (WHO grade 2)	Chordoid, clear cell, and atypical meningioma. These are not clearly malignant, but grow faster than benign meningiomas 4 or more mitotic cells per hpf and/or 3 or more of the following features: small cells, increased cellularity, necrosis, prominent nucleoli, sheeting, &/or brain invasion in an otherwise Grade I tumor
Anaplastic malignant meningioma (WHO grade 3)	Rhabdoid, papillary, and anaplastic meningioma 20 or more mitoses per 10 hpf and/or possess cytological characteristics of an obvious malignancy such that the tumor cell resembles carcinoma, sarcoma, or melanoma.

Gallery

Histology showing meningothelial meningioma source:Case courtesy of Dr Victor Yang, <a href="https://radiopaedia.org/">Radiopaedia.org</a>.

Histology showing psammomatous meningioma source:Case courtesy of A.Prof Frank Gaillard, <a href="https://radiopaedia.org/">Radiopaedia.org</a>.

Histology slide showing papillary meningiomasource:Jensflorian-wikimedia commons

Alcian blue histology slide showing chordoid meningioma source:Jensflorian-wikimedia commons

References

↑ ^1.0 ^1.1 Harter, Patrick N.; Braun, Yannick; Plate, Karl H. (2017). "Classification of meningiomas—advances and controversies". Chinese Clinical Oncology. 6 (S1): S2–S2. doi:10.21037/cco.2017.05.02. ISSN 2304-3865.
↑ Commins, Deborah L.; Atkinson, Roscoe D.; Burnett, Margaret E. (2007). "Review of meningioma histopathology". Neurosurgical Focus. 23 (4): E3. doi:10.3171/FOC-07/10/E3. ISSN 1092-0684.

[HarterBraun2017-1] 1.0 ^1.1 Harter, Patrick N.; Braun, Yannick; Plate, Karl H. (2017). "Classification of meningiomas—advances and controversies". Chinese Clinical Oncology. 6 (S1): S2–S2. doi:10.21037/cco.2017.05.02. ISSN 2304-3865.

[ComminsAtkinson2007-2] Commins, Deborah L.; Atkinson, Roscoe D.; Burnett, Margaret E. (2007). "Review of meningioma histopathology". Neurosurgical Focus. 23 (4): E3. doi:10.3171/FOC-07/10/E3. ISSN 1092-0684.

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@@ Line 7: / Line 7: @@
 ==Classification==
-*WHO has classified meningiomas into histo- and cytomorphological variants. Nine variants correspond to WHO grade I which are the [[benign]] classic meningiomas, three correspond to WHO grade II which are atypical meningiomas, and two in WHO grade III and are [[anaplastic]] [[malignant]] meningiomas.<ref name="HarterBraun2017">{{cite journal|last1=Harter|first1=Patrick N.|last2=Braun|first2=Yannick |last3=Plate|first3=Karl H. |title=Classification of meningiomas—advances and controversies|journal=Chinese Clinical Oncology|volume=6|issue=S1|year=2017|pages=S2–S2|issn=23043865|doi=10.21037/cco.2017.05.02}}</ref>
+*WHO has classified meningiomas into histo- and cytomorphological variants. Nine variants correspond to WHO grade I which are the [[benign]] classic meningiomas, three correspond to WHO grade II which are atypical meningiomas, and three in WHO grade III and are [[anaplastic]] [[malignant]] meningiomas.<ref name="HarterBraun2017">{{cite journal|last1=Harter|first1=Patrick N.|last2=Braun|first2=Yannick |last3=Plate|first3=Karl H. |title=Classification of meningiomas—advances and controversies|journal=Chinese Clinical Oncology|volume=6|issue=S1|year=2017|pages=S2–S2|issn=23043865|doi=10.21037/cco.2017.05.02}}</ref>
 *The table below lists the subtypes of meningioma according to the WHO grades:<ref name="HarterBraun2017">{{cite journal|last1=Harter|first1=Patrick N.|last2=Braun|first2=Yannick |last3=Plate|first3=Karl H. |title=Classification of meningiomas—advances and controversies|journal=Chinese Clinical Oncology|volume=6|issue=S1|year=2017|pages=S2–S2|issn=23043865|doi=10.21037/cco.2017.05.02}}</ref><ref name="ComminsAtkinson2007">{{cite journal|last1=Commins|first1=Deborah L.|last2=Atkinson|first2=Roscoe D.|last3=Burnett|first3=Margaret E.|title=Review of meningioma histopathology|journal=Neurosurgical Focus|volume=23|issue=4|year=2007|pages=E3|issn=1092-0684|doi=10.3171/FOC-07/10/E3}}</ref>