Meningioma pathophysiology: Difference between revisions

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Revision as of 18:22, 24 September 2015

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 multiple myeloma according to WHO histological classification:


Grade	Histologic criteria	Image

Benign (Grade I) meningioma	Less then 4 mit/10 HPF and no atypia	Grade 1 Meningioma
Atypical (Grade II) meningioma	Brain invasion, 4 or more mit/10 HPF, necrosis, increased cellularity, high nucleus:cytoplasm ratio, nucleoli, sheeting	Grade 2 menigioma.jpg
Anaplastic (Grade III) meningioma	20 or more mitoses/10 HPF, morphology 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:

Meningothelial meningioma syncytial appearance and whorl formations
Meningothelial meningioma psammoma body
Meningothelial meningioma onion bulb formation in smear
Meningothelial meningioma Meningioma HPS stain

References

Template:WikiDoc Sources

@@ Line 1: / Line 1: @@
 __NOTOC__
 {{Meningioma}}
-{{CMG}}
+{{CMG}} {{AE}}{{HL}}
 ==Overview==
-==Pathophysiology==
-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.
+==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.
-Histologically, the cells are relatively uniform, with a tendency to encircle one another, forming whorls and [[psammoma body|psammoma bodies]] (laminated calcific concretions). They have a tendency to calcify and are highly vascularized.
+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==
+<gallery>
+</gallery>
+==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 multiple myeloma according to WHO histological classification:
+{| style="border: 0px; font-size: 90%; margin: 3px; width: 800px"
+|valign=top|
+|+
+! style="background: #4479BA; width: 200px;" | {{fontcolor|#FFF|Grade  }}
+! style="background: #4479BA; width: 400px;" | {{fontcolor|#FFF|Histologic criteria}}
+! style="background: #4479BA; width: 150px;" | {{fontcolor|#FFF|Image}}
+|-
+| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |
+'''Benign (Grade I) meningioma'''
+| style="padding: 5px 5px; background: #F5F5F5;" |
+Less then 4 mit/10 HPF and no atypia
+| style="padding: 5px 5px; background: #F5F5F5;" |
+[[File:Grade 1 Meningioma.jpg|thumb|none|500px|Grade 1 Meningioma]]
+|-
+| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |
+'''Atypical (Grade II) meningioma'''
+| style="padding: 5px 5px; background: #F5F5F5;" |
+Brain invasion, 4  or more mit/10 HPF, necrosis, increased cellularity, high nucleus:cytoplasm ratio, nucleoli, sheeting
+| style="padding: 5px 5px; background: #F5F5F5;" |
+[[File:Grade 2 menigioma.jpg|thumb|none|500px|Grade 2 menigioma.jpg]]
+|-
+| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |
+'''Anaplastic (Grade III) meningioma'''
+| style="padding: 5px 5px; background: #F5F5F5;" |
+or more mitoses/10 HPF, morphology similar to carcinoma or sarcoma
+| style="padding: 5px 5px; background: #F5F5F5;" |
+[[File:Grade 3 menigioma.jpg|thumb|none|500px|Grade 3 menigioma]]
+|}
+*Shown below is a series of microscopic images featuring specific findings seen in each subtype of meningioma:
+<gallery>
+Image:Meningeotheliomatous meningeoma 1.jpg|Meningothelial meningioma syncytial appearance and whorl formations
+Image:Meningothelial Meningioma showing 2.jpg|Meningothelial meningioma psammoma body
+Image:Meningothelioal Meningioma 3.jpg|Meningothelial meningioma onion bulb formation in smear
+Image:Meningothelial Meningioma 4.jpg|Meningothelial meningioma Meningioma HPS stain
+</gallery>
 ==References==