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{{Meningioma}}
{{Meningioma}}
{{CMG}} {{AE}}{{HL}}
{{CMG}} {{AE}} {{IO}} {{HL}}


==Overview==
==Overview==
Meningioma may be classified according to histological criteria of the WHO into 3 groups: benign classic meningioma (WHO grade 1), atypical meningioma (WHO grade 2), and anaplastic malignant meningioma (WHO grade 3). Meningioma may also be classified according to the tumor location into 2 main subtypes: intradural and extradural meningioma.
Meningioma has been [[Classification|classified]] into 3 groups by the [[World Health Organization|WHO]]: [[benign]] classic meningioma ([[WHO]] grade 1), atypical meningioma ([[World Health Organization|WHO]] grade 2), and [[anaplastic]] [[malignant]] meningioma ([[World Health Organization|WHO]] grade 3). The [[World Health Organization|WHO]] grade 1 group grow very slowly and consists of about 9 variants. About 3 variants correspond to [[World Health Organization|WHO]] grade II, their association with [[Cancer|malignancy]] is not clear but they grow faster than [[benign]] meningiomas. About 2 variants correspond to [[World Health Organization|WHO]] grade III.


==Classification==
==Classification==
*Meningioma may be classified according to WHO histological criteria into 3 groups: benign classic meningioma (WHO grade 1), atypical meningioma (WHO grade 2), and anaplastic malignant meningioma (WHO grade 3).
*[[World Health Organization|WHO]] has [[Classification|classified]] meningiomas into [[Histology|histological]] and cytomorphological variants. Nine variants correspond to [[World Health Organization|WHO]] grade I which are the [[benign]] classic meningiomas, three correspond to [[World Health Organization|WHO]] grade II which are atypical meningiomas, and three in [[World Health Organization|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 grade:
*The table below lists the subtypes of meningioma according to the [[World Health Organization|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>
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! style="background: #4479BA; width: 200px;" | {{fontcolor|#FFF|WHO grade }}
! style="background: #4479BA; width: 200px;" | {{fontcolor|#FFF|WHO Grade }}
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Benign classic meningioma<br> (WHO grade 1)
Benign classic meningioma<br> (WHO grade 1)
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Meningeothelial, fibroblastic, transitional, psammomatous,<br> angiomatous, microcytsic, secretory, lymphoplasmacyte-rich, metaplastic
*Meningothelial, fibrous, [[transitional]], psammomatous,<br> angiomatous, micrcystic, secretory, lymphoplasmacyte-rich, and metaplastic meningioma
*They are low-grade [[Tumor|tumors]] that grow very slowly and rarely invade the surrounding [[tissues]]
|-
|-
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |
Atypical meningioma<br> (WHO grade 2)
Atypical meningioma<br> (WHO grade 2)
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Chordoid, clear cell
*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]]
|-
|-
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Anaplastic malignant meningioma<br> (WHO grade 3)
Anaplastic malignant meningioma<br> (WHO grade 3)
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
Rhabdoid, papillary
*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]].
|}
|}


*Meningioma may also be classified according to the tumor location into 2 main subtypes: intradural and extradural meningioma.
==Gallery==
[[File:Meningioma-histopathology-1.jpg|400px|thumb|left|Meningothelial meningioma [https://radiopaedia.org/articles/meningioma?lang=us Source: Case courtesy of Dr Victor Yang, <a href="https://radiopaedia.org/">Radiopaedia.org</a>.]]]
<br style="clear:left" />
[[File:Psammomatous meningioma histopathology.jpg|400px|thumb|left|Psammomatous meningioma [https://radiopaedia.org/articles/meningioma?lang=us Source: Case courtesy of A.Prof Frank Gaillard, <a href="https://radiopaedia.org/">Radiopaedia.org</a>.]]]
<br style="clear:left" />
[[File:Papillary meningioma HE.jpg|400px|thumb|left|Papillary meningioma [https://commons.wikimedia.org/wiki/File:Papillary_meningioma_HE.jpg Source: Jensflorian-wikimedia commons]]]
<br style="clear:left" />
[[File:Chordoid meningioma.jpg|400px|thumb|left|Alcian blue histologic slide showing chordoid meningioma [https://commons.wikimedia.org/wiki/File:Alcian_blue_chordoid_meningioma.jpg Source: Jensflorian-wikimedia commons]]]
<br style="clear:left" />


==References==
==References==


{{Reflist|2}}
{{Reflist|2}}


[[Category:Disease]]
[[Category:Disease]]
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[[Category:Neurosurgery]]
[[Category:Neurosurgery]]
[[Category:Neurology]]
[[Category:Neurology]]
[[Category:Up-To-Date]]
[[Category:Oncology]]
[[Category:Medicine]]
[[Category:Neurology]]
[[Category:Neurosurgery]]

Latest revision as of 20:51, 19 September 2019

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Ifeoma Odukwe, M.D. [2] Haytham Allaham, M.D. [3]

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 is not clear but they grow faster than benign meningiomas. About 2 variants correspond to WHO grade III.

Classification

  • 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

Meningothelial meningioma Source: Case courtesy of Dr Victor Yang, <a href="https://radiopaedia.org/">Radiopaedia.org</a>.


Psammomatous meningioma Source: Case courtesy of A.Prof Frank Gaillard, <a href="https://radiopaedia.org/">Radiopaedia.org</a>.


Papillary meningioma Source: Jensflorian-wikimedia commons


Alcian blue histologic slide showing chordoid meningioma Source: Jensflorian-wikimedia commons


References

  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.
  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.