Meningioma

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Author: Mikael Häggström [note 1]

Gross processing

Further information: Brain/meningeal tumor

Microscopic evaluation

Histopathology of a typical WHO grade 1 meningioma, H&E stain. It is of the meningothelial histologic type, which is the most common meningioma type. It shows its typical findings:
- A woven architectural pattern
- Psammoma bodies (spheroid calcifications)
- Syncytial cells (having indistinct cell membranes) with eosinophilic (pink) cytoplasms
- Round uniform nuclei
- Whorls (concentric cell arrangements)[1]

Look for the signs of both typical meningioma and main histological variants. On frozen sections, mention the presence of atypia/high-grade cells.

On permanent sections, classify by WHO grade:

Meningioma grades[4]
WHO Grade I WHO Grade II WHO Grade III
Benign Atypical Malignant
  • Meningiothelial
  • Fibrous (fibroblastic)
  • Transitional (mixed)
  • Psammomatous
  • Angiomatous
  • Microcystic
  • Secretory
  • Lymphoplasmacyte-rich
  • Metaplastic
  • Chordoid
  • Clear Cell
  • Atypical
  • Papillary
  • Rhabdoid
  • Anaplastic

Reporting

Example frozen section report:

A. Right frontal tumor:
-Meningioma. Negative for atypia.

Example permanent section report:

A. Right frontal tumor:
-Meningioma, WHO grade 1.

Notes

  1. For a full list of contributors, see article history. Creators of images are attributed at the image description pages, seen by clicking on the images. See Patholines:Authorship for details.

Main page

References

  1. Image by Mikael Häggström, MD. Reference for typical findings: Chunyu Cai, M.D., Ph.D.. Meningioma. Pathology Outlines. Last author update: 10 November 2021}}
  2. Brabec J, Friedjungová M, Vašata D, Englund E, Bengzon J, Knutsson L (2023). "Meningioma microstructure assessed by diffusion MRI: An investigation of the source of mean diffusivity and fractional anisotropy by quantitative histology. ". Neuroimage Clin 37: 103365. doi:10.1016/j.nicl.2023.103365. PMID 36898293. PMC: 10020119. Archived from the original. . 
    - "This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/)"
  3. Wu C, Zhong J, Lin L, Chen Y, Xue Y, Shi P (2022). "Segmentation of HE-stained meningioma pathological images based on pseudo-labels. ". PLoS One 17 (2): e0263006. doi:10.1371/journal.pone.0263006. PMID 35120175. PMC: 8815980. Archived from the original. . 
    - Creative Commons Attribution 4.0 International license
  4. Jeffrey I. Traylor, MD and John S. Kuo, MD, PhD, FAANS.. Meningiomas. American Association of Neurological Surgeons. Retrieved on 2024-01-11.

Image sources