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Pathology of meningiomas
David A Solomon1, Melike Pekmezci1
1Division of Neuropathology, Department of Pathology, University of California San Francisco, San Francisco, CA, United States.
Handbook of Clinical Neurology
|June 20, 2020
Summary
Meningiomas, tumors originating from arachnoid cap cells, are classified by histologic features and grade. Understanding these pathological features is crucial for diagnosis and prognosis.
Area of Science:
- Neuro-oncology
- Pathology
Background:
- Meningiomas are neoplasms originating from arachnoid cap cells.
- They present diverse morphologies and clinical behaviors, classified into grades I, II, or III.
Purpose of the Study:
- To discuss the pathological features of meningiomas.
- To highlight the importance of histologic variants, grading criteria, and ancillary tests.
Main Methods:
- Review of classic histologic features (whorls, psammoma bodies).
- Classification based on mitotic activity, brain invasion, and minor criteria.
- Immunohistochemical staining for vimentin, epithelial membrane antigen, Ki-67, and progesterone receptor.
Main Results:
- Meningiomas exhibit characteristic histological features.
- Grading correlates with mitotic activity and invasion.
- Vimentin and EMA positivity support dual cell nature.
- Elevated Ki-67 and loss of progesterone receptor indicate higher grade.
Conclusions:
- Pathological assessment is key for meningioma diagnosis and grading.
- Histologic variants and immunohistochemistry aid in determining prognosis.
- Accurate grading guides clinical management and predicts outcomes.
