Meningioma classification

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

Overview

Meningioma may be classified according to the 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.

Classification

  • WHO has classified meningiomas into histo- and cytomorphological variants. Nine variants correspond to WHO grade I which are the benign classic meningiomas, two correspond to WHO grade II which are atypical meningiomas, and two 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.

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.