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**Infantile, p53 wildtype: Usu. desmoplastic/nodular, 10q loss. |
**SHH-p53 mutant: Usu. large cell/anaplastic, 17q loss. |
*Non WNT/Non SHH: |
**Group 3 (approx. 20%). |
***Classic and large cell/anaplastic, MYC amplification, isochromosome 17q. |
**Group 4 (approx. 40%). |
***Classic phenotype, MYCN amplification, isodicentric 17q. |
Note: Within Group 3+4 two or more of chromosome 7 gain, chromosome 8 loss, and chromosome 11 loss separates standard risk medulloblastoma samples into favorable and classifies the remaining i17q diploid cases as high-risk. |
==Prognosis== |
*Prognosis based on histology:<ref name=pmid18841049>{{cite journal |author=Gulino A, Arcella A, Giangaspero F |title=Pathological and molecular heterogeneity of medulloblastoma |journal=Curr Opin Oncol |volume=20 |issue=6 |pages=668–75 |year=2008 |month=November |pmid=18841049 |doi=10.1097/CCO.0b013e32831369f4 |url=}}... |
</ref> DNMB & MBEN > classic > anaplastic & large cell variant. |
*Prognosis based on genetics:<ref>{{Cite journal | last1 = Ramaswamy | first1 = V. | last2 = Remke | first2 = M. | last3 = Bouffet | first3 = E. | last4 = Bailey | first4 = S. | last5 = Clifford | first5 = SC. | last6 = Doz | first6 = F. | last7 = Kool | first7 = M. | last8 = Dufour | first8 = C. | last9 = Vassal | fi... |
==See also== |
*[[Neuropathology tumours]]. |
*[[Small round cell tumours]]. |
==References== |
{{Reflist|2}} |
[[Category:Neuropathology tumours]] |
[[Category:Diagnosis]] |
[[Category:Small round blue cell tumours]] |
835f5391e93315fcb5b89638c2c881aba88f63d22870e89ee8972f25a82e37cd librepath-medulloblastoma.txt |
{{ Infobox diagnosis |
| Name = {{PAGENAME}} |
| Image = Meningioma_high_mag.jpg |
| Width = |
| Caption = Meningioma. [[HPS stain]]. |
| Synonyms = |
| Micro = whorled appearance, calcification - [[psammoma bodies|psammomatous]], +/-[[nuclear pseudoinclusions]] |
| Subtypes = Grade I (meningothelial, fibrous, transistional, psammomatous, angiomatous, microcystic, secretory, lymphoplasmacyte-rich, metaplastic), Grade II (invasive, clear cell, chordoid), Grade III (papillary, rhabdoid) |
| LMDDx = [[schwannoma]], [[solitary fibrous tumour]], [[hemangiopericytoma]], others |
| Stains = |
| IHC = EMA +ve, [[keratins]] usu. -ve, CD34 -ve/+ve, S-100 -ve (usu.), PR +ve (-ve in more aggressive ones) |
| EM = |
| Molecular = |
| IF = |
| Gross = |
| Grossing = |
| Site = see ''[[CNS tumours]]'' |
| Assdx = |
| Syndromes = [[Neurofibromatosis|neurofibromatosis 2]], [[nevoid basal cell carcinoma syndrome]] |
| Clinicalhx = +/-radiation |
| Signs = |
| Symptoms = |
| Prevalence = common |
| Bloodwork = |
| Rads = extra-axial, intradural lesion, dural tail sign (on MRI) |
| Endoscopy = |
| Prognosis = usually benign, dependent on grade |
| Other = |
| ClinDDx = dependent on site - see ''[[CNS tumours]]'' |
| Tx = surgical removal |
}} |
'''Meningioma''' a very common [[CNS tumours|tumour]] in [[neuropathology]]. |
==General== |
===Prevalence=== |
*Most common primary brain tumour.<ref name=pmid25343186>{{Cite journal | last1 = Rogers | first1 = L. | last2 = Barani | first2 = I. | last3 = Chamberlain | first3 = M. | last4 = Kaley | first4 = TJ. | last5 = McDermott | first5 = M. | last6 = Raizer | first6 = J. | last7 = Schiff | first7 = D. | last8 = Weber | firs... |
*May be caused by prior radiation.<ref name=pmid25249493>{{Cite journal | last1 = Baldi | first1 = I. | last2 = Engelhardt | first2 = J. | last3 = Bonnet | first3 = C. | last4 = Bauchet | first4 = L. | last5 = Berteaud | first5 = E. | last6 = Grüber | first6 = A. | last7 = Loiseau | first7 = H. | title = Epidemiology ... |
*Women develop meningioma twice as likely as men.<ref>{{Cite journal | last1 = Wiemels | first1 = J. | last2 = Wrensch | first2 = M. | last3 = Claus | first3 = EB. | title = Epidemiology and etiology of meningioma. | journal = J Neurooncol | volume = 99 | issue = 3 | pages = 307-14 | month = Sep | year = 2010 | doi = ... |
*More than 90% are solitary. |
===Prognosis=== |
*Most are benign - usu. a good prognosis. |
**Even benign tumors may show extensive local spread - considerable morbidity and mortality. |
**Metastases are rare and then usu. after surgery. |
*May be malignant - bad prognosis. |
*Factors associated with unfavourable prognosis: |
**BAP1 mutations.<ref>{{Cite journal | last1 = Shankar | first1 = GM. | last2 = Abedalthagafi | first2 = M. | last3 = Vaubel | first3 = RA. | last4 = Merrill | first4 = PH. | last5 = Nayyar | first5 = N. | last6 = Gill | first6 = CM. | last7 = Brewster | first7 = R. | last8 = Bi | first8 = WL. | last9 = Agarwalla | fi... |
**Presence of TERT promotor mutation.<ref>{{Cite journal | last1 = Sahm | first1 = F. | last2 = Schrimpf | first2 = D. | last3 = Olar | first3 = A. | last4 = Koelsche | first4 = C. | last5 = Reuss | first5 = D. | last6 = Bissel | first6 = J. | last7 = Kratz | first7 = A. | last8 = Capper | first8 = D. | last9 = Schefz... |
**Loss of H3K27me3.<ref>{{Cite journal | last1 = Katz | first1 = LM. | last2 = Hielscher | first2 = T. | last3 = Liechty | first3 = B. | last4 = Silverman | first4 = J. | last5 = Zagzag | first5 = D. | last6 = Sen | first6 = R. | last7 = Wu | first7 = P. | last8 = Golfinos | first8 = JG. | last9 = Reuss | first9 = D. ... |
===Genetics=== |
*May be seen in genetic disorders such as: |
**[[Neurofibromatosis|Neurofibromatosis 2 (NF2)]].<Ref>URL: [http://moon.ouhsc.edu/kfung/jty1/neurotest/Q13-Ans.htm http://moon.ouhsc.edu/kfung/jty1/neurotest/Q13-Ans.htm]. Accessed on: 26 October 2010.</ref> |
**[[Nevoid basal cell carcinoma syndrome]] (Gorlin syndrome).<ref name=pmid15545745>{{Cite journal | last1 = Kimonis | first1 = VE. | last2 = Mehta | first2 = SG. | last3 = Digiovanna | first3 = JJ. | last4 = Bale | first4 = SJ. | last5 = Pastakia | first5 = B. | title = Radiological features in 82 patients with nevoi... |
===Quick overview=== |
{| class="wikitable sortable" |
! Name |
! Histologic criteria |
! Subtypes |
! Image |
|- |
| Classic, WHO I |
| less then 4 mit/10 HPF and no atypia |
| meningeothelial, fibroblastic, transitional, psammomatous, angiomatous, microcytsic, secretory, lymphoplasmacyte-rich, metaplastic |
| [[File:Miningioma_(1)_transitional_type.jpg|thumb|center|150px]] |
|- |
| Atypical, WHO II |
| brain invasion, 4 or more mit/10 HPF, or 3 of the following: necrosis, increased cellularity, high nuc:cyto ratio, nucleoli, sheeting |
| chordoid, clear cell |
| [[File:Brain_invasion_meningioma.jpg|thumb|center|150px]] |
|- |
| Anaplastic, WHO III |
| 20 or more mitoses/10 HPF, morphologiy similiar to carcinoma or sarcoma |
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