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*Usu. spinal cord.<ref>{{Ref PSNP|200}}</ref>
Microscopic:
*Clear cells - contain glycogen (PAS +ve).
<gallery>
File:HE_clear_cell_meningioma.jpg | Clear cell meningioma, HE (WC/jensflorian)
</gallery>
Molecular:
*SMARCE1 mutations.<ref>{{Cite journal | last1 = Smith | first1 = MJ. | last2 = Wallace | first2 = AJ. | last3 = Bennett | first3 = C. | last4 = Hasselblatt | first4 = M. | last5 = Elert-Dobkowska | first5 = E. | last6 = Evans | first6 = LT. | last7 = Hickey | first7 = WF. | last8 = van Hoff | first8 = J. | last9 = Ba...
Images:
*[http://www.surgicalpathologyatlas.com/glfusion/mediagallery/media.php?f=0&sort=0&s=20080802174938386 Clear cell meningioma (surgicalpathologyatlas.com)].
*[http://blog.lib.umn.edu/santa013/neuropathology/2009/10/meningioma-with-clear-cell-features.html Clear cell meningioma (umn.edu)].
=====Chordoid meningioma=====
*Chordoma-like.
Microscopic:
*[[Myxoid]] appearance.
<gallery>
File:Chordoid meningoma HE x200.jpg | Chordoid meningioma - HE (WC/jensflorian)
File:Alcian blue chordoid meningioma.jpg | Chordoid meningioma - alcian blue (WC/jensflorian)
</gallery>
Image:
*[http://frontalcortex.com/?page=oll&topic=24&qid=914 Chordoid meningioma (frontalcortex.com)].
====Grade III====
=====Papillary meningioma=====
Microscopic:
*discohesive meningothelial tumour cells around a fibrovascular core.
*perivascular pseudorosettes.
<gallery>
File:Papillary meningioma HE.jpg | Papillary meningioma (WC/jensflorian)
File:Pap meningioma.jpg | Papillary meningioma (WC)
</gallery>
=====Rhabdoid meningioma=====
Microscopic:
*Rhabdoid appearance (abundant cytoplasm).
**Cross-striations.
<gallery>
Image:Rhabdoid Meningioma Histopathology.jpg | Rhabdoid meningioma. (WC/Marvin 101)
File:Rhabdoid meningioma frozen section HE.jpg | Frozen section (WC/jensflorian)
</gallery>
www:
*[http://path.upmc.edu/cases/case373.html Rhabdoid meningioma - case 1 - several images (upmc.edu)].
*[http://path.upmc.edu/cases/case393.html Rhabdoid meningioma - case 2 - several images (upmc.edu)].
====Other morphological variants====
These are currently not listed in the WHO as separate entities.
*Oncocytic.<ref>{{Cite journal | last1 = Zunarelli | first1 = E. | last2 = Tallarico | first2 = E. | last3 = Valentini | first3 = A. | last4 = Maiorana | first4 = A. | title = Oncocytic meningioma: study of eight new cases and analysis of 13 reported cases. | journal = Pathology | volume = 42 | issue = 6 | pages = 587...
*Whorling-sclerosing.<ref>{{Cite journal | last1 = Haberler | first1 = C. | last2 = Jarius | first2 = C. | last3 = Lang | first3 = S. | last4 = Rössler | first4 = K. | last5 = Gruber | first5 = A. | last6 = Hainfellner | first6 = JA. | last7 = Budka | first7 = H. | title = Fibrous meningeal tumours with extensive non-...
*Rosette-forming.<ref>{{Cite journal | last1 = Liverman | first1 = C. | last2 = Mafra | first2 = M. | last3 = Chuang | first3 = SS. | last4 = Shivane | first4 = A. | last5 = Chakrabarty | first5 = A. | last6 = Highley | first6 = R. | last7 = Hilton | first7 = DA. | last8 = Byrne | first8 = NP. | last9 = Wesseling | fi...
<gallery>
File:Meningioma_Whorling_sclerosing.jpg | Whorling-sclerosing features in meningioma (HE/jensflorian)
File:Meningioma_pseudorosettes.jpg | Meningioma with rosette-forming features (HE/jensflorian)
</gallery>
===Histologic grading===
Grading:<ref name=Ref_PSNP194>{{Ref PSNP|194}}</ref>
*Grade 1:
**Low mitotic rate (< 4 mitoses/10 HPF - for whatever HPF means, see [[HPFitis]]).
**Excludes ''clear cell'', ''chordoid'', ''papillary'', and ''rhabdoid'' subtypes.
*Grade 2 (either #1, #2 or #3):
*#Brain-invasive meningioma.
*#*Invasion of meningioma into brain.
*#**Meninogioma with entraped GFAP +ve tissue.
*#Atypical meningioma (by histomorphology) - either ''A'' or ''B''.
*#* A. Intermediate mitotic rate (>= 4 mitoses/10 HPF - for whatever ''HPF'' means, see [[HPFitis]].)
*#* B. Three of the following five features:
*#*#Sheeting architecture.
*#*#High [[NC ratio]] clusters; clusters of "lymphocyte-like" cells.
*#*#Hypercellularity.
*#*#Macronucleoli.
*#*#[[Necrosis]] not caused by treatment, e.g. radiation or embolization.
*#''Clear cell'' or ''chordoid'' subtype.
*Grade 3 (either of the following):
**High mitotic rate (>=20 mitoses/10 HPF - for whatever ''HPF'' means, see [[HPFitis]].)
**"Frank anaplasia"; marked nuclear atypia.
**''Papillary'' or ''rhabdoid'' subtype.
Notes:
*Grade II soft criteria memory device ''HMNs'': hypercellular, macronucleoli, NC ratio increased, necrosis, sheeting.
==IHC==
*EMA +ve (approx. 90%).<ref name=Ref_PSNP13>{{Ref PSNP|13}}</ref>
*PR +ve (approx. 75%, expression decreases from grade I to III).
*SSTR2A +ve (approx. 95%).
*S100 variable (up to 35% cases, usually patchy).<ref>{{cite journal |vauthors=Behling F, Fodi C, Skardelly M, Paulsen F, Tabatabai G, Honegger J, Tatagiba M, Schittenhelm J |title=The prognostic role of the immunohistochemical expression of S100 in meningiomas |journal=J Cancer Res Clin Oncol |volume= |issue= |pages= ...
*SOX10 -ve.
*GFAP -ve.
*CD34 usu. -ve (approx 8% cases positive).