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*CD13 +ve.<ref>{{cite journal |vauthors=Marletta S, Luchini C, Sperandio N, Torresani E, Sorio A, Girolami I, Scarpa A, Eccher A, Ghimenton C |title=CD13 is a useful tool in the differential diagnosis of meningiomas with potential biological and prognostic implications |journal=Virchows Arch |volume=480 |issue=6 |pages... |
*Other CKs usually -ve (approx 6% cases positive, mostly secretory meningiomas). |
==Molecular== |
Non-syndromal meningiomas may show AKT1/TRAF7, SMO, KLF4/TRAF7, and PIK3CA mutations (1/3 of cases).<ref>{{Cite journal | last1 = Clark | first1 = VE. | last2 = Erson-Omay | first2 = EZ. | last3 = Serin | first3 = A. | last4 = Yin | first4 = J. | last5 = Cotney | first5 = J. | last6 = Ozduman | first6 = K. | last7 = A... |
*AKT/TRAF7 mutations are usually basal and associated with meningothelial histology. |
*KLF4/TRAF7 mutations are highly specific for secretory histology. |
*TRAF7 mutations are the first step and occur thorughout the WD40 domain. <ref>{{cite journal |vauthors=Dogan H, Blume C, Patel A, Jungwirth G, Sogerer L, Ratliff M, Ketter R, Herold-Mende C, Jones DTW, Wick W, Vollmuth P, Zweckberger K, Reuss D, von Deimling A, Sahm F |title=Single-cell DNA sequencing reveals order of... |
Intraventricular meningiomas have NF2 mutations. |
<ref>{{cite journal |vauthors=Jungwirth G, Warta R, Beynon C, Sahm F, von Deimling A, Unterberg A, Herold-Mende C, Jungk C |title=Intraventricular meningiomas frequently harbor NF2 mutations but lack common genetic alterations in TRAF7, AKT1, SMO, KLF4, PIK3CA, and TERT |journal=Acta Neuropathol Commun |volume=7 |issu... |
Several inherited diseases are associated with meningiomas: |
*[[Neurofibromatosis]] type II<ref>{{Cite journal | last1 = Fontaine | first1 = B. | last2 = Rouleau | first2 = GA. | last3 = Seizinger | first3 = BR. | last4 = Menon | first4 = AG. | last5 = Jewell | first5 = AF. | last6 = Martuza | first6 = RL. | last7 = Gusella | first7 = JF. | title = Molecular genetics of neurofi... |
*Germline SMARCE1 and SMARCB1 mutations<ref>{{Cite journal | last1 = Smith | first1 = MJ. | last2 = O'Sullivan | first2 = J. | last3 = Bhaskar | first3 = SS. | last4 = Hadfield | first4 = KD. | last5 = Poke | first5 = G. | last6 = Caird | first6 = J. | last7 = Sharif | first7 = S. | last8 = Eccles | first8 = D. | last... |
*Loss of SUFU (SHH-Pathway).<ref>{{Cite journal | last1 = Aavikko | first1 = M. | last2 = Li | first2 = SP. | last3 = Saarinen | first3 = S. | last4 = Alhopuro | first4 = P. | last5 = Kaasinen | first5 = E. | last6 = Morgunova | first6 = E. | last7 = Li | first7 = Y. | last8 = Vesanen | first8 = K. | last9 = Smith | f... |
*Rare YAP1 fusions in a subset of pediatric meningioma (HIPPO pathyway).<ref>{{Cite journal | last1 = Sievers | first1 = P. | last2 = Chiang | first2 = J. | last3 = Schrimpf | first3 = D. | last4 = Stichel | first4 = D. | last5 = Paramasivam | first5 = N. | last6 = Sill | first6 = M. | last7 = Gayden | first7 = T. | l... |
Methylation profiling distinguishes two major groups with six distinct clinically relevant methylation classes.<ref>{{Cite journal | last1 = Sahm | first1 = F. | last2 = Schrimpf | first2 = D. | last3 = Stichel | first3 = D. | last4 = Jones | first4 = DT. | last5 = Hielscher | first5 = T. | last6 = Schefzyk | first6 =... |
===DDx of meningioma & IHC<ref name=pmid16393681>{{cite journal |author=Hahn HP, Bundock EA, Hornick JL |title=Immunohistochemical staining for claudin-1 can help distinguish meningiomas from histologic mimics |journal=Am. J. Clin. Pathol. |volume=125 |issue=2 |pages=203–8 |year=2006 |month=February |pmid=16393681 |doi... |
*S-100 strong +ve - [[schwannoma]]. |
**+ve in ~80% of fibrous meningiomas. |
*CD34 +ve - [[solitary fibrous tumour]]. |
**+ve in ~60% of [[fibrous meningioma]]s. |
*STAT6 nuclear +ve: [[solitary fibrous tumour]]. |
*[[EMA]] +ve in ~30% of [[solitary fibrous tumour]]/[[hemangiopericytoma]]. |
*Claudin-1 - new kid on the block: +ve in meningioma, but low [[sensitivity]]. |
*SSTR2A +ve in meningioma, usu. -ve in [[Perineurioma]] <ref>{{Cite journal | last1 = Agaimy | first1 = A. | last2 = Buslei | first2 = R. | last3 = Coras | first3 = R. | last4 = Rubin | first4 = BP. | last5 = Mentzel | first5 = T. | title = Comparative study of soft tissue perineurioma and meningioma using a five-mark... |
* Progesterone receptor: +ve in mostly grade I and meningeothelial tumors.<ref>{{Cite journal | last1 = Grunberg | first1 = SM. | title = The role of progesterone receptors in meningioma. | journal = Cancer Treat Res | volume = 58 | issue = | pages = 127-37 | month = | year = 1991 | doi = | PMID = 1683782 }}</ref> |
* [[Pulmonary meningothelial-like nodule]] |
===A standard work-up=== |
*Ki-67 >5-10% - predicts re-occurrence.<ref>Croul, SE. 8 November 2010.</ref> |
*PR (progesterone receptor) +ve in > 80% of meningiomas.<ref>{{Cite journal | last1 = Takei | first1 = H. | last2 = Buckleair | first2 = LW. | last3 = Powell | first3 = SZ. | title = Immunohistochemical expression of apoptosis regulating proteins and sex hormone receptors in meningiomas. | journal = Neuropathology | v... |
**Loss of PR staining predicts recurrence. |
**Strong association with tumour grade:<ref name=pmid22616825>{{Cite journal | last1 = Tao | first1 = Y. | last2 = Liang | first2 = G. | last3 = Li | first3 = Z. | last4 = Wang | first4 = Y. | last5 = Wu | first5 = A. | last6 = Wang | first6 = H. | last7 = Lu | first7 = Y. | last8 = Liu | first8 = Z. | last9 = Hu | fi... |
***Low WHO grade tumours usu. +ve. |
***High WHO grade tumours usu. -ve. |
==See also== |
*[[Neuropathology]]. |
*[[Neurohistology]]. |
*[[CNS tumours]]. |
*[[Pulmonary meningothelial-like nodule]]. |
==References== |
{{Reflist|2}} |
[[Category:Neuropathology tumours]] |
[[Category:Diagnosis]] |
f6c29931a632fb67a8fdf92fe4194196ca595c35018c63a59c0d4a2e1fae3aaa librepath-meningioma.txt |
[[Image:Gemistocytic Astrocytoma 003.jpg|thumb|right|A brain stem [[astrocytoma]]. (WC)]] |
The article covers '''tumours in neuropathology'''. Tumours are a large part of [[neuropathology]]. [[Cytopathology]] of CNS tumours is dealt with in the article ''[[CNS cytopathology]]''. |
There are separate articles for ''[[peripheral nerve sheath tumours]]'' and ''[[pituitary gland|pituitary/peri-pituitary lesions]]''. |
==Brain tumours - overview== |
===Alphabetical=== |
For overview see [[:Category:Neuropathology_tumours|here]] |
===By age group=== |
====Adult==== |
Four most common types of brain tumours:<ref>[http://neurosurgery.mgh.harvard.edu/abta/primer.htm http://neurosurgery.mgh.harvard.edu/abta/primer.htm]</ref> |
# Metastatic brain tumours (barely edges out primary tumours) |
#*[[Lung cancer|Lung]] (most common). |
#*[[Invasive breast cancer|Breast]]. |
#*[[Melanoma]]. |
#*[[Renal cell carcinoma]] (RCC). |
# [[Glioblastoma]], IDH-wildtype. |
# [[Astrocytoma, IDH-mutant]]. |
# [[Meningioma]]. |
====Children==== |
# [[Pilocytic astrocytoma]]. |
# [[Medulloblastoma]]. |
# [[Ependymoma]]. |
# Pontine glioma, often [[Diffuse midline glioma, H3 K27-altered]]. |
===By location=== |
Certain tumours like to hang-out at certain places:<ref>URL: [http://www.msdlatinamerica.com/ebooks/DiagnosticNeuropathologySmears/files/4ce563fb7e8e48fc9ed8b42e296a7747.gif http://www.msdlatinamerica.com/ebooks/DiagnosticNeuropathologySmears/files/4ce563fb7e8e48fc9ed8b42e296a7747.gif] and [http://www.msdlatinamerica.c... |
====Cerebrum==== |
*Cortical based - [[oligodendroglioma]]. |
*Grey-white junction - metastases. |
*White matter - astrocytoma, [[glioblastoma]]. |
*Periventricular - CNS lymphoma. |
*Cystic - [[ganglioglioma]], [[pilocytic astrocytoma]], [[pleomorphic xanthoastrocytoma]]. |
====Cerebellum==== |
*Midline/central - [[medulloblastoma]]. |
*Cystic lesion - pilocytic astrocytoma (younger individual), [[hemangioblastoma]] (older individual). |
*Solid lesion (older individual) - [[metastasis]]. |
====Sella turcica==== |
* [[Pituitary adenoma]]. |
* [[Craniopharyngioma]]. |
less common: |
* [[Pituicytoma]]. |
* [[Granular cell tumour]]. |
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