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Washington University Experience | NEOPLASMS (MENINGIOMA) | Anaplastic | 20F Case 20 Denouement
20F Denouement Case 20 ---- In this clinical context, this histological/immunohistochemical pattern is consistent with anaplastic meningioma with focal glandular metaplasia, WHO grade III. ---- Loss of chromosome 22q is the most common karyotypic abnormality identified in meningiomas. Losses of chromosomes 1p, 14q and 18q are often observed in atypical meningiomas (WHO grade II), with loss of chromosome 14q also commonly occurring in anaplastic meningiomas. Loss of chromosome 9 (and more specifically, locus 9p21) demonstrates association with higher grade meningiomas, and has additionally been associated with poorer prognosis among anaplastic meningiomas. FISH studies were performed and showed losses of chromosome 22q, chromosome 9, chromosomes 1p and 14q, and a normal complement of chromosome 18 were identified in both the epithelial and non-epithelial tumor elements. These findings are consistent with anaplastic meningioma, WHO grade III, providing firm evidence for the monoclonal origin of both morphologic components of the tumor; it further places this tumor in a 'genetically unfavorable' subgroup of anaplastic meningiomas. (This case has been published: Patil et al. PMID: 21558975)
