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Washington University Experience | NEOPLASMS (MENINGIOMA) | Anaplastic | 8D Case 8 Denouement
Case 8 Denouement ---- The differential diagnosis in this case included metastatic carcinoma versus anaplastic meningioma. Losses of chromosomes 1p, 14q, 18p, and 22q occur during tumorigenesis and malignant progression of meningeal neoplasms. FISH was performed on paraffin-embedded tissue localizing to 1p32, 14q32, 18p11.3 and 22q11.2. The latter two probes include detection of deletions of the DAL-1 and NF2 genes, respectively. In this particular case, deletions were found in all four chromosomal regions. It would be highly unlikely that a metastatic carcinoma would harbor such genetic lesions simultaneously, as most of these tumors have marked aneuploidy. These results are therefore highly suggestive that this lesion represents an anaplastic meningioma, WHO grade III of IV, a tumor that can show widely variable morphological and immunohistochemical features, some of which overlap significantly with carcinomas.
