Meningioma

Histopathology

Immunohistochemistry

Epithelial markers:

Meningioma subtype

CK5/6

CK7

CK8

CK14

CK16

CK17

CK18

AE1

AE3

EMA

CEA

BerEP4

CD15

 

Secretory

14/201

19/201, 9/92

19/201, 9/92

6/201

7/201

6/201

19/201

20/201

20/201

9/92

9/92

0/92

0/92

 

Meningothelial

1/601

16/601

3/601

6/601

1/601

1/601

43/601

33/601

5/601

 

 

 

 

 

Transitional

0/2001

44/2001

18/2001

25/2001

 0/2001

 0/2001

138/2001

80/2001

17/2001

 

 

 

 

 

Fibroblastic

0/1001

14/1001

5/1001

0/1001

 0/1001

 0/1001

54/1001

28/1001

5/1001

 

 

 

 

 

Psammomatous

0/101

4/101

1/101

4/10

 0/101

 0/101

7/101

8/101

1/101

 

 

 

 

 

Microcystic

0/71

2/71

1/71

0/71

 0/71

 0/71

7/71

2/71

0/71

 

 

 

 

 

Chordoid

0/21

1/21

0/21

0/21

0/21

0/21

1/21

1/21

0/21

 

 

 

 

 

Atypical

 0/601

26/601

22/601

19/601

 0/601

 0/601

52/601

30/601

12/601

 

 

 

 

 

Anaplastic

 0/41

3/41

3/41

2/41

0/41

0/41q

4/41

2/41

2/41

 

 

 

 

 

NOS

 

 

 

 

 

 

 

 

 

100%3

 

 

 

 
                             

Other cytokeratins: CK10 and CK15 were negative in all 4631 meningiomas studied. CK20 was negative in all 4711,2 meningiomas studied. Extremely limited focal expression of CK13 was seen in one secretory meningioma around luminal structures and in one transitional meningioma at the periphery of whorls1.

In summary:

Other marker:

 

S-100

39%3

 

vimentin

100%3

   

Prognosis

The risk of recurrence and aggressive behaviour depends on location, brain invasion, histological subtype and mitotic index. The WHO grading recognises:

Anti-PHH3 is reportedly useful in assessing the mitotic index and the malignancy of meningiomas.

 

Differential diagnosis

References

1Miettinen, M. and Paetau, A. Mapping of the keratin polypeptides in meningiomas of different types: an immunohistochemical analysis of 463 cases. Hum Pathol 2002;33:590-8.

2Assi A., Declich P., Iacobellis M., Cozzi L., Tonnarelli G. Secretory meningioma, a rare meningioma subtype with characteristic glandular differentiation: an histological and immunohistochemical study of 9 cases. Adv Clin Path 1999; 3:47-53.

3Radley, M. G., P. A. di Sant'Agnese, et al. (1989). "Epithelial differentiation in meningiomas. An immunohistochemical, histochemical, and ultrastructural study--with review of the literature." Am J Clin Pathol 92(3): 266-72.

4Alguacil-Garcia, A., N. M. Pettigrew, et al. (1986). "Secretory meningioma. A distinct subtype of meningioma." Am J Surg Pathol 10(2): 102-11.

 

This page last revised 24.12.2003.

©SMUHT/PW Bishop