The study explores the integration of histopathology and complex genomic data to enhance the identification of distinct subgroups of meningiomas, influencing clinical care. Notably, new molecular signatures were discovered, alongside a reclassification of certain neoplasms based on genomic findings. This approach indicates that histological and genetic assessments collectively improve diagnosis and management for meningioma patients.

1. MENINGIOMA
Diagnóstico Patológico

16. Clinical Molecular Staging in
Meningiomas: Prospective Experience of a
Single Institution Using Routine FFPE
Samples
•
Malak S Abedalthagafi, Shakti H Ramkissoon, Keith L Ligon, Azra H Ligon, Rebecca D Folkerth, Sandro Santagata. Brigham and
Women's Hospital and Harvard Medical School, Boston, MA
Results: In addition to the known CNVs in the WHO classifications, we identified several new molecular signatures including: single
copy loss in 12q , polysomy in chromosomes 3, 4, 5, 6, 7, 9, 13, 16, 18, 19, 20 and 21, occurring singly or in combination, in our sample.
Three WHO grade I meningiomas with brain invasion, but insufficient WHO features of atypia, had grade II genomic signatures. Our
genomic approach also led to the histologic re-classification of two uncertain "poorly differentiated neoplasms" into anaplastic
meningioma.
WHO grade22q- and/or 1p-mono6 and/or 6q-Significant OthersI (n=65)*36 (55.3 % of have 22q- , 27% have 22q- and 1p- )6 (9.3% )
Trisomy 1,2,3,5,9,10,12,13,15,18,20,21 5(7.69%)II (n=37)25 (67.5%)8(21.6%)-3P,-19q, 1q+, monosomy 8trisomy 15 and 20 (18.9%)III
(n=14)**7 (50%)4 (28.5%)19p+, trisomy 5 and 20, 9q-,17q- (21.4%)
* 3 cases had some but not all features of grade II, **2 cases had non-meningothelial tumors in differential.
Conclusions: The integration of histopathology with complex genetic/genomic data, results in the improved identification of clinically
distinct meningioma subgroups, which in turn directs the clinical care plan for certain patients. Such results

19. Variedades (50% o mas del tumor)
• WHO grado I (90%)
Meningoendotelial
Fibroso (Fibroblástico)
Transicional (mixto)
Psamomatoso
Angiomatoso
Microquístico
Secretor
Linfoplasmocítico
Metaplásico

25. • WHO II (5-7 %)
De células claras
Cordoide
Meningioma atípico

26. MENINGIOMA ATÍPICO
• Incremento de la actividad mitótica (4 ó más x
10 HPF) o tres o más de los siguientes cuadros
• Incremento de la celularidad
• Células pequeñas con un alto ratio
nucleo:citoplasma
• Nucleolo prominente
• Patrón en mantos
• Necrosis espontanea o geografica

30. • Se considerara también
atípico a la combinación
de hipercelularidad con
5 o más mitosis x 10
HPF

35. • WHO III (1-3 %)
Meningioma papilar
Meningioma anaplásico (maligno)
Rabdoide

39. MENINGIOMA ANAPLASICO
• Histológicamente francamente maligno
(similar a sarcoma, carcinoma o melanoma
focal o difusamente) o un alto índice mitotico
(20 o más mitosis por 10 HPF)

44. CONCLUSIONES
• TUMORES DE LA CAPA MENINGOTELIAL
• SON DEL 13 AL 26% DE LAS NEOPLASIAS
INTRACRANEALES
• DELECION DEL CROMOSOMA 22q
• INMUNOHISTOQUIMICA:
• VIM, EMA, CEA, R. Progesterona
• MENINGIOMA ATIPICO KI67; 7.2%
• MENINGIOMA ANAPLASICO KI 67; 14.7%
• KI67 >O IGUAL A 4.2; ALTO
• EL HALLAZGO DE INVASION CEREBRAL ES INDICADOR
DE RECURRENCIA FRECUENTE (GRADO II OMS).

45. Referencia Bibliografica
• Diagnostic Value of HER2 expression in meningioma: an immunohistochemical
and fluorescence in situ hybridization study. Delphine Loussouarn, Huaman
Pathology (2006) 37, 415-421.
• Molecular pathogenesis of meningiomas. Arie Perry, Journal of Neuro-Oncology
70: 183-202, 2004.
• Aggressive Phenotypic and Genotypic Features in Pediatric and NF2-Associated
Meningiomas: A Clinicopathologic Study of 53 cases. Arie Perry, Journal of
Neuropathology and Experimental Neurology Vol. 60, Nº10, 994-1003, 2001.
• “Malignancy” in Meningiomas. A Clinicopathologic Study of 116 Patients, with
Grading Implicatios. Arie Perry, Cancer May 1, 1999/ Vol. 85/ Nº9, 2046-2056.
• The Prognostic Significance of MIB-1, p53, and DNA Flow Cytometry in
Completely Resected Primary Meningiomas. Arie Perry, Cancer June 1, 1998/
Vol. 82/ Nº11, 2262-2268.
• Meningioma Grading. An Analysis of Histologic Parameters. Arie Perry, The
American Journal of Surgical Pathology 21 (12): 1455-1465, 1997.
• Clear Cell Meningioma. A Clinicopathologic Study of a Potentially Aggressive
Variant of Meningioma. S. Zorludemir, The American Journal of Surgical
Pathology 19(5): 493-505, 1995.

46. GRACIAS