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Presented by Peter Illei, M.D. and prepared by ChanJuan Shi, M.D., Ph.D.
Case 5: 57 y.o. woman with a brain mass.
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Question 1 of 1
1. Question
Week 359: Case 5
57 y.o. woman with a brain mass.images/07-28-2008-5a.jpg
images/07-28-2008-5b.jpg
images/07-28-2008-5c2.jpg
images/07-28-2008-5d2.jpgCorrect
Answer: Meningioma, WHO grade 3
Histology: The tumor is composed relatively uniform round to oval cells that are arranged in sheets and infiltrate normal brain parenchyma. Focal necrosis is present and the mitotic index is high (25-30 mitoses per 10 hpf) with single fields containing up to 5 mitoses.
Discussion: These features are diagnostic of a WHO grade 3 meningioma. The WHO classification separates meningiomas into three grades (grade I, Grade II or atypical meningioma and Grade III meningioma). The classification is based on several factors with mitotic count being the most important factor. Tumors with high mitotic activity (>20 mitoses per 10 hpf) should be considered grade 3 regardless of their histologic appearance.
Incorrect
Answer: Meningioma, WHO grade 3
Histology: The tumor is composed relatively uniform round to oval cells that are arranged in sheets and infiltrate normal brain parenchyma. Focal necrosis is present and the mitotic index is high (25-30 mitoses per 10 hpf) with single fields containing up to 5 mitoses.
Discussion: These features are diagnostic of a WHO grade 3 meningioma. The WHO classification separates meningiomas into three grades (grade I, Grade II or atypical meningioma and Grade III meningioma). The classification is based on several factors with mitotic count being the most important factor. Tumors with high mitotic activity (>20 mitoses per 10 hpf) should be considered grade 3 regardless of their histologic appearance.
