Ayerbe et al used a scoring system for the histologic grading of a meningioma. This is based on the scoring system of Jaaskelainen et al and the WHO guidelines. The authors are from Hospital 12 de Octubre in Madrid, Spain.
Parameters:
(1) extent of lobulated pattern
(2) hypercellularity
(3) nuclear pleomorphism
(4) nucleolar prominence
(5) necrosis
(6) number of mitoses in 10 high power fields (hpf, x400 magnification)
(7) brain infiltration
|
Parameter |
Finding |
Points |
|
extent of lobulated pattern |
100% |
0 |
|
|
66 - 99% |
1 |
|
|
33 - 65% |
2 |
|
|
< 33% |
3 |
|
hypercellularity |
none |
0 |
|
|
mild |
1 |
|
|
moderate |
2 |
|
|
intense |
3 |
|
nuclear pleomorphism |
none |
0 |
|
|
mild |
1 |
|
|
moderate |
2 |
|
|
intense |
3 |
|
nucleolar prominence |
none |
0 |
|
|
focal |
1 |
|
|
abundant |
2 |
|
|
massive |
3 |
|
necrosis |
none |
0 |
|
|
focal |
1 |
|
|
abundant |
2 |
|
|
massive |
3 |
|
mitoses per 10 hpf |
0 or 1 |
0 |
|
|
2 or 3 |
1 |
|
|
4 or 5 |
2 |
|
|
>= 6 |
3 |
|
brain infiltration |
none |
0 |
|
|
< 5% |
3 |
|
|
>= 5% |
malignant |
where:
• The area of a microscopic field was not stated.
• One option is to score >= 5% brain infiltration as 10 points.
total score =
= SUM(points for all 7 parameters)
Interpretation:
• minimum score: 0
• maximum score: 21 (28 if score brain infiltration using 10 points)
|
Score |
Histologic Grade |
|
> 5% brain infiltration |
malignant |
|
0 to 4 |
conventional |
|
5 to 9 |
atypical |
|
10 - 21 |
malignant |
Specialty: Hematology Oncology, Surgery, general, Neurology
