title: Clonal analysis of a case of multiple meningiomas using multiple molecular genetic approaches: pathology case report.
abstract: OBJECTIVE
  Multiple meningiomas are uncommon brain tumors occurring concurrently in several intracranial locations in the same patient. In the present study, we determined the clonality, methylation status of deoxyribonucleic acid, and relationship of genetic alterations in eight meningiomas from one female patient.
  
  
  METHODS
  Six molecular genetic techniques, including two methylation-based clonality assays and one transcription-based clonality assay, methylation analysis of CpG islands by methylation-specific polymerase chain reaction, loss of heterozygosity, microsatellite instability, and mutational analysis of the NF2 gene on chromosome 22, were used in comparative investigations on clonality and genetic alterations.
  
  
  RESULTS
  The presence of clonal tumor cells was demonstrated by 1) loss of the same copy of chromosome 22 in all eight tumors; 2) transcription of the human AR gene from the same allele in six of eight tumors; 3) a common unmethylated allele at the AR locus in all eight tumors; and 4) the identical single-basepair insertion mutation in exon 9 of the NF2 gene in six of eight tumors. In addition, loss of a copy of the X chromosome in one tumor nodule and microsatellite instability in another nodule were observed.
  
  
  CONCLUSIONS
  Taken together, this case of multiple meningiomas was most likely monoclonal in origin. Loss of chromosome 22 was an early event during the development of multiple meningiomas and was followed by mutations at the NF2 locus. Later events, including loss of the X chromosome, variation of AR gene expression, or microsatellite instability, may also have played a role in the development of multiple meningiomas in this patient.
authors.affiliation: Neurosurgical Laboratories and Brain Tumor Center, Brigham and Women's Hospital, Boston, Massachusetts, USA.
authors.forename: J J
authors.initials: JJ
authors.lastname: Zhu
authors.forename: T
authors.initials: T
authors.lastname: Maruyama
authors.forename: L B
authors.initials: LB
authors.lastname: Jacoby
authors.forename: J G
authors.initials: JG
authors.lastname: Herman
authors.forename: J F
authors.initials: JF
authors.lastname: Gusella
authors.forename: P M
authors.initials: PM
authors.lastname: Black
authors.forename: J K
authors.initials: JK
authors.lastname: Wu
mesh_terms: D001921:Brain / Q000473:pathology; D002874:Chromosome Mapping; D002892:Chromosomes, Human, Pair 22 / Q000235:genetics; D002999:Clone Cells / Q000473:pathology; D004252:DNA Mutational Analysis; D004273:DNA, Neoplasm / Q000235:genetics; D005260:Female; D006801:Humans; D019656:Loss of Heterozygosity / Q000235:genetics; D008279:Magnetic Resonance Imaging; D008577:Meningeal Neoplasms / Q000175:diagnosis / Q000235:genetics* / Q000473:pathology; D008579:Meningioma / Q000175:diagnosis / Q000235:genetics* / Q000473:pathology; D008745:Methylation; D018895:Microsatellite Repeats; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D014158:Transcription, Genetic / Q000502:physiology; D014960:X Chromosome / Q000502:physiology
chemical_list: D004273:DNA, Neoplasm