Table 1 :

Mahmood’s modified grading system for meningioma (6)

Score	Brain invasion	Mitosis	Nuclear pleomorphism	Necrosis*	Hypercellularity	Loss of architecture
0	Absent	none	Uniform, bland nuclei, no nucleoli	none	10 whorls fascicles/ HPF	none
1	Tumor pushing the brain without intervening meaning	1-1/10HPH	Occasional larger nuclei, 2–3 times larger with irregular contours	Rare, each involving less than 1/2 of HPF	10 whorls-fascicles/ HPF or increased cellularity in perivascular area	Incipient loss
2	Cords infiltrating the brain	3–4/10HPF	Many cells with large pale nuclei, small non prominent nucleoli	Frequent foci involving more than 1/2 but less than 1 HPF	Less defined, small, more closely packed whorls (up to 30/ HPF)	Involving 1–2 HPF
3		>5/10HPF	Most cells with nuclei, variable size, prominent nucleoli	Large confluent areas of necrosis >1 HPF	Densely crowded overlapping nuclei with loss of whorls	Involving more than 2 adjacent HPF

Score 0–4 =benign, Score 5–11 =atypical, Score>11 =malignant

^*In the absence of preoperative tumor embolization and radiation therapy