Neuropathology Flashcards
what is a neoplasm
abnormal and excessive growth of tissue
general principles of neoplasia
benign vs malignant
rare metastasis is rare
- treatment of choice neurosurgery so good
malignant is invasive but rarely metastatic
benign is not invasive but grows in a limited space therefore compress brain and symptomatic, raised ICP
- so can’t be left
non-metastatic effects– maybe a tumour from somewhere else but present in a different way
what are common primary tumours in the brain
what are the effects
breast
lung
melanoma
kidney
gut
lymphoma/leukaemia
ovarian
any tumour can metastasise to the brain
may have no effects (picked up if have lung cancer then have NCS findings)
space occupying lesions
-fits
-visual disturbance (occipital)
-drowsiness (frontal)
-behavioural change
haemorrhage
what is the commonest cancer type that gets to the brain
SMALL CELL UNDIFFERENTIATED
highly aggressive
also
squamous
adeno
what is meningioma
intracranial primary neoplasm
usually benign- (not invasive)
rise from meninges of the brain- at sites of ARACHNOID
pushes- EROSIVE and COMPRESSIVE
fits, drowsiness, headaches
surgical removal
slowly growing – personality changes, chronic history of headaches
what can cause meningiomas
sporadic
genetic syndrome- NF2 (neurofibromatosis type 2)
post-irradiation
what are neural tumours
why are they more common in children
children still producing neurons
in adult neuron population is permanent/ no proliferation
stem cells being activated is limited
GLIAL CELLS TUMOURS
name some gliomas
astrocytomas
oligodendroglioma
ependymoma
choroid plexus tumours
medulloblastoma and PNET
what is important about gliomas
never benign
sometimes low grade malignancy
always have a degree of invasion
but on a SPECTRUM
not an old person disease
What is glioma grading (WHO)
I LOCALISED
(can see margins and so easy to remove)
II DIFFUSE
III ANAPLASTIC ASTROCYTOMA
(high differentiation)
IV GLIOBLASTOMA MULTIFORME
(v aggressive- haemorrhagic)
what PNET / medulloblastoma
PRIMITIVE NEUROECTODERMAL TUMOURS
neuroectoderm origin
highly aggressive
tend to be in children
often in cerebellum (balance problems)
present acutely
why is molecular genetic testing important
good at determining if high or low grade
see if some treatments will work (depending on what gene affected)
classify
genetic changes help predict which treatment you should be using to give to patient
what are the commonest type of gliomas
astrocytomas
what is acoustic Schwannoma
most common type in the brain
arise from Schwann cells
acoustic neuroma (intercranial peripheral nerve tumour)
can cause deafness
grow on acoustic nerve CNVIII
what is SCHWANNOMA
arise from myelinating Schwann cells
push out and can compress nerve trunk
can cleave out
