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Neuro Exam 2 > Brain Tumors I > Flashcards

Brain Tumors I Flashcards

1
Q

What is better: grading or staging? Why?

A

grading because brain tumors don’t often metastasize

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2
Q

Most common primary brain tumor?

A

astrocytomas

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3
Q

What is shown in this image?

A

Grade II astrocytoma

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4
Q

What is shown in this image?

A

Grade III astrocytoma

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5
Q

What is shown in this image?

A

Grade IV astrocytoma

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6
Q

What does this image show?

A

Grade II/IV astrocytoma

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7
Q

What is shown in this image?

A

Grade II astrocytoma

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8
Q

What does this image show?

A

H and E stain of grade II astrocytoma

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9
Q

What does this image show?

A

GFAP stain with positive tumor cells (stage II astrocytoma)

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10
Q

What is shown in this image?

A

Grade III astrocytoma/ anaplastic astrocytoma

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11
Q

What is shown in this image?

A

Grade III astrocytoma/ anaplastic astrocytoma

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12
Q

What is the most reliable indicator of a glioblastoma, grade IV?

A

necrosis

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13
Q

Genetic- Primary GBM

—Occurs in older______

—Amplification of ______ gene

—MDM2 _______, p16 _____, PTEN mutations

A

Genetic- Primary GBM

—Occurs in older adults

—Amplification of EGFR gene

—MDM2 overexpression, p16 deletion, PTEN mutations

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14
Q

Genetic- secondary GBM

____ patients

—Arises from_____ tumor

—Shares p53 ______ (and PDGF-A) amplifications with lower grade

A

Genetic- secondary GBM

Younger patients

—Arises from lower-grade tumor

—Shares p53 inactivation (and PDGF-A) amplifications with lower grade

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15
Q

Label the following image

A
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16
Q

Label the following image

A

GBM

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17
Q

What does this image show?

A

GBM with necrosis and vascular proliferation

18
Q

Pilocytic Astrocytoma

►Occurs in children and young adults

►Often occurs in _____; can occur around ____ventricle, optic nerves, and cerebral hemispheres

A

Pilocytic Astrocytoma

►Occurs in children and young adults

►Often occurs in cerebellum; can occur around 3rd ventricle, optic nerves, and cerebral hemispheres

19
Q

What is show in this image?

A

Pilocytic astrocytomas are often in posterior fossa, are cystic, and feature long, hair-like processes and Rosenthal fibers (protein globules or droplets).

20
Q

What is shown in this image?

A

Pilocytic astrocytoma

21
Q

Oligodendroglioma

►Arises from oligodendroglial cells

►Occurs most commonly in _____ matter

►Occurs in 4th or 5th decade; often with _____

A

Oligodendroglioma

►Arises from oligodendroglial cells

►Occurs most commonly in white matter

►Occurs in 4th or 5th decade; often with seizures

22
Q

Oligodendroglioma morphology

—Well-circumscribed

—Cells

►Surrounded by _____(artifact) – “fried eggs”

►At border with grey matter, cells surround _____ – satellitosis

—Delicate network of _____

—Calcifications

____ mitotic rate

—GFAP-positive cells (especially microgemistocytes)

A

Oligodendroglioma morphology

—Well-circumscribed

—Cells

►Surrounded by halo (artifact) – “fried eggs”

►At border with grey matter, cells surround neurons – satellitosis

—Delicate network of capillaries

—Calcifications

—Low mitotic rate

—GFAP-positive cells (especially microgemistocytes)

23
Q

What does this image show?

A

Oligodendroglioma with perinuclear halos and satellitosis of neurons

24
Q

Ependymoma

►Arise from ependymal cells

►______(in and around ventricles)

►Most common around _____ventricles in first 2 decades and in ____ _____ in adults

A

Ependymoma

►Arise from ependymal cells

►Central (in and around ventricles)

►Most common around 4th ventricles in first 2 decades and in spinal cord in adults

25
Q

Morphology of ependymoma

  • —____ pseudorosettes – result from cells sending processes (without nuclei) to vessels; this results in clear, perivascular zone
  • —_____rosettes – neoplastic cells appear to form primitive central canal-like structures
  • —Tends to _____ and not infiltrate
A

Morphology of ependymoma

  • —Perivascular pseudorosettes – result from cells sending processes (without nuclei) to vessels; this results in clear, perivascular zone
  • —Ependymal rosettes – neoplastic cells appear to form primitive central canal-like structures
  • —Tends to push and not infiltrate
26
Q

What does this image show?

A

Ependymoma

27
Q

Label the following image

A
28
Q

Choroid Plexus Papilloma

  • Papillary
  • Hydrocephalus
    • —Noncommunicating
    • —Overproduction of _____
  • Carcinoma can occur
  • Cells are often S100, cytokeratin, and transthyretin (pre-albumin) ____
A

Choroid Plexus Papilloma

  • Papillary
  • Hydrocephalus
    • —Noncommunicating
    • —Overproduction of CSF
  • Carcinoma can occur
  • Cells are often S100, cytokeratin, and transthyretin (pre-albumin) positive
29
Q

What is shown in this image?

A

Choroid plexus papilloma

30
Q

Medulloblastoma

  • Poorly differentiated/”undifferentiated”
  • Arises in cerebellum
    • —Midline (vermis) – ____
    • —Lateral – _____
  • “Small blue cells”: Homer-Wright rosettes can be seen
  • _____ for synaptophysin
  • Often shows ______ dissemination
  • Genetic
    • —Commonly shows loss of 17p, sometimes with isochromosome 17q
    • —Genetic profile – prognostic value
  • Survival – with radiation and chemotherapy – 75%
  • Can metastasize to bone
A

Medulloblastoma

  • Poorly differentiated/”undifferentiated”
  • Arises in cerebellum
    • —Midline (vermis) – children
    • —Lateral – adults
  • “Small blue cells”: Homer-Wright rosettes can be seen
  • Positive for synaptophysin
  • Often shows subarachnoid dissemination
  • Genetic
    • —Commonly shows loss of 17p, sometimes with isochromosome 17q
    • —Genetic profile – prognostic value
  • Survival – with radiation and chemotherapy – 75%
  • Can metastasize to bone
31
Q

What does this image show?

A

Medulloblastoma

32
Q
A
33
Q

What does the following image show?

A

primary CNS lymphoma

34
Q

What does this image show?

A

CNS lymphoma invading blood vessels

35
Q

Label the following images

A
36
Q

What does this image show?

A

meningioma

37
Q

What does this image show?

A

Metastases

38
Q

What does the following image show?

A

Mestastases

39
Q

Label the following image

A
40
Q

What does this image show?

A

Neurofibroma

This is a plexiform neurofibroma involving peripheral nerve. The histology shows the wavy cytoplasm of tumor cells. The tumor often separates axons.

41
Q

Neurocutaneous Syndromes/Phakomatoses

  • Genetic diseases
  • Often with skin, nervous system, and other organ system involvement (neurocutaneous syndromes)
  • Mental retardation and/or seizures can occur
A

Neurocutaneous Syndromes/Phakomatoses

  • Genetic diseases
  • Often with skin, nervous system, and other organ system involvement (neurocutaneous syndromes)
  • Mental retardation and/or seizures can occur
42
Q

What do these images show?

A

Hemangioblastoma

Hemangioblastomas are often cystic and located in posterior fossa. The microscopic features include stroma cells that contain lipid (shown on oil red O stain). It is highly vascular. This tumor can secrete erythropoietin.

Neuro Exam 2 (18 decks)

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