6/15- Neuro-oncology I Flashcards Preview

Term 5: Neuro > 6/15- Neuro-oncology I > Flashcards

Flashcards in 6/15- Neuro-oncology I Deck (25):
1

What are the processes of life/death in balance physiologically?

Necrosis/apoptosis:

- Degeneration

- Inflammation

- Stroke

- Trauma

Growth:

- Neoplasm

- Developmental

2

Brain tumors are 2nd only to ____ in malignancies of childhood?

Brain tumors are 2nd only to leukemia in malignancies of childhood?

3

At the most fundamental level, cancer is a set of disorders characterized by _________?

At the most fundamental level, cancer is a set of disorders characterized by mutations of genes regulating cell growth, differentiation, and death

(as cell proliferation, differentiation, and programmed cell death are under genetic control)

4

Tumor progression results from __________?

Tumor progression results from the sequential acquisition of new mutations which confer selective advantage

5

How are nervous system tumors named?

(Like other tumors)

According to the similarity of the tumor cells to architecture of normal tissues during development

6

CNS tumors are ____ (graded/staged) but not ____ (graded/staged). Definitions?

CNS tumors are graded but not staged

Staging = gross size and spread of tumor (local, nodal, systemic...)

Grading = only and ever histological (although may be used to estimate/predict tumor behavior; grades 3/4 are more likely infiltrative, but neuro-tumors are not officially staged)

7

Cellular constituents of the nervous system (3 broad categories)?

- Neuroectodermal elements

- Mesenchymal elements

- Neural crest

8

Cellular constituents of the nervous system (details)?

Neuroectodermal elements

- Neurons

- Astrocytes

- Oligodendroglia

- Ependymocytes

Mesenchymal elements

- Meninges

- Microglia and lymphocytes

- Blood vessels

Neural crest

- Schwann cells

9

T/F: These are normal neurons? 

Q image thumb

True

10

What immunomarkers can be used for neurons?

- Synaptophysin (reddish)- stains synapses

- Neu-N (dark, more well-defined)

11

What is this? 

Q image thumb

Neu-N (immunomarker for neurons)

12

What is this?

Q image thumb

Synaptophysin (immunomarker for neurons)

13

What is this? 

Q image thumb

Glia in the neuropil

- Oligodendrocyte has smaller, denser nucleus (maker of myelin in the CNS) than astrocyte

14

Whit is this?

Q image thumb

Reactive astrocytes (marks process of gliosis)

- Increased protein synthesis

- Prepares to form scar-like tissue

- Eosinophilic cytoplasm in astrocyte may be reactive or neoplsatic

15

What immunomarker can be used for glia?

Glial Fibrillary Acidic Protein (GFAP)

- Center of the picture is astrocyte highlighted by GFAP (star-shaped with  many processes branching out to touch synapses, forming tight junctions around endothelial cells of BVs..)

- GFAP is stronger in astrocytes than ependymal cells and oligodendrocytes

A image thumb
16

What immunomarker can be used for oligodendrocytes?

No good immunomarkers (have tried myelin-based proteins, but hasn't worked yet)

- On pic, can see them lining up to support neurons

- Make myelin (CNS)

A image thumb
17

What is shown on the left? right? 

Q image thumb

Left: normal oligodendroyctes

Right: oligodendroglioma

Key difference is that there are more cells on the right (hypercellular); this would be a well-behaved (low-grade) tumor

When cut this way, look like "fried-egg" cells (characteristic of oligodendrocytes); have that halo around them

18

What is this? 

Q image thumb

Ependyma

- Line the ventricles and central canal of SC

19

What is a good immunomarker for ependyma?

No good immuno; however, EM shows microvilli and cilia (more epithelial characteristics than other cells)

A image thumb
20

What can be used to mark meningothelial cells?

EMA: epithelial membrane antigen

(have desmosomes- dura is very tough)

A image thumb
21

How do nervous system tumors produce symptoms?

What are these symptoms?

Compressing or invading adjacent neural tissue

- Therefore, focal signs and symptoms are common in pts with these tumors

- May result in seizures (especially in cortex) or other deficits

- In addition to focal effects, CNS tumors produce increased ICP, with its attendant signs and symptoms

22

In addiction to classification along histological lines, tumors should be organized by _________?

In addiction to classification along histological lines, tumors should be organized by gross localization:

- Dura, subarachnoid, intraparenchymal (also "intra-axial") or intraventricular

23

What is Nissl substance?

Found in Rough ER; marker for neurons (?)

24

In children, brain tumors tend to occur where? Examples?

In the posterior fossa:

- Medulloblastoma (primitve neuroectodermal tissue; small blue cells that may look relatively normal)

- Diffuse intrinsic glioma of the pons, DIG (pontine glioma)- will take out ipsilateral CNs and long tracts (contralateral Sx)

- Ependymoma

- Pilocytic astrocytoma

25

____ (low/high) grade tumors are more serious?

High grade tumors are more serious?