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Term 5: Neuro > 6/16- Neuro-oncology III > Flashcards

6/16- Neuro-oncology III Flashcards

(42 cards)

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1
Q

Meningiomas are typically what grade?

A

Grade 1

  • Well-circumscribed
  • Surgically resectable (although over convexity is much easier than in cavernous sinus…)

They can progress to a higher grade (there is such a thing as a malignant meningioma), but they’re rare

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2
Q

What is this?

A

Meningioma

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3
Q

What is this?

A

Meningioma

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4
Q

What kind of cells form meningiomas? Where are they located?

A

Meningoethelial cells

  • Located in dura and arachnoid caps?
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5
Q

What is this?

A

Meningioma???

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6
Q

Where can a Schwannoma occur? Common?

A

Anywhere there are Schwann cells

  • Peripheral nerves
  • Any cranial nerves
  • Very common = CN 8 (cerebro-pontine angle/ponto-medullary junction)
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7
Q

What is this?

A

Meningoethelial cells

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8
Q

What is this?

A

Meningioma of the lateral convexity

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9
Q

What is this?

A

Meningioma

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10
Q

What is this? Origin?

A

Meningioma of the optic nerve

  • Arises from dural sheath of the nerve
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11
Q

Symptoms of CP angle Schwannoma

(auditory neuroma - bad terminology)?

A
  • Unilateral hearing loss
  • Tinnitus possible
  • Nystagmus and vertigo if vestibular n. involved
  • Can compress adjacent nerves (e.g. 5 and 7) if it enlarges
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12
Q

Compare these two tumors of the optic nerve. What are they?

A

L = Meningioma

R = Pilocytic __?

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13
Q

What is this?

A

Meningioma histopathology

(Little Orphan Annie cells??)

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14
Q

What is this?

A

Meningioma histopathology

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15
Q

What is this?

A

Meningioma histopathology

  • Hurricane/tropical storm cells
  • Psammoma bodies
  • Little Orphan Annie cells??
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16
Q

What can be used to confirm that something is a meningioma?

A
  • Epithelial membrane antigen
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17
Q

What can be seen ultrastructurally in meningioma?

18
Q

What is a useful feature that can be used to characterize a Schwannoma (1)?

Study These Flashcards
A

Two different types of architecture

  • Antoni A (dense)
  • Antoni B (less dense)
19
Q

What is another useful feature that can be used to characterize a Schwannoma (2)?

Study These Flashcards
A

Verocay body

  • nuclei adjacent to area without nuclei
20
Q

What is this? Treatment options?

Study These Flashcards
A

CP Angle Schwannoma

  • Can see “ice cream sign” as it spreads into internal auditory canal

Treatment:

  • Surgical resection
  • Stereotactic radiosurgery
21
Q

Genetic predisposition to CP Angle Schwannoma?

Study These Flashcards
A

NF2

  • Bilateral tumors
  • Chromosome 22
  • Merlin gene (schwannoma, meningioma, glioma)
22
Q

Genetic predisposition to Neurofibroma?

Study These Flashcards
A

NF1

  • Neurofibramin -> neurofibroma spindle cell
  • Chromosome 17
23
Q

What is this?

24
Q

What are two common settings in which you will see primary CNS lymphomas (PCNSL)?

Study These Flashcards
A
  • Immunocompromised patients (most)
  • Elderly patients
25
- Can Schwannomas be fatal? - Can Neurofibromas be fatal?
?? - Schwannomas typically not bad - Neurofibromas may become malignant
26
What is this?
**Primary CNS lymphoma (PCNSL)** - **Angiocentric accumulation** of cells - Prominent nucleolus (look like immature lymphocytes) - Most PCNSLs are **large** cell lymphomas (like this) - **Infiltrates** tissue (like gliomas); no distinct tumor/mass
27
What immunohistochemistry marker can be used for Primary CNS Lymphomas (PCNSL)?
CD20- usually B cell lymphomas
28
What is this? Effects?
Metastatic tumors - Tend to loosen up vascular junctions, leading to edema - Multiple lesions (pretty typical); results in multiple focal neurological deficits
29
What is this?
Metastases (3) - Multiple discrete lesions with surrounding **edema** - Often occur at grey matter- white matter junction, but may occur anywhere - Some pushing over of the cingulate (swollen hemisphere)
30
T/F: PCNSL tumors are surgically resectable?
**False** - Typically not, because infiltrate tissue (like gliomas) - Not a clear mass
31
T/F: People with PCNSL tumors typically don't have lymphomas anywhere else
**True** - Only about 3% will have systemic lymphoma (although eye sometimes involved)
32
What is this?
Metastasis to midbrain
33
What is this? Symptoms?
**Meningeal carcinomatosis** - Spread to CSF - Can see little lumps all along the cauda equina: **tumor implants on the spinal roots** - May result in multiple **radiculopathies** (spinal nerve root symptoms) - Disturbances of higher cortical function or other problems
34
What virus may cause PCNSLs? Especially in what population?
- **Ebstein-Barr** virus (EBV) driven - Especially in **AIDS** patients
35
What is this? Symptoms?
**_Top (under 10mm)- microadenoma_** - Little **microadenoma** can only present with endocrine symptoms **_Bottom (\>10mm)_** - Endocrine effects + chiasm compression - May result in **bitemporal** visual field defect
36
What are some autosomal dominant disorders causing hereditary brain tumor syndromes?
- Neurofibromatosis (NF1 and NF2) - Tuberous sclerosis - von Hippel Lindau disease
37
What tumors does **neurofibromatosis** cause? Which type?
**NF1** (chromosome 17) - Neurofibromas - Neurofibrosarcomas **NF2** (chromosome 22) - Schwannomas - Meningiomas - Gliomas
38
What tumors does **tuberous sclerosis** cause?
- Subependymal giant cell astrocytoma (with rare malignant degeneration to:) - Glioblastoma multiforme - "Tubers"- heterotopias
39
What tumors does **von Hippel Lindau cause**? Genetic mechanism?
(oncogene knocked out on **chromosome 3**) - Hemangioblastoma - Metastatic renal cell carcinoma
40
What is this?
Hemangioblastoma
41
What is this? Cellular origin?
**Hemangioblastoma** - Very **bloody** tumor (many vascular channels) - Cells making up tumor have **foamy** cytoplasm with clear areas - **Hemangioblast** origin (circular cell from bone marrow that is repairing endothelial cells of BVs) - Once seen, then have to worry about them develping a renal carcinoma
42
What are the most common cancers causing metastases in the brain?
Most (80%): **- Lung** **- Breast** Then: - Melanomas - Renal - GI

Term 5: Neuro (24 decks)

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