Sketchy Path: Neuro - "Pediatric CNS Tumors"

Question 1

Most pediatric CNS tumors develop in which part of the cranium?

Answer 1

Infratentorial (like the kids beneath their tents)

Question 2

How do pediatric CNS tumors present?

Answer 2

• FNDs
• Seizures
• Cerebellar signs (ataxia)
• ICH
• Irritability

(Think of the kid shaking, the blown-up balloon next to the fire, and the kid doing the zombie walk.)

Question 3

Pediatric CNS tumors often block the ______________.

Answer 3

4th ventricle, because pediatric CNS tumors are infratentorial and occur in the cerebellum; the cerebellum is just posterior to the pons and 4th ventricle

Question 4

The most common CNS tumor in children is _____________.

Answer 4

pilocytic astrocytoma (like the large PILe O’ sTICks with the kid in the sleeping bag with stars)

Question 5

Pilocytic astrocytomas have _____________ on microscopy.

Answer 5

hairlike projections (like the projections of sticks from the pile) and cystic portions (like the puddles of water around the teepee)

Question 6

A majority of pilocytic astrocytomas have the ______________ mutation.

Answer 6

BRAF (like the kid playing with the Ben FRAnklin action figure)

Question 7

What cytologic feature is classic of pilocytic astrocytoma (and other gliomas)?

Answer 7

Rosenthal fibers –pink bands in the cytoplasm (pink stripes on the sleeping bag with stars)

Question 8

Pilocytic astrocytoma stains for _______________.

Answer 8

GFAP (like the GFAP comic)

Question 9

Medulloblastoma cells are partly derived from _____________.

Answer 9

neuronal lineage (like the neuron swordfight happening over the MarshmaLLOw BLAST fire)

This is why they stain for synaptophysin and enolase.

(Synaptophysin = synapse fighting –like the swordfight.)

Question 10

Medulloblastomas often contain _______________ amplifications.

Answer 10

myc (like the MiCe running by the fire)

Question 11

Morphologically, medulloblastomas often have __________________.

Answer 11

necrosis (like the burnt marshmallows)

Question 12

Medulloblastomas will have what kind of cells on microscopy?

Answer 12

Small blue cells (like the bag of blue marshmallows)

Question 13

What tumor is represented by the teacher’s drawing?

Answer 13

Ependymoma (he has a PEN)

Question 14

Ependymomas commonly occur in the ______________.

Answer 14

4th ventricle in children (like the diamond behind the teacher) and the spinal cord in adults (like the adult with the pen in his pants parallel to his spine)

Question 15

The microscopic finding of ependymomas is ________________.

Answer 15

pseudorosettes (rings of tumor cells around a false lumen)

Question 16

The most common supratentorial tumor in children is ________________.

Answer 16

craniopharyngioma (like the clown’s cranium)

Question 17

Craniopharyngiomas have what on pathology?

Answer 17

Calcification (like the clown’s creepy big teeth)

Question 18

Craniopharyngiomas are derived from ____________.

Answer 18

oral ectoderm (like the clown’s creepy teeth)

Question 19

Recall that germ cell tumors can occur ______________.

Answer 19

in the CNS (like the pineal pine trees across the river)

Question 20

Germinomas look like _________________ under the microscope.

Answer 20

fried eggs