Oncology

Question 1

Types of germ cell tumors

Answer 1

Germinoma - sensitive to radiation and chemo

Non-germinomatous:
Teratoma
Yolk-sac tumor
Embryonal carcinoma
Choriocarcinoma

Question 2

Germ cell tumor markers

Answer 2

CSF alpha fetoprotein, beta HCG, CEA

Question 3

CNS lymphoma patient population

Answer 3

primarily immunocompromized

Question 4

CNS lymphoma path

Answer 4

tightly packed B&T cells

Question 5

CNS lymphoma imaging

Answer 5

diffusely enhancing, can cross CC

Question 6

CNS lymphoma tx

Answer 6

high dose methotrexate

Question 7

MPNST (Malignant Peripheral Nerve Sheath Tumor) patient population

Answer 7

50% in NF1, mutation of plexiform neurofibroma

Question 8

MPNST (Malignant Peripheral Nerve Sheath Tumor) primary site

Answer 8

sciatic nerve

Question 9

Craniopharyngioma origin

Answer 9

from remnants rathke’s cleft

Question 10

Craniopharyngioma 2 types

Answer 10

Adamantinous - cystic, “motor oil” fluid

Squamous papillary - solid

Question 11

Craniopharyngioma path

Answer 11

mixture of cell types in picture, looks like skin
“pickt fence” line of cells
“wet keratin” clumps of pink keratin

Question 12

Medulloblastoma Grade, location, age

Answer 12

Grade 4
Cerebellar, often vermis
primarily kids (most common malignant brain tumor of childhood)

Question 13

Medulloblastoma path

Answer 13

dense round blue cells

neuroblastic rosettes

Question 14

Medulloblastoma imaging

Answer 14

heterogeneous enhancement

Question 15

Ependymoma location

Answer 15

intracranial or spinal

primarily posterior fossa

Question 16

Ependymoma path

Answer 16

perivascular pseudorosettes
Ependymal rosettes
GFAP+

Question 17

Ependymoma imaging

Answer 17

relatively circumscribed +/- cystic

heterogeneous enhancement

Question 18

Oligodendroglioma Path

Answer 18

uniform round nuclei with perinuclear halo

“fried egg”

Question 19

Oligodendroglioma imaging

Answer 19

calcifications

Question 20

Oligodendroglioma favorable mutation

Answer 20

1p19q

Question 21

Glioblastoma path

Answer 21

endothelial prolifateration
pseudopalisading necrosis
Dense pink clusters of cells
GFAP+

Question 22

Glioblastoma imaging

Answer 22

Heterogeneously enhancing

can cross CC

Question 23

Meningioma grade, location

Answer 23

Gr 1

Dural, extraparenchymal

Question 24

Meningioma path

Answer 24

Meningothelial "whorls" (or fascicles)
Psammoatous calcifications (like tree rings)

Question 25

Pilocytic astrocytoma Grade, location

Answer 25

Gr 1

primarily posterior fossa, optic nerve in NF1

Question 26

Pilocytic astrocytoma path

Answer 26

mix spongy and compact spindle areas
bipolar astrocytes with “hairlike” processes
Rosenthal fibers

Question 27

Pilocytic astrocytoma imaging

Answer 27

vividly enhancing
well circumscribed
solid and cystic

Question 28

Cowden syndrome mutation

Answer 28

PTEN

Question 29

Cowden syndrome sx

Answer 29

Lots of tumors
CNS - dysplastic ganglioglioma of cbl (tiger stripe on imaging)
Other cancers: breast, follicular thyroid, endometrial
Benign tumors: intestinal hamartomas, trichilemmoma skin
macrocephaly

Question 30

DNET grade, loc, imaging

Answer 30

Gr 1
primarily anterior temporal
Bubbly appearing on imaging