B7-095 Brain Tumors 1: Non-glial Flashcards

1
Q

specialized macrophages of the CNS

A

microglia

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2
Q

types of glia [4]

A

astrocytes
oligodendrocytes
ependymal cells
microglia

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3
Q

post-mitotic cells with selective vulnerability

A

neurons

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4
Q

“dead reds” due to anoxia, ischemia, hypoglycemia

A

acute neuronal injury

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5
Q

lipofuscin can be seen in the

A

dentate nucleus

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6
Q

neuromelanin can be seen in the

A

substantia nigra

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7
Q

seen in normal aging and Alzheimer’s

A

granulovacuolar change

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8
Q

associated with dementia

A

neurofibrillary tangles

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9
Q

associated with parkinson’s

A

Lewy bodies in substantia nigra

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10
Q

associated with rabies

A

negri bodies

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11
Q

what layer gives rise to microglia

A

mesoderm

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12
Q

what layer gives rise to astrocytes, oligodentrocytes, and ependymal cells

A

neuroectoderm

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13
Q

small oval nuceli with star-like processes

A

astrocyte

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14
Q

contain GFAP

A

astrocytes

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15
Q

foot processes form the BBB

A

astrocytes

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16
Q

indicator of injury

A

astrocytosis/gliosis

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17
Q

reactive phenomenon; seen in tumors

A

gemistocytic astrocytes

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18
Q

associated with metabolic encephalopathy

A

alzheimer type II astrocytes

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19
Q

astrocytic process inclusions

seen in chronic gliosis, pilocytic astrocytomas, Alexander’s disease

A

rosenthal fibers

(seen in slow, chronic processes)

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20
Q

ab-crystallin
hsp27

A

rosenthal fibers

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21
Q

make and maintain myelin

A

oligodendrocytes

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22
Q

JC virus infects oligodendrocytes causing demyelination

A

PML (progressive multifocal leuko-encephalopathy)

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23
Q

ciliated columnar epithelial glial cells that line the ventricular system

A

ependymal cells

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24
Q

CMV affects […] cells preferentially

A

ependymal

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25
Q

creates CSF

A

choroid plexus

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26
Q

what layers does choroid plexus originate from?

A

ectoderm and mesoderm
(dual origin)

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27
Q

tumor types that arise from choroid plexus [2]

A

papillomas
carcinoma

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28
Q

resident CNS macrophage

A

microglia

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29
Q

express CD68

A

microglia

30
Q
A

meningothelial cell whorls

31
Q

histologic hallmarks of hypoxic neurons [4]

A

profound eosinophilia
loss of basophillia
pyknosis/atrophy
loss of Nissl

32
Q

what area of the brain is most vulnerable to hypoxia in adults?

A

hippocampus-CA1 segment

33
Q

nonspecific finding that indicates a chronic pathological process

A

Rosenthal fibers

34
Q

how long does it take to be able to see ischemic neurons?

A

4-6 hours after ischemic event

(patient has to survive ischemic event to see changes)

35
Q

most common brain tumors in adults in outside hospitals is

A

metastatic tumors

(lung cancer is most likely to metastasize)

36
Q

cause “hemorrhagic mets”

A

lung
RCC
melanoma
choriocarcinoma

37
Q

lymphomas of the CNS [2]

A

diffuse large B cell
intravascular large B cell

38
Q

“naked nuclei”
round uniform cells with atypia and multiple prominent nucleoli
“dirty background”

A

lymphoma

39
Q

CD20+ [2]

A

diffuse large B cell lymphoma
intravascular large B cell

40
Q
A

lymphoma

41
Q

most common lymphoma

A

diffuse large B cell

42
Q

associated with EBV

A

diffuse large B cell lymphoma

43
Q

confined to the CNS at presentation
angiocentric growth pattern

A

diffuse large B cell lymphoma

44
Q

what should be avoided prior to biopsy of diffuse large B cell lymphoma?

A

preoperative steroids

(will cause negative biopsy, “partially treated lymphoma)

45
Q

can be preceded by demyelinating and/or inflammatory lesions for up to two years

A

diffuse large B cell lymphoma

46
Q

mimics cerebral infarcts or subacute encephalopathy

A

intravascular large B cell

(characterized by exclusively intravascular growth)

47
Q

mesenchymal, non-meningothelial tumors [2]

A

solitary fibrous tumor
hemangioblastoma

48
Q

dural-based lesion of the meninges

A

solitary fibrous tumor

49
Q

what gene fusion causes solitary fibrous tumor?

A

NAB2 and STAT6

50
Q

detection of STAT6 nuclear expression via IHC is recommended for diagnosis of

A

solitary fibrous tumor

51
Q

describe grading of solitary fibrous tumors

A

Grade 1: <5 mitoses/10 HPF
Grade 2: >5 mitoses/10 HPF without necrosis
Grade 3: >5 mitoses/HPF with necrosis

high rate of recurrence, even years later regardless of grade

52
Q

recurrence may occur decades after initial diagnosis so require long-term follow up

A

solitary fibrous tumor

53
Q

surrounding parenchyma may show profound gliosis and rosenthal fibers

A

hemangioblastoma

very very slow growing

54
Q

associated with VHL

A

hemangioblastoma

55
Q

VHL tumor suppressor gene is located on chromosome [..]

A

3

56
Q

inhibin positive but patchy

A

hemangioblastoma

57
Q

markers helpful to differentiate hemangioblastoma from RCC

A

keratin (CAM5.2)
PAX8 (renal marker)

58
Q

classic meningioma findings [2]

A

perfectly formed whorls on smear
psammoma bodies on H&E sections

59
Q

progesterone receptors

A

meningioma

60
Q

genetic association causing multiple meningioma

A

loss of chromosome 22q (NF2 gene)

61
Q

[what grade meningioma]
4-19 mitotic figures in 10 HPF

A

grade 2

62
Q

[what grade meningioma]
<4 mitotic figures in 10 HPF

A

grade 1

63
Q

[what grade meningioma]
20 or more mitotic figures in 10 HPF

A

grade 3

(begins looking like something else entirely: sarcoma, carcinoma, melanoma, etc)

64
Q

[what grade meningioma]
TERT promoter mutation

A

grade 3

65
Q

[what grade meningioma]
homozygous deletion of CDKN2A/B

A

grade 3

66
Q

[what grade meningioma]
brain invasion

A

grade 2

67
Q

[what grade meningioma]
chordoid or clear cell subtype

A

grade 2

68
Q

[what grade meningioma]

A

grade 2 (brain invasion)

69
Q

[what grade meningioma]

A

grade 2 (chordoid)

70
Q

[what grade meningioma]

A

grade 2 (clear cell)