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GEN PATH > BRAIN TUMOR > Flashcards

BRAIN TUMOR Flashcards

1
Q

Tentorium Cerebelli
Adult:
Children:

A

Adult: Supratentorial (cerebrum)
Children: Infratentorial (cerebellum)

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2
Q

Benign Brain Tumors

A
  • Meningioma
  • Schwannoma
  • Pituitary tumors
  • Craniopharyngioma
  • Hemangioblastoma
  • Dysembryoplastic neuroepithelial tumors (DNT)
  • Epidermoid cyst
  • Dermoid cyst
  • Colloid cyst
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3
Q

Most common primary brain tumor
and adults most commonly affected

A

Meningioma

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4
Q

Meningioma is attached to the __
and is composed of

A
  • dura mater

- neoplastic meningothelial (arachnoid cap) cells

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5
Q

Risk factor of Meningioma

A

Prior radiation to the head and neck

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6
Q

Pathogenesis of Meningioma
iinvolves the truncating (inactivating) mutations in the neurofibromatosis 2 (NF2) gene (merlin) on chromosome

A

22

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7
Q

Histologic patterns of Meningioma

A
  • syncytial (“meningothelial”)

- psammomatous, with psammoma bodies

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8
Q 
Meningioma
Sporadic meningioma: absence of \_\_ 
Meningiomas without NF2 mutations: 
Common site of involvement: 
Often express \_\_\_ receptors
Treatment:
A

Sporadic meningioma: absence of merlin (50% to 60% of cases)
Meningiomas without NF2 mutations: TNF-receptor associated factor 7 (TRAF7)
Common site of involvement: Sagittal sinus
Often express progesterone receptors
Treatment: Surgery

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9
Q

Involves the Schwann cells on the nerve sheaths.
Adults most commonly at risk.

A

Schwannoma (Acoustic Neuroma)

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10
Q

Schwannoma (Acoustic Neuroma)
Risk factor:
Hallmark of the genetically distinct neurofibromatosis type 2
Part of ___ neurofibromatosis

A

Risk factor: patients with NF2
Frequently bilateral: hallmark of the genetically distinct neurofibromatosis type 2
Part of von Recklinghausen neurofibromatosis

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11
Q

Microscopic finding of Schwannoma (Acoustic Neuroma)

A

Biphasic: compact hypercellular Antoni A areas and myxoid hypocellular Antoni B areas (may be absent in small tumors)

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12
Q

Schwannoma (Acoustic Neuroma)
Diagnostic test:
MRI:
Treatment:

A
  • Gadolinium (contrast) enhanced MRI
  • MRI: densely enhancing lesions, enlarging the internal auditory canal and often extending into the cerebellopontine angle -> compression of CN VII and CN V
  • Surgery
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13
Q
  • Originate from cell rests (remnants of Rathke’s pouch) at the junction of the infundibular stem and pituitary
  • Bimodal distribution
  • More often in children; adults 55-65 years
A

Craniopharyngioma

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14
Q

Histologic appearance of Craniopharyngioma

A
  • cords and whorls of epithelial cells (with intercellular bridges and keratohyalin) separated by a loose network of stellate cells
  • Cyst contains dark albuminous fluids, cholesterol crystals, ad calcium deposits
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15
Q

Craniopharyngioma
is found in

A
  • On the optic chiasm or cranial nerves

- Frequently bulge into the floor of the third ventricle and base of the brain

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16
Q
  • Located in the cerebellum
  • Most often in connection with von Hippel-Lindau syndrome
  • Age at onset: 15-50 years
  • Blacks, Whites, and Asians are equally affected
A

Hemangioblastoma

17
Q

Hemangioblastoma

Risk factor:
Angiographic picture:
MRI:

A

Risk factor: autosomal dominant inheritance of VHL
Angiographic picture: tightly packed cluster of small vessels forming a mass 1 to 2 cm in diameter
MRI: cerebellar cyst containing an enhancing nodular lesion on its wall

18
Q

Clinical presentation:

  • Dizziness
  • Ataxia of gait or of the limbs on one side
  • Increased intracranial pressure from compression of the fourth ventricle
  • Retinal angioma of hepatic and pancreatic cysts
  • Polycythemia vera
A

Hemangioblastoma

19
Q

Treatment of Hemangioblastoma

A

craniotomy with opening of the cerebellar cyst, and excision of the mural hemangioblastomatous nodule

20
Q
  • Located in the supratentorial area of the temporal lobe
  • In children and young adults
  • Males usually affected
A

Dysembryoplastic Neuroepithelial Tumors (DNT)

21
Q

Microscopic findings:
Dysembryoplastic Neuroepithelial Tumors (DNT)

A
  • Uniform oligodendroglioma-like cells in a mucin-rich background
  • Hallmark: specific glioneuronal elements (columns formed of axons lined by uniform oligodendroglioma-like cells) with intervening floating neurons (cortical neurons in mucin pools)
22
Q

MRI:
Hyperintense; ‘bubbly appearance
Enhancement (1/3 of cases): heterogeneous or multiple ring pattern

CT:
May show calcification, may scallop the inner table of the skull vault

A

Dysembryoplastic Neuroepithelial Tumors (DNT)

23
Q

Dysembryoplastic Neuroepithelial Tumors (DNT)

Predisposing factor:
Clinical presentation:
Treatment:

A

Predisposing factor: long-standing history of seizures
Clinical presentation: Chronic partial seizures in supratentorial tumors
Treatment: Gross total resection or even subtotal resection

24
Q

Consists of squamous epithelial cells surrounding a keratin-filled cyst. On the cerebellopontine angle and the intra- and suprasellar regions. Well defined round mass, thin walled, pearly white.

A

Epidermoid Cysts

25
Q

Epidermoid Cysts

MRI:

Miscroscopic findings:

A

MRI: extra-axial lesions with characteristics that are similar to CSF but have restricted diffusion

Microscopic finding: Fibrous wall lined by keratinizing squamous epithelium; contains anucleate squames but no skin adnexae and no hair

26
Q

Clinical presentation of Epidermoid Cysts

Treatment

A
  • Headache
  • Cranial nerve abnormalities
  • Seizures
  • Hydrocephalus

Tx: Surgery

GEN PATH (17 decks)

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