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OMS - 2 Neuro Final > Brain Tumor DSA > Flashcards

Brain Tumor DSA Flashcards

(56 cards)

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1
Q

______ account for 80% of
primary brain tumors

A

Astrocytomas

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2
Q

2 types of astrocytomas

A
  1. diffusely infiltrating
  2. localized
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3
Q

Astrocytomas are MC found in the _______ location

A

cerebral hemispheres

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4
Q

Astrocytomas are typically _______ grade tumors.

A

low

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5
Q

Astrocytomas are strongly positive for _______

A

glial fibrillary acidic protein (GFAP)

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6
Q

Anaplastic astrocytoma (grade III/IV) show ________ (3 histologic findings)

A
  1. nuclear enlargements
  2. mitotic figures
  3. gametocytes (yellow arrow)

(NO necrosis)

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7
Q

Diffuse astrocytomas are frequently due to _______ mutation, but are the majority are ______ mutation.

A
  • TP53
  • IDH1
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8
Q
A

Diffuse astrocytoma (grade II) high power

(note the fibrillar background)

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9
Q

What is this? Why?

A
  • gemistocytic astrocytoma
  • eosinophilic cytoplasm w/eccentric nuclei
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10
Q

Dx? Why?

A
  • Anaplastic astrocytoma (grade III)
  • mitotic activity (black arrow)
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11
Q

Necrosis is NOT a feature of astrocytoma; that would make it ______.

A

glioblastoma

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12
Q

Dx? Why?

A
  • Anaplastic astrocytoma
  • mitotic figures (black and yellow arrows)

(yellow arrow: circular mitotic figure)

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13
Q
A

Glioblastoma

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14
Q

Glioblastomas are rapidly growing tumors that cause _______.

A

herniation

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15
Q

Glioblastomas are grade IV and are derived from ______ cells

A

astrocytic progenitor

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16
Q

Survival rate for IDH-mutant glioblastoma

A

3 years

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17
Q

Survival rate for IDH-wild type glioblastomas

A

15 months

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18
Q

Dx? Why

A

Glioblastoma

large tumor cells w/pleomorphic hyperchromatic nuclei

(yellow arrows: multinucleated)

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19
Q

Dx? Why?

A
  • Glioblastoma
  • Palisading: serpiginous or serpentine foci of necrosis & hypercellularity
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20
Q

Dx? Why?

A
  • Glioblastoma
  • Glomeruloid body (yellow arrow): tufts of microvascular hyperplasia w/multiple lumen
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21
Q

Dx? Why?

A
  • Pilocytic astrocytoma
  • cystic w/gelatinous material (arrow)
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22
Q

WHO grade for pilocytic astrocytoma? Why?

A
  • Grade I
  • slow growing
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23
Q

_________ (2) set Pilocytic astrocytomas apart from other astrocytomas.

Study These Flashcards
A
  1. rarely caused by TP53 mutation
  2. genetic alterations of MAP kinase pathway
24
Q

Dx? Why?

Study These Flashcards
A
  • Pilocytic astrocytoma
  • nuclei have little atypia & microcysts
25
Dx? Why?
* Pilocytic astrocytoma * Rosenthal fibers (arrow)
26
Define Rosenthal fibers (arrow)
elongated eosinophilic bodies containing GFAP and heat-shock proteins (found in pilocytic astrocytoma)
27
Dx? Why?
* Pilocytotic astrocytoma * hair-like fibrillary processes of tumor cells ("pilo" meaning hair)
28
Dx?
Oligodendroglioma (yellow arrow)
29
What is the cause of this?
IDH1 or IDH2 mutation & deletion of 1p & 19q (oligodendroglioma)
30
Dx? Why?
* oligodendroglioma * sheets of round to oval nuclei, “fried egg appearance”: clear halo around nucleus ("oligodendro" because tumor cells resemble oligodendrocytes; see picture)
31
Dx? Why?
* oligodendroglioma * fried egg appearance: nuclei are small & uniform w/vacuolated cytoplasm
32
Dx? Yellow arrow?
* oligodendroglioma * calcified foci
33
Most oligodendrogliomas are WHO grade \_\_\_\_\_\_.
II (anaplastic oligodendrogliomas are grade III)
34
How are anaplastic oligodendrogliomas characterized?
1. high cell density 2. nuclear anaplasia 3. high mitotic activity
35
Survival rate for oligodendroglioma
w/surgery, chemo, radiation: * Grade II: 20 years * Grade III: 15 years
36
MC location for Oligodendrogliomas
white matter of cerebral hemispheres
37
Dx?
Ependymoma
38
MC location for ependymoma
spinal cord (central canal)
39
Ependymomas often lead to \_\_\_\_\_\_.
secondary hydrocephalus (rarely disseminate to CSF)
40
Ependymomas typically arise from \_\_\_\_\_\_\_.
Ependymal cells lining the ventricles of the brain and central canal of the spinal cord
41
In adults with ependymoma, there is typically a ______ mutation.
Neurofibromatosis Type 2 (NF2)
42
Dx? Yellow arrow? Black arrow?
* Ependymoma * perivascular pseudorosettes * canal: gland-like structure
43
Define perivascular pseudorosettes (yellow arrow)
anuclear cells create a zone around blood vessels (but **NOT** around the lumen) (characteristic of ependymomas)
44
Dx?
Ependymoma (note the rosettes at the arrow & GFAP stain)
45
WHO grade?
II | (ependymoma)
46
Location of ependymoma with the most favorable outcomes?
spinal cord | (85% have 5 year survival)
47
Dx? Why?
* **Myxopapillary** Ependymoma * papillary structures lined by bland-appearing cuboidal cells w/myxoid stroma (containing mucopolysaccarides)
48
MC location for **myxopapillary** ependymoma?
cauda equina of spinal cord
49
Myxopapillary ependymomas can disseminate to the _______ if not completely excised.
subarachnoid space
50
Dx? Why?
* Choroid plexus papilloma * papilla lined by cuboidal epithelium line the tumor (closely resembles the normal structure of the choroid)
51
MC location of choroid plexus papilloma in adults? children?
* 4th ventricle * lateral ventricles
52
MC neuronal tumor
ganglioglioma (WHO grade I) (this is a mix or ganglion & glial cells; glial cells usually resemble pilocytic astrocytoma)
53
blue arrows
ganglion cells (ganglioglioma)
54
MC location for gangliogliomas?
temporal lobe
55
Dx? Black arrows?
ganglioglioma
56
Gangliogliomas are typically WHO grade I, when is surgery necessary?
medically refractory epilepsy

OMS - 2 Neuro Final (36 decks)

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