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Flashcards in brain tumors Deck (65):
1

primary brain tumors are divided to

1. Adult primary brain tumors
2. Childhood primary brain tumors

2

Adult primary brain tumors - types

1. Glioblastoma multiforme (grade IV astrocytoma)
2. Meningioma
3. Hemangioblastoma
4. Schwannoma
5. Oligodendroglioma
6. Pituitary adenoma

3

Childhood primary brain tumors - types

1. Pilocytic (low grade) astrocytoma
2. Medulloblastoma
3. Ependymoma
4. Craniopharyngioma
6. pinealoma

4

grade IV astrocytoma - also called

Glioblastoma multiforme

5

Glioblastoma multiforme - median survival / behavioral / frequency / found in

median surv: 1 year
behavioral: highly malignant primary brain tumor
frequency: common
found in cerebral hemisphere

6

Glioblastoma multiforme - special feature in gross image

can cross corpus callosum (butterfly glioma)

7

Glioblastoma multiforme - histology

- stain astrocytes with GFAP
- pseudoplaisading pleomorphic tumor cells
- border central areas of necrosis and hemorrhage

8

Meningioma behavioural / frequency

typically benign
common

9

Meningioma - most common areas

convexities of hemispheres (near surface of brain) and parasagittal region

10

Meningioma - symptoms

often asymptomatic
may present with seizures or focal neurological signs

11

Meningioma - treatment

resection and/or radiosurgery

12

Meningioma - histology

- spindle cells concentrically arranged in a whorled pattern
- psammoma bodies (laminated calcification)

13

Meningioma - arises from

arachnoid cells

14

Meningioma - spatial distribution

is extra-axial (external to brain parenchyma and may have a dural attachment (tail)

15

Hemangioblastoma - most often area

cerebellum

16

Hemangioblastoma - can produce

erytrhopoietin (2ry polycethemia)

17

Hemangioblastoma is associated with

von Hippel-Lindau syndrome when found with retinal angiomas

18

Hemangioblastoma - histology

closely arranged, thin walled capillaries with minimal intervening parenchyma

19

Pituitary adenoma - most commonly is

prolactinoma

20

Pituitary adenoma can cause

1. bitemporal hemianopia
2. hypopituitarism
3. hyperpituitarism

21

Pituitary adenoma - bitermporal hemianopia is due to

pressure on optic chiasm

22

Schwannoma - area

classically at the cerebellopontine angle but can can be along any peripheral nerve (especially at VIII)

23

Schwannoma - especially in ... nerve

VIII

24

Schwannoma of VIII

vestibular Schwannoma

25

Schwannoma - origin

Schhann cell origin

26

Schwannoma stain

S-100 positive

27

Schwannoma treatment

resectable or treated with stereotactic radiosurgery

28

NF2 -brain tumor

bilateral vestibular Schwannoma

29

bilateral vestibular Schwannoma - found in

NF2

30

Oligodendroglioma - progression rate/ area / frequency

slow growing
Most often in frontal lobes
relatively rare

31

oligodendroglioma - histology

1. chicken wire capillary pattern
2. oligodendrocytes= fried egg cells - round nuclei with clear cytoplasm
3. often calcified

32

oligodendroglioma - capillary pattern

chicken wire

33

adult primary brain tumor - GFAP positive

Glioblastoma multiforme (grade IV astrocytoma)

34

childhood primary brain tumor - types

1. pilocytic (low grade) astrocytoma
2. Medulloblastoma
3. Ependymoma
4. Craniopharyngioma
5. Pinealoma

35

pilocytic (low grade) astrocytoma - benign or malignant?
prognosis?

Benign
good prognosis

36

pilocytic (low grade) astrocytoma - area

most often found in posterior fossa (eg. cerebellum)
May be supratentorial

37

supratentorial region of the brain is

the area located above the tentorium cerebelli

38

pilocytic (low grade) astrocytoma - gross appearance

usually well circumscribed cystic + solid tumors

39

pilocytic (low grade) astrocytoma - histology

GFAP+
Rosenthal fibers: eosinophilic, corkscrew fibers

40

ependymoma - area / prognosis

most commonly found in 4th ventricle
poor prognosis

41

ependymoma can cause

Hydrocephalus

42

ependymoma - histology

characteristic perivascular rosettes.
Rod-shaped blepharoplasts (basal ciliary bodies) found near nucleus

43

Most common supratentorial tumor in childhood

craniopharyngioma

44

craniopharyngioma - benign or malignant

benign

45

craniopharyngioma can cause

1. bitemporal hemianopia
2. hypopituitarism
3. hyperphagia (destruction of ventromedial area - satiety area of hypothalamus)

46

craniopharyngioma may be confused with ... (why)

Pituitary adenoma
both can cause bitemporal hemianopia

47

craniopharyngioma - derived from

Rathke pounch

48

craniopharyngioma - appearance

-calcification is common
-tooth enamel-like
- Cholesterol crystals found in "motor oil" - like fluid within tumor

49

Medulloblastoma - benign or malignant / area

highly malignant
area cerebellum

50

Medulloblastoma is a form of

primitive neuroectodermal tumor

51

Meduloblastoma can -->

1. compress 4th ventricle causing hydrocephalus
2. send "drop metastases" to spinal cord

52

Medulloblastoma - gross appearance

solid

53

Medulloblastoma - histology / gross appearance

1. Homer-Wright rosettes
2. small blue cells
gross: solid

54

brain tumor - hydrocephalus

1. ependymoma
2. medulloblastoma

55

brain tumor - bitemporal hemianopia

1. Pituitary adenoma
2. Craniopharyngioma

56

brain tumor - rosenthal fibers

Pilocytic astrocytoma

57

brain tumor - drop metastases

medulloblastoma

58

brain tumor - GFAP positive

1. Glioblastoma multiforme (grade IV astrocytoma)
2. Pilocytic (low grade) astrocytoma

59

brain cancer - stains?

GFAP --> GBM, pilocytic
S100 --> Schwannoma

60

Pinelioma - area

Pineal gland

61

Pinelioma can cause ... (and mechanism)

1. Parinaud syndrome: compression of tectum --> ertical gaze palsy
2. obstructive hydrocephalus (compression of cerebral aqueduct)
3. precosious puberty in males (increased β-HCG production)

62

tectum?

uppermost part of the midbrain, lying to the rear of the cerebral aqueduct

63

Pinelioma - precosious puberty in males - mechanism

increased β-HCG production

64

Pinelioma - histology

similar to germ cell tumors

65

Pinelioma can cause ... (and mechanism)

1. Parinaud syndrome: compression of tectum --> ertical gaze palsy
2. obstructive hydrocephalus (compression of cerebral aqueduct)
3. precosious puberty in males (increased β-HCG production)