Flashcards in Brain Tumors Deck (98)
What is the incidence of brain tumors?
1-2 / 10,000
What percent of brain tumors are primary? Secondary?
2' = 50%
What are the origins of brain tumors? (4)
-Cells intrinsic to the brain (Gliomas/neuronal/others)
What is the order of incidence of mets in the brain?
Where are mets in the brain usually located? What are their characteristics?
Multiple, well circumscribed; usually present at the gray white junctions
What cells give rise to glioblastoma multiforme?
What cells give rise to astrocytomas?
What cells give rise to meningioma?
What cells give rise to medulloblastomas?
Neural cell precursors
What cells give rise to schwannomas?
Which usually has multiple lesions: primary brain tumors, or secondary?
True or false: mets to the brain are usually well circumscribed masses
How often do primary tumors of the brain metastasize?
True or false: even benign tumors of the brain are problematic
True--limited space in the skull
What are the s/sx of increased ICP? (6)
What is the drug of choice for emergent increased ICP?
What percent of childhood cancers are brain cancers?
The majority of adult brain tumors are found where? Children?
Adults = supratentorial
Child = infratentorial (posterior fossa)
What are the 4 major childhood primary brain tumors?
What are the top four adult brain cancers?
Are astrocytomas benign or malignant tumors?
What are the gross characteristics of astrocytomas?
Large, multicolored (red) mass with a central area of necrosis and hemorrhage
What are the histological characteristics of Glioblastoma multiforme? (4)
-Palisading around necrosis
Histological slide of the brain with hypercellularity, hyperchromatism, pleomorphic cells, and palisading cells around a central area of necrosis = ?
What is the prognosis for Glioblastoma multiforme?
Is Glioblastoma multiforme benign or malignant?
Where in the brain are Glioblastoma multiforme usually found?
Cerebral hemispheres, and can cross corpus callosum
What are butterfly gliomas?
Glioblastoma multiforme that crosses the corpus callosum
What is the stain that can be used to highlight Glioblastoma multiforme?
What is GFAP? Where is it found?
Glial fibrillary acidic protein
intermediate filament that is expressed by numerous cell types in the CNS, including astrocytes, and ependymal cells
How can you identify meningiomas grossly?
White capsule that surrounds it
What are the histological characteristics of meningiomas?
Spindle cells in a Tight whorling tumors cells
Spindle cells in a Tight whorling tumors cells = what?
Are meningiomas benign or malignant?
Where are meningiomas usually found?
Convexities of the hemispheres
What cells give rise to meningiomas?
Arachnoid cells external to brain parenchyma, that may have a dural attachment
True or false: meningiomas are often asymptomatic
What is the treatment for meningiomas ?
What are the 4 tumors that has psammoma bodies?
1. Papillary thyroid carcinoma
2. Papillary serous cystadenomas
4. Papillary renal cell CA
What are the gross characteristics of hemangioblastomas?
large, exophytic red mass
What, generally, are hemangioblastomas composed of?
What are the histological characteristics of hemangioblastomas?
Closely arranged, thin-walled capillaries with minimal interleaving parenchyma + foamy cells
Are hemangioblastomas malignant or benign?
Where are hemangioblastomas usually found in the brain?
What diseases are associated with hemangioblastomas?
VHL syndrome if found with retinal angiomas
What is the hematological disorder that can be brought about 2/2 hemangioblastomas? Why?
Polycythemia 2/2 EPO production
Closely arranged, thin-walled capillaries with minimal interleaving parenchyma + foamy cells = ?
Polycythemia 2/2 to a brain tumor point to what type of brain tumor?
What is the genetic cause of VHL syndrome?
VHL suppressor gene on chromosome 3
What is the genetic cause of tuberous sclerosis?
TSC1, TSC2 genes which code for hamartin, tuberin respectively
What are the gross characteristics of Schwannomas?
"Fish flesh"--soft tan appearance
What is the antoni A pattern of Schwannoma?
Palisading nuclei surrounding pink areas
What is the antoni B pattern of Schwannoma?
Looser stroma, fewer cells, and myxoid changes
Where are Schwannoma usually found in the brain?
What is the stain that can be used for Schwannoma?
S100 is used to stain for what brain tumors? (3)
Schwannoma, neurofibromas, melanoma
Which CN is usually affected with Schwannomas?
Bilateral Schwannomas = what inherited disease?
Are Schwannomas benign or malignant?
What are the CT findings with oligodendroglioma?
Calcifications with a central mass
What are the gross characteristics of oligodendrogliomas?
Thickened corpus callosum and diffuse involvement
How fast do oligodendrogliomas grow?
What are the histological characteristics of oligodendrogliomas?
Small, round nuclei with a *perinuclear halo*
*Chicken wire vasculature*
Small, round nuclei with a perinuclear halo + Chicken wire vasculature= ?
What age group do oligodendrogliomas usually present?
"Fried egg" cells with round nuclei and clear cytoplasm = ?
True or false: oligodendrogliomas usually have calcifications on a noncontrast CT
What is the most common pituitary adenoma?
What is the classic visual field deficit associated with pituitary adenomas?
What is the effect of a secreting prolactinoma on GnRH?
What stimulate prolactin release, and which inhibits?
Stimulate = TSH
Inhibits = dopamine
What is the typical appearance of a pilocytic astrocytoma?
What is the prognosis for pilocytic astrocytomas?
What are the histological characteristics of pilocytic astrocytomas?
What are the rosenthal fibers that can be found in pilocytic astrocytomas?
Thick, elongated, worm-like or corkscrew eosinophilic bundles
Where in the brain are pilocytic astrocytomas usually found?
What is the stain that is useful for highlighting pilocytic astrocytomas?
Are pilocytic astrocytomas usually malignant or benign?
What are the histological characteristics of pilocytic astrocytoma?
Homer wright Rosettes are found in what brain tumor?
What are Homer wright Rosettes?
Small, blue cells cells
Are Medulloblastoma malignant or benign?
What are the cells that give rise to Medulloblastomas?
What are the mass effect problems associated with Medulloblastomas? (2)
Compression of 4th ventricle
Spinal drop mets to the spinal cord
What are the histological characteristics of medulloblastomas?
What are the histological characteristics of Ependymomas?
-Rod shaped blepharoplasts found near nucleus
Where are Ependymomas usually found in the brain?
What is the major sequelae of Ependymoma? Why?
Hydrocephalus--usually invades the 4th ventricle
What is the prognosis for Ependymomas?
What are the blepharoplasts found in Ependymomas?
Are craniopharyngiomas malignant or benign?
What are the mass effect problems associated with craniopharyngiomas?
What is the most common childhood supratentorial tumor?
What cells give rise to craniopharyngiomas?
Cells from Rathke's pouch
True or false: calcification is common with craniopharyngiomas?
Closely arranged, thin-walled capillaries with minimal interleaving parenchyma + foamy cells = what brain tumor?
Rosenthal fibers are found in what brain tumor?