CNS Neoplasms - Usera

Question 1

What makes up 70-80% of all CNS tumors?

Answer 1

astrocytomas

Question 2

What parts of the brain do astrocytomas normally involve?

Answer 2

cerebral hemispheres

Question 3

What is a grade 1 astroyctoma?

Answer 3

pilocytic astrocytoma

Question 4

What is a grade 2 astroyctoma?

Answer 4

diffusely infiltrating astrocytoma

Question 5

What is a grade 3 astroyctoma?

Answer 5

anaplastic astrocytoma

Question 6

What is a grade 4 astroyctoma?

Answer 6

glioblastoma multiforme

Question 7

What is this?
cystic, well circumscribed
in the cerebellum
dense, "hair like" fibrillary meshwork
little/no nuclear atypia
Rosenthal Fibers

Answer 7

pilocytic astrocytoma

Question 8

Does a pilocytic astrocytoma have a p53 mutation?

Answer 8

no

Question 9

in what age group does pilocytic astrocytoma usually occur?

Answer 9

children and young adults

Question 10

What is the adult tumor that arises from astrocytes?

Answer 10

GBM

Question 11

T/F: diffusely infiltrating astrocytomas are poorly differentiated

Answer 11

true

Question 12

T/F: diffusely infiltrating astrocytoma has high mitotic figures

Answer 12

false; none

Question 13

What is this?
poorly defined
distorts brain architecture
increased cellularity with mild to moderate nuclear atypia
no mitotic figures

Answer 13

diffusely infiltrating astrocytoma

Question 14

Does diffusely infiltrating astrocytoma have a p53 mutation?

Answer 14

yup

Question 15

What is the prognosis for DIA?

Answer 15

variable, but usually indolent lesion

Question 16

What is this?

High mitotic figures, cellularity, and nuclear atypia with a p53 mutation

Answer 16

Anaplastic astrocytoma

Question 17

what is the median survival of anaplastic astrocytoma?

Answer 17

3 yearz

Question 18

what is the most common CNS neoplasm?

Answer 18

GBM

Question 19

What does AMEN stand for in GBM?

Answer 19

Atypia
Mitotic figures
Endothelial proliferation
Necrosis

Question 20

T/F: GBM shows high mitotic figures but no nuclear pleomorphism

Answer 20

false; shows both

Question 21

Does GBM have a p53 mutation?

Answer 21

yes

Question 22

GBM characteristically crosses the (blank), forming a butterfly lesion

Answer 22

corpus callosum

Question 23

Describe the histologic appearance of GBM?

Answer 23

regions of necrosis surrounded by PSEUDOPALLISADING tumor cells

Question 24

T/F: all astrocytomas, including GBM, are GFAP +

Answer 24

true

Question 25

T/F: oligodendromas are GFAP+

Answer 25

false; only astrocytomas

Question 26

what is the lowest grade of oligodendroma?

Answer 26

2

Question 27

when is an oligodendroma most common?

Answer 27

4-5th decade of life

Question 28

What is this? | infiltrating, cystic, hemorrhagic, frequent calcifications of the cerebral hemispheres

Answer 28

oligodendroma

Question 29

Oligodendroma has a (hi/low) proliferative rate

Answer 29

low

Question 30

Loss of 1p and 19q is associated with a (good/bad) response to chemo in OGD

Answer 30

good

Question 31

what grade is an anaplastic oligodendroma?

Answer 31

grade 3

Question 32

oligodendromas that have many features similar to GBM are what grade?

Answer 32

4

Question 33

What is this? | fried egg nuclei with chicken wire vasculature

Answer 33

oligodendroma

Question 34

T/F: meningiomas are benign

Answer 34

true

Question 35

Do meningiomas happen more in females or males? how do we remember this?

Answer 35

females 3:2 | PR+ and ER+

Question 36

Meningiomas are associated with loss of chromosome (blank)

Answer 36

22

Question 37

Meningiomas arise from the meningoepithelial cells of the (blank)

Answer 37

arachnoid

Question 38

what are the common locations of meningiomas?

Answer 38

``` parasagittal olfactory groove suprasellar Clivus Foramen magnum Cerebellar ```

Question 39

Da fuck are these found in? WHORLED pattern of growth Psamomma bodies

Answer 39

meningiomas (psamomma looks like boobs since this happens more in women)

Question 40

Where do we find normal ependymal cells?

Answer 40

lining the ventricular system

Question 41

T/F: ependyomas happen in both children and adults

Answer 41

true

Question 42

Ependyoma is associated with which genetic dz?

Answer 42

NF2

Question 43

From ages 0-20 yrs, what is the most common location for an ependyoma?

Answer 43

paraventricular or 4th ventricle

Question 44

A tumor in the spinal cord in an adult is most likely what type of cancer?

Answer 44

ependyoma

Question 45

A cerebellar tumor in kids that was derived from the external granular cell layer (aka NEUROECTODERM) and associated with 17p- and MYC amplification is most likely...

Answer 45

medulloblastoma

Question 46

17p- and MYC amplification has what effect on prognosis of medulloblastoma?

Answer 46

poor, agressive

Question 47

T/F: medulloblastoma is not radiosensitive and requires special imaging procedures

Answer 47

false

Question 48

``` What is this? small round blue cell tumor neuronal and glial phenotypes Homer-Wright rosettes in the neuronal phenotype GFAP+ in the glial phenotype ```

Answer 48

medulloblastoma

Question 49

(Medulloblastoma/ependyoma) shows perivascular PSEUDOrosettes

Answer 49

ependyoma

Question 50

primary CNS lymphomas are high-grade B cell NHL associated with which virus?

Answer 50

EBV

Question 51

Do normal people get primary CNS lymphomas?

Answer 51

nope, need to be immunosuppressed | AIDS, post-transplant

Question 52

T/F: primary CNS lymphomas are multifocal

Answer 52

true

Question 53

Primary CNS lymphomas are BCL (2/6) pos

Answer 53

BCL-6

Question 54

What are the most common mets to the brain?

Answer 54

1. lung 2. breat 3. melanoma 4. RCC 5. GI

Question 55

Mets to the brain make up what percent of all intracranial malignancy?

Answer 55

25-50%

Question 56

where do mets normally present?

Answer 56

at the grey-white junction as well circumscribed lesions

Question 57

Pimary tumors in adults occur (above/below) the tentorium

Answer 57

above

Question 58

primary tumors in children occur (above/below) the tentorium

Answer 58

below