Flashcards in CNS Tumors Deck (51)
What are the 3 types of gliomas?
Are most tumors of the CNS primary or metastatic?
metastatic - 70%!
What is the most common primary brain tumor in adults?
What are the general characteristics of a metastatic tumor to the brain?
generally well circumscribed
usually located in junction between gray and white matter
What are the general characteristics of a primary brain tumor?
location varies by type
Where do metastatic brain tumors often come from?
lung, bladder, breast, melanoma and others
What does pleomorphic mean?
It means the cells come in many different odd shapes - it's generally not a good sign
How common are CNS tumors in children? Which are most common in children?
In general, CNS tumors are the 2nd most common neoplasia in children
medulloblastoma and astrocytoma are the most common types
As for the location in the CNS, where do adult CNS tumors occur and where to childhood CNS tumors occur?
children - 70% posterior foss
adults - 70% supratentorial
What does the WHO base it's grading scale on?
mostly histological appearance
What are the 4 WHO grades?
1 - low proliferative potential, possible to cure wiht resection
2 - infiltrative, but low proliferative activity
3- evidence of malignancy = nuclear atypia and much mitotitc activity
4 - cytologically malignant, mitotically active, necrosis prone
What are the survival estimates for grade 2, 3, and 4?
2 = greater than 5 years
3: 2-3 years
4 = depends on treatment, but often not more than a year
What do gliomas arise from?
what is the highest-grade astrocytoma?
What are the most common symptoms of a glioma
it depends on location of tumor obviously, but headaches, seizures, memory loss and changes in behavior are common
What do you call a grade 1 astrocytoma?
(low proliferative potential)
Are pilocytic astrocytomas more common in chidlren or adults, and where in the brain d they usually occur?
children - frequently posterior fossa - cerebellum
What are the morphologic features of pilocytic astrocytomas?
bipolar cells with long hair-like processes
What genetic point is associated with pilocytic astrocytoma?
a BRAF and KIAA fusion/duplication - diagnosed with FISH
they have a worse prognosis
What is a grade 2 astrocytoma?
What is the main characteristic of a diffuse astrocytoma?
it's actually very slowly progressive, but it will almost always eventually become anaplastic
Which type of diffuse astrocytoma is most likely to progress to a grade 3?
What is the grade 3 astrocytoma called?
What are the characteristics of an anaplastic astrocytoma?
Starting to be much more cellular and pleomorphic. Often has GFAP (glial fibrillary acidic protein) as an intermediate filament
What is a grade 4 astrocytoma?
What are the usual signs and symptoms of a GBM?
slowly profressiv neuro defect, headache, symptoms of increased ICP - headaches, nausea, vomiting, cognitive impariemtn, seizures
What age group in particular developes GBMs?
60-69 is the most common
Are oligodendrogliomas usually in adults or kids?
How do patients with oligodendrogliomas usually present?
What is the mean survival for an oligodendroglioma?
What genetic deletions actually IMPROVE survival of oligodendoglioma?
deletion of both 1p and 19q
What are the morphological features of oligodendroglioma?
- shaprly circumscribe hemispheric masses
- round nuclei with cytoplasmic halos
- delicate capillary network
- most calcified
What does the perinuclear halo seen in oligodendrogliomas look like?
a fried egg
Who usually gets ependymomas? where?
children - usually near the 4th ventricle (but in adults there is a spinal cord variant)
What is the prognosis for an ependymoma?
the tumor is slow growing, but prognosis is will porr - 4 years
What are the main morphological features of ependymomas?
solid or papillary mass
dense fibrillary background
canals, pseudorosettes, rosettes
What do pseudorosettes have in their center?
a blood vessel
What WHO grade do medulloblastomas receive?
Are medulloblastomas more common in adults or children?
where in the brain do medulloblastomas usually occur?
What genetic variation is associated with poor prognosis ih medulloblatoma?
i(17q) - the short arm of chromosome 7 gets deleted and replaced with another long arm
What are the histologic geatures of medulloblastoma?
small, dark, elongated, anaplastic cells with homer-wright rosettes
What are the usual presenting symptoms with medulloblastoma?
headache, morning vomiting which gets worse with time, back pain and motion difficulties
What gender developes medulloblastoma more often?
What is a meningioma a tumor of?
arachnoid cells - attached to dura
What is the prognosis of meningiomas?
very god - they're slow growing and benign, cured by resection
What are the morphological characteristics of a meningioma?
attached to dura
forms in syncytial pattern
psammoma bodies (calcium deposits)
Who typically gets primary brain lymphomas?
How canyou diagnose a primary brain lymphoma?
easily detectable in the CSF
Where is a common place for a schwannoma to be located? What symptoms?
around CN7 at the cerebellopontine angle
hearing loss, tinnitus