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Neuro Block 5 > CNS Tumors > Flashcards

Flashcards in CNS Tumors Deck (51)
1

What are the 3 types of gliomas?

astrocytomas
oligodendrogliomas
ependymoma

2

Are most tumors of the CNS primary or metastatic?

metastatic - 70%!

3

What is the most common primary brain tumor in adults?

glioblastoma multiforme

4

What are the general characteristics of a metastatic tumor to the brain?

generally well circumscribed
often multiple
usually located in junction between gray and white matter

5

What are the general characteristics of a primary brain tumor?

poorly circumscribed
usually single
location varies by type

6

Where do metastatic brain tumors often come from?

lung, bladder, breast, melanoma and others

7

What does pleomorphic mean?

It means the cells come in many different odd shapes - it's generally not a good sign

8

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

9

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

10

What does the WHO base it's grading scale on?

mostly histological appearance

11

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

12

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

13

What do gliomas arise from?

ASTROCYTES
oligodencrocytes
ependymal cells

14

what is the highest-grade astrocytoma?

glioblastoma

15

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

16

What do you call a grade 1 astrocytoma?

pilocytic astrocytoma
(low proliferative potential)

17

Are pilocytic astrocytomas more common in chidlren or adults, and where in the brain d they usually occur?

children - frequently posterior fossa - cerebellum

18

What are the morphologic features of pilocytic astrocytomas?

ofen cystic
bipolar cells with long hair-like processes
rosenthal fibers****
biphasic

19

What genetic point is associated with pilocytic astrocytoma?

a BRAF and KIAA fusion/duplication - diagnosed with FISH
they have a worse prognosis

20

What is a grade 2 astrocytoma?

diffuse astrocytoma

21

What is the main characteristic of a diffuse astrocytoma?

it's actually very slowly progressive, but it will almost always eventually become anaplastic

22

Which type of diffuse astrocytoma is most likely to progress to a grade 3?

gemistocytic astrocytoma

23

What is the grade 3 astrocytoma called?

anaplastic astrocytoma

24

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

25

What is a grade 4 astrocytoma?

a blioglastoma

26

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

27

What age group in particular developes GBMs?

60-69 is the most common

28

Are oligodendrogliomas usually in adults or kids?

adults

29

How do patients with oligodendrogliomas usually present?

with seizures

30

What is the mean survival for an oligodendroglioma?

5-10 years

31

What genetic deletions actually IMPROVE survival of oligodendoglioma?

deletion of both 1p and 19q

32

What are the morphological features of oligodendroglioma?

- shaprly circumscribe hemispheric masses
- round nuclei with cytoplasmic halos
- delicate capillary network
- most calcified

33

What does the perinuclear halo seen in oligodendrogliomas look like?

a fried egg

34

Who usually gets ependymomas? where?

children - usually near the 4th ventricle (but in adults there is a spinal cord variant)

35

What is the prognosis for an ependymoma?

the tumor is slow growing, but prognosis is will porr - 4 years

36

What are the main morphological features of ependymomas?

solid or papillary mass
round nuclei
dense fibrillary background
canals, pseudorosettes, rosettes

37

What do pseudorosettes have in their center?

a blood vessel

38

What WHO grade do medulloblastomas receive?

grade 4

39

Are medulloblastomas more common in adults or children?

children

40

where in the brain do medulloblastomas usually occur?

cerebellum

41

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

42

What are the histologic geatures of medulloblastoma?

small, dark, elongated, anaplastic cells with homer-wright rosettes

43

What are the usual presenting symptoms with medulloblastoma?

headache, morning vomiting which gets worse with time, back pain and motion difficulties

44

What gender developes medulloblastoma more often?

boys

45

What is a meningioma a tumor of?

arachnoid cells - attached to dura

46

What is the prognosis of meningiomas?

very god - they're slow growing and benign, cured by resection

47

What are the morphological characteristics of a meningioma?

attached to dura
forms in syncytial pattern
psammoma bodies (calcium deposits)

48

Who typically gets primary brain lymphomas?

immunosuppressed patients

49

How canyou diagnose a primary brain lymphoma?

easily detectable in the CSF

50

Where is a common place for a schwannoma to be located? What symptoms?

around CN7 at the cerebellopontine angle

hearing loss, tinnitus

51

What CNS tumor is associated with Flexner-Wintersteiner rosettes?

retinoblastoma