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Neuropath > CNS tumors > Flashcards

CNS tumors Flashcards

1
Q

What is the most common brain tumor type?

A

Glioma

besides metastatic disease

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2
Q

What tumors are included under gliomas?

A

astrocytomas
glioblastoma
ependymoma
oligodendocytoma

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3
Q

Where can diffuse type astrocytomas be developed? Adults v children?

A

cerebral white matter of hemispheres in adults, and in brainstem of children

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4
Q

What is the name for WHO grade II diffuse astrocytoma, and the survival?

A

astrocytoma- 5-10 years

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5
Q

What is the name for WHO grade III, and survival?

A

anaplastic astrocytoma- 2-3 years

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6
Q

What grade and survival does glioblastoma multiforme have? Is it a diffuse astrocytoma?

A

yes, WHO grade IV- <1 year

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7
Q

What is the key radiographical presentation that glioblastoma multiforme shows?

A

ring-enhancement from leaky neovascularization

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8
Q

What is the histiological presentation of GBM?

A

pseudopalisading necrosis, pleomorphism, mitoses and vascular endothelial proliferation

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9
Q

What is the molecular pathway of primary GBM?

A

spontanous, short duration and high grade in older individuals,

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10
Q

What is the molecular pathway of secondary GBM?

A

younger, p53, lower grade astrocytoma precipitant

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11
Q

How does a pilocytic astrocytoma present? Prognosis?

A

cerebellar cyst with mural nodule

good prognosis, subtype of glioma

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12
Q

What is the histological pattern?

A

biphasic with:
hairlike elongations- tighly packed cells
microscopic cysts
rosenthal fibers- eosinophillic

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13
Q

What other syndrome looks like pilocytic astrocytoma? How is it different?

A

Hemangioblastoma that is a vascular tumor arising sporadically or with Von-Hippel- Lindau

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14
Q

What diffuse CNS tumor often presents with foci of calcification? What are is characteristics and location?

A

oligodendroglioma: slow growing tumor typically in cerebral hemisphere

1p 19q favorable prognosis

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15
Q

What are common histological features of oligodendrogliomas?

A

uniform fried egg appearance with calcification

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16
Q

What is the name of the slow growing tumor that commonly grows within ventricles, and in younger adults?

A

ependymomas- 4th ventricle (children) and spinal cord (adults)

17
Q

How does ependymomas histologically present?

A

pseudorosettes in perivascular regions

ependymal rosettes

18
Q

What clinical consequences result from choroid plexus papilloma?

A

increased CSF production–> hydrocephalus

19
Q

What example does Dr. Yachnis use for a PNET?

A

medulloblastoma- cerebellar PNET

20
Q

What is the most common malignant Brain tumor of children?

A

medulloblastoma- cerebellar PNET

21
Q

What cells does medulloblastoma arise from? What does it commonly obstruct?

A

primitive embryonic/fetal neuroepithelial cells,

vermis of cerebellum obstructing 4th ventricle

22
Q

Histologically, how does MB present?

A

small blue cell tumor with Homer Wright rosettes

molding, leptomeningeal dissemination

23
Q

What factors improves the prognosis of medulloblastomas?

A

9q22.3 PTCH gene mutation

cerebellum localization

24
Q

What sites are the primary metastases to CNS?

A

lung then breast

25
Q

Where do mets from other CA form in brain?

A

gray-white jnx cerebrum

epidural- Spinal cord

26
Q

What benign CNS tumor presents with whorls and psammoma bodies?

A

meningiomas- dura attachment

27
Q

What is the epidemiology of meningiomas?

A

3:2 women:males, progesterone and middle age

28
Q

How do meningiomas exert their effects?

A

compression causing seizures

29
Q

Describe the invasion possibilities of meningiomas?

A

bone invasion causing hyperostosis- cone head

30
Q

Are all meningiomas benign?

A

no. malignant meningioma has an increased recurrance risk

31
Q

Describe the location, origin, growth characteristics of schwannoma?

A

peripheral n. sheath of CN 8 from schwann cell. Slow growth compressing brainstem.

32
Q

What are bilateral acoustic neuromas/schwannomas pathognomonic for?

A

neurofibromatosis type II- chromosome 22

33
Q

What are some histological features of scwannoma?

A

Antoni A-spindle/B-vacuole, and verocay bodies.

pallisading nuclei

34
Q

Where are neurofibromas formed?

A

peripheral nerve sheath`

35
Q

How is neurofibroma physically manifested?

A

diffuse/fusiform enlargement of nerve

36
Q

What will a neurofibroma transform to?

A

malignant peripheral nerve sheath tumor MPNST

37
Q

What is a common clinical picture of a pituitary tumor, due to compression?

A

bitemporal hemianopsia

38
Q

Characterize the types of pituitary adenomas?

A

nonsecreting- hypofunction

secreting- prolactinoma

Neuropath (8 decks)

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