Flashcards in CNS tumours (9) Deck (50):
1
What percentage are CNS tumours of all neoplasms?
2%
2
What's the most common cancer in children?
Leukaemia, then CNS tumours
3
Which CNS tumours are most common in women?
Meningioma
4
Which CNS tumours are most common in men?
Glioma
5
What CNS tumours are most common in children?
Cerebellum, PNET (medulloblastoma)
6
Which CNS tumours are most common in adults?
Cerebrum, glioma and meningioma
7
Function of arachnoid membrane and pia mater
Protein and support
8
Tumour of arachnoid membrane and pia mater
Meningioma
9
Function of neurons
Sit in cortex, cause epilepsy, not in contact with blood supply need quiet environment, don't give origin to many tumours, metabolic needs supplied by glia cells
10
Tumour of neuronal
Neurocytoma
11
Tumour of nerve sheath
Schwannoma
12
Glia cells
Astrocytes, Oligodendrocytes, Ependymal cells and choroid plexus cells, microglia
13
Tumour of glia
Glioma
14
Function of astrocytes
Support and protect (connect neurons with blood supply)
15
Tumour of astrocytes
Astrocytoma
16
Function of oligodendrocytes
Myelination
17
Tumours of oligodendrocytes
Oligodendroglioma
18
Function of ependymal cells
Controls, produces and moves CSF
19
Tumour of ependymal cells
Ependyoma
20
Function of choroid plexus cells
Specialised ependymal cell
21
Function of microglia
Defence (activated if ischaemia, allows inflammatory cells cross BBB)
22
Benign behaviour
Slow growing, respect surrounding tissue, no/slow progression, no recurrence, surgery
23
Malignant behaviour
Rapid growing, invade and destroy surrounding tissue, progress, recurrent, surgery and adjuvant therapy
24
Grade 1
Benign, no recurrence, no/very slow progression
25
Grade 2
Low grade, progression (astrocytoma 6-7 y)
26
Grade 3
High grade, rapid progression (astrocytoma 2-3 y)
27
Grade 4
Aggressive (necrosis and vascular proliferation)
28
Histological criteria for malignancy
1. Cellular density and atypia
2. Mitotic activity
3. Necrosis
4. Vascular proflieration
29
Atypia
Structural abnormality in cell
30
Hardest part about treating Gliomas?
Cells migrate through brain, can't see borders/take it out completely, no barriers in communication
31
Space occupying lesion
Only 50ml allowed to accumulated, malignancy, abscess, haematoma
32
Astrocytic tumours
Fine fibrillary and microcytic background, increased cellular density, pleomorphism (size/shape/chromasia)
33
Diffuse astrocytoma II
Infiltrative, microcytic, fibrillary, low cellular density, mild atypia, no mitotic activity
34
Anaplastic astrocytoma III
Moderate cellular density, moderate pleomorphism, mitoses
35
Glioblastoma IV
High cellular density and mitoses, necrosis, vascular proliferation
36
Pilocytic astrocytoma I
Benign, non-infiltrative, children, cerebellum, well-defined, cystic, pilocytes (thin hair-like), Rosenthal fibres (think elongated worm-like), vascular proliferation
37
Oligodendroglioma II/III
Round uniform nuclei with clear cytoplasm (fried-egg appearance), arborising capillaries (chicken wire), calcifications
38
Ependymoma II/III
Well-defined tumour, ventricles, pseudo rosettes, round small uniform cells
39
Meningioma I
(Can be grade 2/3 aggressive), females, dura, adults, well-defined extra-axial tumour, whorls/swirls, psammonma bodies (lamellate calcified structures)
40
PNET (medulloblastoma) IV
Children, cerebellum, very high cellular density, anaplastic hyper chromatic cells, frequent mitoses and apoptosis, rosette formation
41
Nerve sheath tumours - Spindle-cell tumours
Benign
42
Nerve sheath tumours - Schwannoma I
8th cranial nerve, biphasic pattern (loose and dense areas), Reticulin
43
Nerve sheath tumours - Neurofibroma I
Spinal nerves, rich in collagen
44
Aetiology
Radiotherapy - meningioma
Immunosuppression - lymphoma
Familial syndromes - NF1, NF2
45
Stem cell pathways - Wnt signalling
Haematopoietic, epidermal, gut self-renewal > colon carcinoma/epidermal tumours
46
Stem cell pathways - Shh
Haematopoietic, neural, germ line self-renewal > medulloblastoma, basal cell carcinoma
47
Stem cell pathways - Notch
Haematopoietic, neural, germ line > Leukaemia, mammary tumours
48
4 markers of molecular diagnostics of gliomas
1. MGMT promotor methylation
2. 1p/19q deletion
3. IDH1/IDH2 mutation
4. BRAF duplication/fusion
49
Prognosis
Glioblastoma IV -
50