CNS tumours (9) Flashcards Preview

CM Clinical Symposia > CNS tumours (9) > Flashcards

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

Factors affecting prognosis

Age, site, surgical resection, adjuvant therapy, genetic