Intracranial & CNS Tumours Flashcards Preview

Symposium > Intracranial & CNS Tumours > Flashcards

Flashcards in Intracranial & CNS Tumours Deck (27):
1

What are symptoms of raised intracranial pressure?

-Headaches (early morning)
-Vomiting
-Blurred vision

2

What are the causes of raised intracranial pressure?

-Tumours
-Surrounding oedema
-Obstructive hydrocephalus

3

What neurological deficits are there?

-Motor
-Sensory
-Cranial nerve
-Visual
-Cognitive

4

What neuro causes are there for seizures?

-Supratentorial tumours
-Partial/complex partial/secondary generlaized

5

What investigations are used for suspected intracranial tumours?

-Haematological
-Tumour markers (PSA, Bhcg, aFP)
-Hormonal assay
-Visual fields
-CXR

6

What can an fMRI identify?

-Measures brain activity by detecting changes associated with blood flow
-Speech lateralised to left hemisphere
-Bilateral hand movements by bilateral motor cortex

7

How are intracranial tumours managed?

-Medical: steroids, anti-convulsants, hormonal replacement, anti-epileptics, radio/chemo
-Surgical: remove mass effect, biopsy (free hand, endoscopic, neuro-navigation, stereotactic), excision (total/partial)
-Adjuvant therapy

8

What is a frozen section?

-Confirm abnormal tissue
-Difficult to establish for some intrinsic tumours
-Oedema surrounding tumour may look abnormal
-Tumour resection can proceed

9

What are complications of surgery?

-Hydrocephalus- third ventriculostomy, ventricle-peritoneal shunt

10

What CNS tumours are most common in males & females?

M= gliomas
F=meningioma

11

What are the types of glial cells and what are their functions?

-Astrocytes (support & protect)
-Oligodendrocytes (myelin)
-Ependymal cells & choroid plexus cells (CSF)
-Microglia (defence)

12

What tumours can arise from nervous tissue?

-Glioma
-Meningioma
-Neurocytoma
-PNET
-Schwannoma

13

What is the histological criteria for malignancy in brain tumours?

-Cellular density & atypia
-Mitotic activity
-Necrosis
-Vascular proliferation

14

What are microscopic features of astrocytic tumours?

-Fine fibrillary & microcystic background
-Inc cellular density
-Pleomorphism

15

Describe the features of a diffuse astrocytoma and its grade

-2
-Infiltrative, microcystic, fibrillary
-Low cellular density
-Mild atypia
-No mitotic activity

16

Describe the features of a anaplastic astrocytoma and its grade

-3
-Moderate pleomorphism
-Mitoses
-Moderate cellular density

17

Describe the features of a glioblastoma and its grade

-4
-Necrosis
-Vascular proliferation
-High cellular density & mitoses

18

Describe the features of pilocytic astrocytoma and its grade

-1
-Well defined cystic
-Children
-Cerebellum
-Pilocytes
-Rosenthal fibres
-Vascular proliferation

19

Describe the features and grade of an oligodendroglioma

-2/3
-Round uniform nuclei with clear cytoplasm (fried egg)
-Calcifications
-Arborising capillaries (chicken wire)

20

Describe the features and grade of an ependymoma

-2/3
-Well defined
-Ventricles
-Pseudorosettes
-Round, small uniform cells

21

Describe the features and grade of a meningioma

-1
-Adult females
-dura
-Well defined extra axial
-Whorls
-Psammoma bodies

22

Describe the features and grade of a PNET

-AKA medulloblastoma
-4
-Children
-Cerebellum
-Very high cellular density
-Anaplastic hyperchromatic cells
-Rosette formation
-Frequent mitoses & apoptosis

23

Name some nerve sheath tumours

-Spindle-cell tumours
-Schwannoma (CN8, reticulin, biphasic pattern)
-Neurofibroma (spinal nerves rich in collagen)

24

What are the causes of:
-Meningioma
-Lymphoma
-NF1/2

-M=radiotherapy
-L=Immunosuppression
-NF1/2= Familial syndromes

25

What 4 markers are relevant for molecular diagnosis of gliomas?

-MGMT promoter methylation
-BRAF duplication/fusion
-1p/19q deletion
-IDH1/IDH2 mutation

26

What are side effects of cranial radiotherapy?

-Acute= hair loss, scalp/ear erythema, cerebral oedema-raised ICP & exacerbation of neuro symptoms
-Intermediate= somnolence syndrome-severe tiredness & exacerbation of neuro symptoms
-Late= damage to sensitive structures-lens/cataracts, pituitary (hypopituitarism), cerebral hemispheres (memory loss)

27

In which tumour types can treatment be curative?

-Germ cell tumours
-Medulloblastomas
-Using chemo/radiotherapy, surgery or combination