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NeuroOncology Flashcards

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1
Q

What controls cell proliferation, differentiation, and programmed cell death

A

Genetics

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2
Q

What controls cell proliferation, differentiation, and programmed cell death

A

Genetics

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3
Q

Cancer is a set of disorders characterized by mutation of genes that regulate

A

cell growth
differentiation
death

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4
Q

Tumor progression results from the sequential acquisition of

A

new mutations which confer selective advantage

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5
Q

How are nervous system tumors named

A

according to their similarities with normal tissue during development

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6
Q

NS tumors derive from

A

cellular constituents of the nervous system
Neuroectodermal elements

Mesenchymal elements

Neural crest elements

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7
Q

Name four neuroectodermal elements that can become tumors

A

neurons
astrocytes
oligodendroglia
ependymocytes

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8
Q

Name three mesenchymal elements (tissue) that can become tumors

A

meninges
microglia &lymphocytes
blood vessels

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9
Q

Name one neural crest cell that can become a tumor

A

schwann cells

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10
Q

Cancer is a set of disorders characterized by mutation of genes that regulate

A

cell growth
differentiation
death

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11
Q

Tumor progression results from the sequential acquisition of

A

new mutations which confer selective advantage

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12
Q

How are nervous system tumors named

A

according to their similarities with normal tissue during development

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13
Q

NS tumors derive from

A

cellular constituents of the nervous system
Neuroectodermal elements

Mesenchymal elements

Neural crest elements

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14
Q

Name four neuroectodermal elements that can become tumors

A

neurons
astrocytes
oligodendroglia
ependymocytes

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15
Q

Name three mesenchymal elements (tissue) that can become tumors

A

meninges
microglia &lymphocytes
blood vessels

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16
Q

Name one neural crest cell that can become a tumor

A

schwann cells

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17
Q

What is synaptophysin

A

It is present in all neurons in the brain and spinal cord that participate in synaptic transmission. It acts as a marker for tumors, and its ubiquity at the synapse has led to the use of synaptophysin immunostaining for quantification of synapses

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18
Q

Name one other tumor marker of neurons

A

neu-N

*questionable brain tumors are stained using neu-N for help with identification

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19
Q

Name one tumor marker for glial cells

A

Glial fibrilary Acidic Protein (GFAP)

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20
Q

What is GFAP

A

Glial fibrillary acidic protein is an intermediate filament (IF) protein that is expressed by numerous cell types of the central nervous system (CNS) including astrocytes

GFAP is thought to help to maintain astrocyte mechanical strength

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21
Q

What are tumor markers for oligodendrocytes

A

None

*seen primarliy in white matter and nested near the cortex

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22
Q

What are tumor markers for ependyma

A

None

*but EM shows microvilli and cilia

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23
Q

What are tumor markers for meningothelial cells

A

Epithelial Membrane Antigen

*contain desmosomes

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24
Q

What is epithelial membrane antigen

A

The protein serves a protective function by binding to pathogens and also functions in a cell signaling capacity

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25
What is a desmosome
A type of junctional complex, they are localized spot-like adhesions randomly arranged on the lateral sides of plasma membranes.
26
What are common s/s in patients with nervous system tumors
focal s/s d/t the tumor compressing or invading adjacent neural tissue
27
Tumors occurring in the dura are classified as
extra-axial tumors
28
Tumors occurring in the NS tissue are classifed as
intra-axial tumors
29
Tumors occurring in the ventricles are classifed as
inter-ventricular tumors
30
Tumors occuring intra-axially are further classifed as
supratentorial infratentorial
31
Infratentorial tumors tend to occur when
in childhood
32
Primitive Neuroectodermal tumors occur where
Germinal Matrix
33
What is the germinal matrix
the germinal matrix is a highly cellular and highly vascularized region in the brain from which cells migrate out during brain development. The germinal matrix is the source of both neurons and glial cells and is most active between 8 and 28 weeks gestation.
34
What is Primitive Neuroectodermal Tumors
is a neural crest tumor. It gets its name because the majority of the cells in the tumor are derived from neuroectoderm, but have not developed and differentiated in the way a normal neuron would, and so the cells appear "primitive".
35
What is neuroectoderm
One of the three primary germ cell layers in the very early embryo. Generally speaking, the ectoderm differentiates to form the nervous system (spine, peripheral nerves and brain)
36
Name three types of neuroglial involved in tumor formation
ependyma astrocyte oligodendrocyte
37
Tumors of the Neuroglial precursors and germinal matrix are classifed as -------- and graded as -----
glioblastoma muliforme grade IV
38
A common tumor of the germinal matrix (primitive neuroectodermal tumors) are
medulloblastoma
39
List three cell types considered in grade III staging of tumors and their names
ependyma (anaplastic ependymoma) astrocyte (anaplastic astrocytoma) oligodendrocyte (anaplastic oligodedroglioma)
40
List the three cell types considered in grade II staging of tumors and their names
ependyma-ependymoma astrocyte-astrocytoma oligodendrocyte-oligoendroglioma *simply drop the aplastic
41
Name and example of grade I tumor
juvenil pilocytic astrocytoma *able to tx and surgical excise
42
What makes glioblastomas hard to tx
highly differentiated and involves neighboring structures, making excision difficult
43
Neurons develop from germinal matrix to form
mature neurons
44
What do you call a tumor of the neuron
neuronal tumors
45
Name the four most common childhood brain tumors
medulloblastoma brainstem glioma pilocytic astrocytoma ependymoma
46
What microscopic characteristics indicate that a tumor is medulloblastoma
multiple irregular nucleus | clustering of cells in a circle with a clear ctr (Rosette)
47
What gross characteristic indicates that a tumor is glioblastoma multiforme
tumor with no clear border with brain tissue *on MRI it looks like a butterfly
48
What area of the brain is commonly infiltrated with glioblastoma multiforme
corpus callosum
49
What deficit is prevalant with a glioblastoma multiforme
frontal loss of inhibition
50
** What two major micorscopic hallmarks are see in glioblastoma multiforme
vascular proliferation necrosis * extreme cellular pleomorphism
51
Anaplastic astrocytoma is what grade tumor
grade III
52
Gross view of anaplastic astrocytoma in a coronal cross section shows abnormal tissue in what brain region
temporal lobe
53
What major sign is seen in patients with temporal lobe anaplastic astrocytoma
partial complex seizures
54
What differentiates anaplastic astrocytoma from astrocytoma
increased cellularity | Mitosis seen
55
What two features differentiates anaplastic astrocytoma from glioblastoma multiforme
no vascular proliferation | no necrosis
56
What are characteristic features in astrocytoma
low cellularity low pleomorphism NO mitotic activity
57
What grade is pilocytic astrocytoma
grade 1 *circumsribed tumor
58
What is pilocytic astrocytoma
a neoplasm of the brain that occurs more often in children and young adults (in the first 20 years of life
59
What are the four places that pilocytic astrocytomas usually arise
the cerebellum, near the brainstem, hypothalamic region, or the optic chiasm
60
What are two microscopic hallmarks of pilocytic astrocytoma
Rosenthal fibers (collection of GFAP) Increased celluarlity
61
What is a characteristic of oligodendroglia on an axial MRI
no sharp borders with infiltration
62
What is the main microscopic characteristic of oligodendroglioma
fried egg cell *round nucleus and clear cytoplasm
63
Ependymal tumors arise from
the ventricle *csf obstruction early, less infiltration than olig/astros
64
What is a hallmark of ependymal tumors under the microscope
cells encircling a clear circle *cell try to make miniture ventricle so they surround a free space or vessel
65
The exact tissue of origin of a tumor is obtained by knowing the
gross location *localization
66
Brain tumors are classified as
primary secondary
67
Primary brain tumors arise in the tissue of the brain and consists of what five types
``` neuroglial meningothelial schwann hematopoetic blood vessels ```
68
Neuroglial tumors are divided into
neuronal tumors gliomas
69
Meningothelial tumors are called
meningioma
70
Schwann cell tumors are divided into
schwanoma neurofibroma
71
Hematopoetic tumors consist of
lymphocytes microglial
72
Blood vessel tumors are called
hemangioblastoma
73
Secondary brain tumors are tumors that
metastasize
74
Brain tumors that metastasize are derived from what 5 areas of the body
``` Lung Breast GI Renal Melanoma ```
75
Neurofibromas are classifed as
NF 1 NF2
76
What chromosome defieciency causes NF1
Chromosome 17
77
What is the protein that comes from NF1
neurofibromin
78
What chromosome deficiency causes NF2
Chromosome 22 * multiple tumors possible
79
What is the name of the NF2 gene
Merlin *tumor suppresor protein gone array
80
Meningioma arise from
arachnoid cap cells of the aracnoid villi
81
Meningiomas have deletions on what chromosome
22
82
What is the prognosis of someone with meningioma
good *These tumors tend to push rather than invade
83
What is the gross appearance of menigiomas on a coronal view
distinct border, well circumscribed
84
A meningioma of the optic nerve arises from
the dural sheath of the nerve
85
A optic nerve pilocytic astrocytoma arises from
the nerve itself-glioma
86
What are the similiarites b/t a meningioma of the optic nerve and optic nerve pilocytic astrocytoma
both lead to progressive vision loss in one eye both can be surgically removed
87
Microscopically, a meningioma look like
tropical storms little orphan annie eyes
88
What are the calcification bodies that surround the "tropical storm" features of meningiomas
Psammoma bodies *meniingiomas are surrounded by psammoma bodies
89
Name two nerve sheath tumors derived from schwann cells
scwannoma | neurofibroma
90
Schwannoma most commoly occurs on
CN VIII at the CP angle *but can occur on CN3 and above
91
Microscopic image of schwannomas reveal what three distinct features
Antoni A (dense elongated nuclei) merged with Antoni B (loosely elongated nuclei) Verocay body (collection of aligned nuclei)
92
Neurofibroma is a
benign nerve sheath tumor in the peripheral nervous system
93
Microscopic, neurofibroma looks like
lake surrounded by a border
94
Primary CNS lymphoma tend to occur in which two patient populations
AIDS Elderly *lymphomas only in CNS
95
Primary CNS lymphoma is highly associated with what virus
epstein barr virus
96
What type of cell does lymphomas tend to affect
B-cell
97
Microscopicallly, primary CNS lymphoma looks like
multiple ring-enhancing lesions in the deep white matter.
98
Metastatic tumors tend to localize at the
grey-white jnuction in multiple areas throught the brain *tend to be well-circumscribed
99
Meningeal carcinomatosis has lesions where
cauda equina *looks like nodule on individual fibers
100
Hemangioblastomas are
neoplasms from the blood vessels
101
Hemangioblastomas tend to occur in the
posterior foss (cerebellum) *well circumscribed>>resectable
102
Microscopicall, hemangioblastomas look like
pink, purple, slide with red markings
103
Von Hippel Lindau syndrome is marked by tumors in what two areas of the body
blood vessels (hemaingioblastomas) kidney (renal cell carcinoma)

Nervous system (7 decks)

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