Path XVI

Question 1

most frequent glial tumor in children

Answer 1

pilocytic astroctyoma

Question 2

pilocytic astrocytomas develop where

Answer 2

cerebellum
thalamus
hypothalamus
optic nerve

Question 3

well circumscribed, not diffuse
solid and cystic in cerebellum in child
hydrocephalus

Answer 3

pilocytic astrocytoma

Question 4

Prognosis pilocytic astrocytoma

Answer 4

overall good prognosis

Question 5

histo of pilocytic astrocytoma

Answer 5

cytoplasm very thin
gelatinous cyst material
GFAP + b/c astrocytic

Question 6

diffuse astrocytoma

Answer 6

any site in CNS: supratentorial
seizures, headaches, focal signs
tendency to progress higher grade

Question 7

prognosis diffuse astrocytoma

Answer 7

5-7 years

Question 8

what is a diffuse pontine glioma

Answer 8

astrocytoma

Question 9

most frequent glial tumor in adults

Answer 9

glioblastoma WHO IV

Question 10

glioblastoma signs

Answer 10

seizures, HA, focal deficits
supratentorial
survival around a year

Question 11

primary glioblastoma

Answer 11

loss of heterogenicity!!

Question 12

secondary glioblastoma

Answer 12

starts low grade astrocytoma, anaplastic
IDH1 and 2 point mutations
TP53
loss of heterogenicity

Question 13

isocitrate dehydrogenase mutation

Answer 13

secondary glioblastoma

Question 14

IDH mutations have better or worse prognosis

Answer 14

better

Question 15

why do glioblastomas light up with contrast

Answer 15

neovascularization

Question 16

what are the sheets of pink in the sea of blue cells in glioblastoma

Answer 16

necrosis

Question 17

where do oligodendrogliomas grow

Answer 17

supratentorial
cortical
white matter
frontal lobe!!

Question 18

presentation oligodendrogliomas

Answer 18

long Hx headaches and seizures

Question 19

mutations in olidodendrogliomas

Answer 19

IDH1/2

deletion 1p and 19q

Question 20

what mutation determines long lasting response to chemo and radiation

Answer 20

1p 19q

Question 21

fried egg appearance on brain tissue histo with calcifications

Answer 21

oligodendroglioma

Question 22

medulloblastomas form where

Answer 22

posterior fossa in vermis

Question 23

signs of medulloblastoma

Answer 23

ataxia and signs of increased pressure

Question 24

where do medulloblastomas disseminate

Answer 24

subarachnoid space

Question 25

prognosis medulloblastomas

Answer 25

50-70% 5 yr

Question 26

medulloblastomas arise from

Answer 26

stem cells in subependymal matrix in extra granular layer of cerebellum

Question 27

are medulloblastomas cystic

Answer 27

no | solid

Question 28

homer wright rosettes

Answer 28

medulloblastoma

Question 29

CSF in medulloblastoma

Answer 29

high protein low glucose tumor cells +

Question 30

Tx medulloblastoma

Answer 30

resection, shunting, radiation, intrathecal chemo

Question 31

"caked" surface on brain of tumor

Answer 31

medulloblastoma

Question 32

CNS lymphoma thought to arise from

Answer 32

microglia

Question 33

patients affected by PCNSL

Answer 33

immunocompromised

Question 34

PCNSL is usually what type

Answer 34

diffuse large B cell lymphoma

Question 35

Dx PCNSL

Answer 35

Biopsy or IHC studies

Question 36

test needed to be done on immunocompromised patient with PCNSL

Answer 36

EBV positive

Question 37

spread of PCNSL

Answer 37

meningeal

Question 38

Tx PCNSL

Answer 38

corticosteroids induce apoptosis

Question 39

majority mets tumors are what kind

Answer 39

brain tumors

Question 40

primary tumor in men causing brain tumors

Answer 40

lung

Question 41

primary tumor in women causing brain tumors

Answer 41

breast cancer

Question 42

tumor with highest rate of mets

Answer 42

melanoma

Question 43

signs of meningeal carcinomatosis

Answer 43

headache, drowsiness,CN deficits, spinal root pain, paresthesias

Question 44

CSF in meningeal carcinomatosis

Answer 44

high protein low glucose few lymphocytes

Question 45

ependymoma

Answer 45

slow growing tumor, well circumscribed but can disseminate hydrocephalus in ventricular sytem and spinal cord

Question 46

where are schwannomas in CNS

Answer 46

vestibular branch of 8th CN

Question 47

syndrome with b/l schwanomas (benign)

Answer 47

NF2

Question 48

histo ependymoma

Answer 48

rossette with empty lumen