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The Nervous System: Pathology > Pathology of Brain Tumours > Flashcards

Pathology of Brain Tumours Flashcards

1
Q

What is the main effect of brain tumours

A

Raised intracranial pressure

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2
Q

What is three anatomically feature to consider in intracranial pressure

A

The cranium is a hard rigid closed box

Falx cerebri/tentorium cerebella -Thick rough fibrous sheet inside

Foramen magnum

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3
Q

How does pressure remain stable in the brain

A

The correct amount brain tissue, blood and CF within the cranium

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4
Q

What is the causes of raised intracranial pressure

A

Space occupying lesion (localised)

Generalised pathology

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5
Q

What is three examples of a space occupying lesion that causes raised intracranial pressure

A

Heamtoma
Tumour
Abscess

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6
Q

What is an examples of a generalised pathology that causes raised intracranial pressure

A

Post trauma oedema

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7
Q

How does space occupying lesion increase intracranial pressure

A

The amount of tissue increases there direct correlation increases the intracranial pressure

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8
Q

What is the pathological affect of raised intracranial pressure on the brain

A

Causes internal shift (herniation) between the intracranial spaces

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9
Q

What are the three directions of herniations that occur

A

Right- left or left - right

Cerebellum moves inferiorly over edge of tentorium

Cerebellum moves inferiorly into foramen magnum

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10
Q

What is the six different brain herniations

A

Cingulate (subfalcine)

Central

Uncal (transtentorial)

Cerebellotonsillar

Upward

Transcalvarial

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11
Q

What occurs in cingulate brain herniations

A

Falx pushed over to side (mid line shift) so the brain pushed away from the tumour

As the cingulate gyrus is pushed over to the side and herniates underneath falxi

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12
Q

What occurs as a result of cingulate hernatio

A

Lateral ventricles crushed flat and displaced downwards

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13
Q

What cause central herniation and what is the potentially result

A

occurs when there is downward pressure centrally and can result in bilateral uncal herniation

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14
Q

What is another name for uncal herniation

A

transtentorial herniation

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15
Q

What occurs in uncal hernation

A

Brain herniated at the side of the tentorieum

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16
Q

What is the affect of uncal herniation

A

Aqueduct is crushed and narrow

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17
Q

What occurs in cerebellotonsillar hernation

A

Cerebellum moved inwards and down into foramen magnum

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18
Q

What is the affect of cerebellotonsilar herniation

A

as cerebellum tonsils move inwards and downwards and crush brainstem resulting in brain stem death

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19
Q

What occurs in trancalvarial

A

Brain herniates out of cranium through skull fracture

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20
Q

What occurs as a result of swelling and shift in the brain

A

Localied ischaemia due to the tumour squeezing the nearby tissue

creating an ischaemia zone around the tumour

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21
Q

What symptoms occurs due to the affect of squeezing on cortex and brain stem

A

Morning headaches

Sickness

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22
Q

As pressure increases on the cortex and the brain stem what sign can be seen

A

A fallling score in the Glasgow coma scale

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23
Q

What is the sign seen due to raised intracranial pressure squeezing optic nerve (CN II) and squeezing and stretching occulomotor nerve (CNIII)

A

CN II - papilloedema

CN III- pupillary dilation

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24
Q

What is the overall symptoms and signs seen for increased pressure eon the brain

A

Morning headaches

Sickness

Papilloedema

Pupillary dialtion

Decreased Glasgow coma coma scale score

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25
Q

What are common metastatic tumours in the CNS

A 
Breast, 
Lung, 
Kidney, 
Colon, (GI tract)
Melanoma
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26
Q

What are two examples of brain cell tumours

A

Gliomas - Gilal cells

Medullablastoma - Embryonic neural cells

27
Q

What kind of tumours are gliomas

A

Malignant tumours - but do not metastases outside the CNS

28
Q

What is the morphology of gliomas

A

Resemble cells of glial differentiation

  • Astrocyte/
  • oligodendrocyte
  • ependymal cells

Diffuse edges not encapsulated

29
Q

What is the main types of gliomas

A

Astocytoma - astrocyte (glioblastoma)

Oligodendroglioma - ogliodendrocyte

ependymomoa - ependymal cells

30
Q

What can be seen in a low grade astrocytoma

A

Bland cells on microscopy similar to star shaped astrocyte cell

Grow very slowly

31
Q

What can be seen in astrocytoma and glioblastoma under the microscope

A

cellular, atypical tumour with necrosis

If appear higher grade = glioblastoma

32
Q

How are astrocytoma and glioblastoma the most malignant glioma

A

as grow very quickly and are often present as large tumours

33
Q

What kind of tumour is medullablastoma and what is it derived from

A

Childhood malignant tumour

tumour derived from primitive neuroctoderm (primitive neural cell)

34
Q

Where is medullablastoma located

A

posterior fossa especially the brain stem

35
Q

Where does medullablastoma metastases

A

other part of the brain and spinal cord

36
Q

What is see under the microscope in medullblastoma

A

sheets of small undifferentiated cells

37
Q

What tumours, originate from cells surrounding or originating outside the brain

A

Meningioma

schwannoma

neurofibroma

adenoma

lymphoma

haemangioblastoma

38
Q

Mengioma is a tumour of what cell

A

arachnoid cell - cells that make up the covering of the brain
(arachnocytes)

39
Q

What kind of tumour is meningioma

A

Benign (slow growing)

40
Q

meningioma does not metastases but how does it spread

A

spreadse locally aggressive and invades the skull

41
Q

What can be seen in the microscopy of meningioma

A

Bland cells foreign small groups resuming arachnoid granulation

sometimes with calcification

42
Q

How are meningioma treated

A

Surgery as often resectable

43
Q

Schwannoma is a tumour of what cell

A

Schwann (nerve sheath) cells - which wrap around peripheral nerves and form electrical insulation (myelin sheath)

44
Q

What is an example of a schwannoma

A

Acoustic neuroma - 8th vestibulocohlear nerve schwannoma

45
Q

Where is an acoustic neuroma located,

A

At angle between pons and cerebellum

46
Q

What is the symptoms of acoustic neuroma

A

unilateral deafness

47
Q

What does the location of acoustic neuroma usually mean

A

removal is technically difficult

48
Q

What is adenoma a tumour of

A

Pituitary gland in pituitary fossa

causes hormone imbalance

49
Q

What type of tumour is an adenoma

A

benign

50
Q

How does an adenoma grow and what affect does this have

A

Grows superiorly and impinges on optic chiasma causing visual problems

51
Q

What is a lymphoma a tumour of

A

Lymphoid tissue

52
Q

What kind of tumour is lymphoma

A

High grade neoplasm

of

53
Q

What specific cell type of lymphoma affects the CNS

A

Usually diffuse large B- cell lymphoma

54
Q

Where is lymphoma located in the CNS

A

Often deep and central site in the brain

55
Q

What does the usually location of lymphoma usually mean

A

Difficulty to make biopsy

difficulty yo treat as drugs cannot cross blood brain barrier

56
Q

How far does lymphoma metastases

A

Doesn’t spread outside of CNS

57
Q

What is haemangioblastoma a tumour of

A

Blood vessels

58
Q

What is the characteristic os a haemangioblastoma

A

Is space occupying lesion
May bleed
most often found in the cerebellum

59
Q

Where are intracranial tumours more likely to be located in adults

A

majority tumours located above the tentorium

60
Q

Where are intracranial tumours more likely to be located in

A

majority tumours located below the tentorium

61
Q

What is the most common brain tumour seen clinically

A

Metastases

62
Q

What is the most aggressive glioma

A

Glioblastoma multiforme (GBM)

63
Q

How and where do glioma spread

A

by tracking through white mater and CSF pathway, don’t metastases outside the CNS

The Nervous System: Pathology (25 decks)

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