Tumors

Question 1

Histologic features of

Pilocytic astrocytoma

Answer 1

Biphasic
Rosenthal fibers [9c]
GFAP+ [9a]

Question 2

Histologic features of

Infiltrating Astrocytoma

Answer 2

hypercellular
nuclear atypic
GFAP+

Question 3

Histologic features of

Anaplastic astrocytoma

Answer 3

Hypercellular
nuclear atypic
GFAP+
**No microvascular proliferation of necrosis **

Bold is differentiator between this and an infiltrating astrocytoma

Question 4

Histologic features of

Glioblastoma

Answer 4

Hypercellular
nuclear atypic
mitotic acitivity
GFAP+ [13f]
pseudo palisading necrosis [13e] sash
microvascular proliferation [13c] red hair beard moustache

Question 5

Histological features of

Oligodendroglioma

Answer 5

“Fried egg” neuronal cell bodies (cytotoxic edema) [14e]
Chicken wire capillaries [14f]

Question 6

Histologic features of

Ependymomas

Answer 6

Perivascular psuedorosettes [11f]
ependymal rosettes [11g]

Question 7

Histologic features of

Meningiomas

Answer 7

Circumscribed [12d]
Spindle cells
Whorl pattern [12b]
Psammoma bodies [12f/18]

Question 8

Histologic features of

Medullablastomas

Answer 8

Small roud cells
Homer-Wright rosettes [10i]

Question 9

Histologic features of

Gangliogliomas

Answer 9

Binucleated ganglion cells
Peripheral Nissl substance
Glia
Calcifications

Question 10

Glioma with WHO grade I

Answer 10

Pilocytic astrocytoma [9]

Question 11

Glioma with WHO grade II

Answer 11

Infiltrating Astrocytoma
Oligodendroglioma [14]

Question 12

Glioma with WHO grade III

Answer 12

Anaplastic Astrocytoma

Question 13

Glioma with WHO grade IV

Answer 13

Glioblastoma [13]

Question 14

Name this glioma

Answer 14

Pilocytic Astrocytoma [9c]

Question 15

Name this glioma

Answer 15

Glioblastoma [13d]

Question 16

Name this glioma

Answer 16

Glioblastoma [13e]

Question 17

Name this glioma

Answer 17

Anaplastic Astrocytoma

Question 18

Name this glioma

Answer 18

Oligodendroglioma [14e] [14f]

Question 19

Name this glioma

Answer 19

Ependymoma [11]

Question 20

Symptoms of

Pilocytic Astrocytoma

Answer 20

Cerebellar deficits [5] [6]

Question 21

Symptoms of

Infiltrating Astrocytoma

Answer 21

New onset seizures

Question 22

Symptoms of

Anaplastic Astrocytoma

Answer 22

New onset seizures
Headache
Focal signs

Question 23

Symptoms of

Oligodenroglioma

Answer 23

Seizures [8]
Headache [10]
Focal signs [9]

Question 24

Symptoms of

Ependymomas

Answer 24

Obstructive hydrocephalus [7]
Headache [2]
Vomiting [5]
Focal signs

Question 25

# Symptoms of Meningioma

Answer 25

Seizures [8] Headache [10] Focal Signs [9]

Question 26

# Symtpoms of Medulloblastomas

Answer 26

Obstructive hydrocephalus [7] Headache [2] Vomiting [5] Ataxia [6] Nystagmus CN VI palsy

Question 27

# Symptoms of Gangliogliomas

Answer 27

Seizures

Question 28

What CNS tumors occur in the supratentorial region?

Answer 28

Infiltrating astrocytoma Oligodendrogliomas Pediatric CNS tumors: Pilocytic astrocytoma, medulloblastoma, ependymomas

Question 29

What tumors occur in the meninges

Answer 29

Meningioma [12]

Question 30

What CNS tumor occurs in the 4th ventricle in children?

Answer 30

Ependymoma [10] Medulloblastoma [11]

Question 31

What CNS tumor occurs in the spinal cord in adults?

Answer 31

Ependymoma [11c]

Question 32

What tumors occur in the hemispheres of the cerebellum?

Answer 32

Glioblastoma Ganglioglioma

Question 33

What glioma occurs in the CNS?

Answer 33

Anaplastic astrocytoma

Question 34

What glioma occurs in the brainstem?

Answer 34

Glioblastoma

Question 35

What gliomas are common in 30-45 year olds?

Answer 35

Infiltrating Astrocytoma Anaplastic Astrocytoma Oligodendrocytoma

Question 36

What gliomas are common in 8-13 year olds

Answer 36

Pilocytic astrocytoma [9]

Question 37

What brain tumors are common in children

Answer 37

Pilocytic astrocytoma [9] Ependymomas [11] Medulloclastoma [10] Gangliogliomas

Question 38

# What chromosomes/ proteins are involved in Tuberous sclerosis

Answer 38

ch9- hamartin [15] ch16- tuberin [14]

Question 39

# What chromosomes/ proteins are involved in Sturge Weber

Answer 39

ch9

Question 40

# What genes are involved in Tuberous Sclerosis

Answer 40

TSC1 TSC2

Question 41

# Clinical features of Tuberous Sclerosis

Answer 41

Skin lesions [24] [25] [26] Seizures [22] Intellectual disability [23]

Question 42

# Clinical features of Sturge Weber

Answer 42

Seizures [9] Port wine birthmark [3] Glaucoma [11]

Question 43

# What gene is involved in Sturge Weber

Answer 43

GNAQ [4]

Question 44

What is a Hamartoma?

Answer 44

Benign overgrowth of tissue

Question 45

What is a Tuber?

Answer 45

Enlarged gyri with disorganized lamination lacking separation between grey and white matter

Question 46

# Pathology seen in Tuberous Sclerosis

Answer 46

Hamartomas [15] Cortical tubers [19] Depigmented nevi Angiofibromas Subungual fibromas Shagreen patches Subependymal nodules Subependymal giant cell astrocytoma

Question 47

# Pathology seen in Sturge Weber

Answer 47

Leptomeningeal angiomas [7] Cortical calcifications with tram track appearance [13]

Question 48

# Histological features of Schwannomas

Answer 48

Biphasic Areas with increased cell density (Antoni A) and lower density (Antoni B). The Antoni A areas contain Verocay bodies, areas of palisading nuclei with an intervening non-nuclear region.

Question 49

How are schwannomas related to the genetic defect in neurofibromas

Answer 49

Defects in the NF-2 [17] gene on chromosome 22 [17b] code for the protein merlin [17a]. Merlin is a cell adhesion molecule that suppresses cell growth in crowded cellular environments. Defects in merlin allow uninhibited growth of Schwann cellsm [8].

Question 50

Where do schwannomas form?

Answer 50

along CN VIII and at the cerebellopontine angle [18]

Question 51

What are some symptoms of a schwannoma?

Answer 51

vertigo[18c], hearing loss [18b], tinnitus, ear fullness, nausea

Question 52

# Chromosome affected in NF1

Answer 52

ch17 [2b]

Question 53

# Chromosome affected in NF2

Answer 53

ch22 [17b]

Question 54

# Protein affected in NF1

Answer 54

Neurofibromin [4]

Question 55

# Protein affected in NF2

Answer 55

Merlin [17a]

Question 56

# Inheritance of NF1

Answer 56

Autosomal dominant [2]

Question 57

# Inheritance of NF2

Answer 57

Autosomal dominant [17]

Question 58

# Symptoms of NF1

Answer 58

Lisch nodules [7] freckling cafe-au-lait spots [6] neuro-fibromas optic nerve gliomas [11] seizures learning disabilities bone deformities [16]

Question 59

# Symptoms of NF2

Answer 59

Schwannomas [8] bilateral vestibular schwannomas [18] cataracts [23a] meningiomas [23]