Tumors Flashcards
(43 cards)
Glioblastoma multiforme
= malignant astrocytic glioma, grade IV; in older ppl.
- primary: malign. mutations start w/ 1st cell
- secondary: mutations accumulate w/ time –> become malignant
Path Dx: “ring enhancement” w/ central necrosis & peripheral vascular proliferation.
most common & most deadly type of glioma
fibrillary astrocytoma
= glioma in younger ppl, solid or cystic, grade II or III;
path: poorly demarcated, diffuse infiltration throughout brain, w/ fibrillary astrocytes & GFAP
pilocytic astrocytoma
~benign astrocytoma that often involves optic n.
* most common CNS tumor in kids, cure w/ surgery.
Path: cystic tumor in cerebellum; alternating dense & loose astrocytes, w/ Rosenthal fibers
Oligodendroglioma
grade II glioma affecting 40s-50s+, in cerebral hemispheres.
Sx: seizures, headaches,
Path: ~well-circumscribed, uniform “fried egg” cells (small round blue cells), grow slow but infiltrate
** 1p19q LOH deletion = responder phenotype (easy to treat)**
Ependymoma
glioma in 4th ventricle/wall, or spinal canal (esp. cauda equina);
Path: perivascular pseudorosettes & true rosettes, well-diff & well-circumscribed.
Tx: resect – good prognosis, + radiation.
primary tumors in cerebral hemispheres (6)
- Glioblastoma 4. Astrocytoma
- Oligodendroglioma 5. Ependymoma
- CNS lymphoma 6. meningioma - benign
primary tumors in cerebellum, brainstem, etc. (posterior fossa) (7)
- Medulloblastoma 5. hemangiomablastoma
- pilocytic astrocytoma 6. schwannoma
- ependymoma 7. meningioma
- (diffuse) astrocytoma
primary tumors in the sellar region (4)
- craniolpharyngioma
- pituitary adenoma
- Germ cell neoplasms (esp. pineal region)
- pilocytic astrocytoma (esp. optic n, hypothalamus)
primary tumors in the spinal canal (5)
- astrocytoma (diffuse or pilocytic)
- ependymoma
- myxopapillary
- schwannoma
- meningioma
- neurofibrola
Meduloblastoma
primitive neuronal cell malignant tumor (grade IV) in cerebellum;
* mostly in children.
Path: homogenous, small round blue cells, invasive - spreads via CSF
Tx: radiation (#1), surgery & chemo
meningioma
benign (grade 1) tumor of meninges, esp. in falx cerebri.
* M>F, very young or older pts, NF2!
Path: “dural tail” w/ contrast enhanced imaging; encapsulated, whorls of cells & calcifications.
Tx: resect, but often recur.
hemangiopericytoma
a sarcoma, vascular tumor in meninges or elsewhere;
Path: “stag horn” blood vessels
Tx: resect, frequently recurs, aggressive
schwannoma
benign, slow growing Schwann cell tumor in PNS,
- esp. CN VIII (“acoustic schwannoma”) or spinal cord sens. n. roots
** NF2 ** M>F, middle age pts
Path: encapsulated, @ nerve margin, biphasic w/ spindle cells.
Tx: resect - easy to preserve nerve!
Neurofibroma
Schwann & fibroblastic cell infiltrative tumor.
** NF1 (w/ cafe au lait spots)**
Path: poorly defined, disordered spindle cells, axons run through (n. f(x) spared).
* 5-10% risk malignant degeneration.
von Rcklinghausen’s disease (NF-1)
type 1 neurofibromatosis,
= peripheral, w/ cafe au lait spots & cutaneous neurofibromas, optic gliomas, etc.
Mut: neurofibromin on chrom. 17
NF-2 neurofibromatosis
central form w/ >1 CN & spinal root schwannomas (ie: bilateral acoustic schwannomas) & gliomas, but NOT usually neurofibromas.
Mut: merlin (chrom 22)
Metastatic brain tumor characteristics
primary sites: lung (#1), breast, melanoma, kidney, colon
Path: multiple, necrosis/hemorrhage, ring enhancement of contrast scan; well-circumscribed w/ surrounding gliosis & edema.
* poor prognosis
Primary CNS Lymphoma
very rare, in older ppl or immunocompromised (esp. transplant or AIDS + EBV), @ deep in hemispheres, not CSF.
path: B-cell tumors w/ angiocentric growth & brain infiltration, w/ reactive astrocytosis.
Tx: radiationm, but often recur.
Secondary lymphomas
= metastatic from systemic lymphomas, not 1st presentation;
mostly in leptomeninges & dura, multiple.
Craniopharyngioma
benign tumor from Rathke’s pouch remains (pituitary stalk),
in children OR adults;
* may invade hypothalamus & compress optic chiasm
Path: lobular encapsulated stratified squam. epithelial, calcified w/ degen. keratin
germinoma
undifferentiated, malignant & invasive brain tumor, mostly pineal;
* young ppl, 95% M
path: large nucleoli, w/ T cell infiltrate +/- other malignant cell types
Tx: curable w/ radiation if pure germinoma
Teratoma
differentiated germ cell tumor, in pineal region.
- ecto, meso, & endodermal parts
- in children, 90+% M, benign OR w/ malignant parts
pituitary adenoma
hormone-producing tumors in sella (expand to brain parenchyma),
Sxs: visual field defects, + sudden severe headache if infarction or hemorrhage of tumor
Metastatic bone tumors
*MOST common bone tumor.
= Mets from breast (#1), prostrate, lung, kidney, thyroid, etc.
Tx: radiation, *reinforce bone 1st if high risk of fracture (functional pain) bc radiation slows healing!
