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Path II > Tumors of CNS > Flashcards

Tumors of CNS Flashcards

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1
Q

What is the most common type of brain tumor in adults?

A

Mets same frequency as Primary (relatively uncommon)
Above Tentorium (cerebrum_
Mets go to Infratentorium

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2
Q

What is the most common type of brain tumor in adults?

A

Mets

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3
Q

What is the most common type of brain tumor in children?

A

Primary brain tumor (below tentorium=cerebellum/brain stem)

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4
Q

What is the most common type of brain tumor in children?

A

Primary brain tumor (below tentorium=cerebellum/brain stem)

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5
Q

What type of tumor do adults get more commonly?

A

Fibrillary astrocytoma and Glioblastoma

Higher grade

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6
Q

What type of tumors do children get more commonly?

A 
Pilocytic astrocytoma (low grade)
Medulloblastoma (embryonal)
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7
Q

What type of spinal cord tumor do adults get more?

A

Meningioma/schwannoma

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8
Q

What type of spinal cord tumor do children get more common?

A

Astrocytoma/ependyoma (adult ones are rare)

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9
Q

What makes CNS neoplasma special about histology benign apearance?

A

Although look benign mass effect can cause major problems makes them malignant fasion

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10
Q

Do primary CNS neoplasms metastasize?

A

Rarely

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11
Q

What are the most common types of neoplasms to metastasize to CNS?

A

Lung, Breast, Colon

Choriocarcinoma/melanoma are rare but very frequently go to CNS

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12
Q

What are tumors of glial origin?

A

Astrocytoma
Oligos
Ependymal

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13
Q

Where are astrocytomas found?

A

Supporting cells of brain, maintain neurons, immuno surveilance, neurotransmitter clearance, neuropil repair

GFAP positive (glial fibrillary acidic protein)

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14
Q

Where are oligodendrocytes found?

A

Myelinating cells of CNS

GFAP positive

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15
Q

Where are ependymal cells found?

A

Ventricular system of CNS
Ventricles, foramens
GFAP positive

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16
Q

What is the most common glial tumor?

A

Astrocytomas
Next is oligo
Next is epedyoma

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17
Q

What is astrocytoma WHO I?

A

Pilocystic astrocytoma
FOUND IN CHILDREN
INFRATENTORIAL

Imaging: Cystic Cerebellum mass with ENHANCING MURAL NODULE
- Outside cerebellum rare and are not cystic

Pathology: Densely fibrillated tumor

  • Areas of microcytic/fibrillar: Biphasic
  • ROSENTHAL FIBERS (eosinophilc granular bodies)
  • Does not progress to increased grade

Treatment: Complete resection

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18
Q

What is Astrocytoma WHOII?

A

FIbrillary Astrocytoma

  • Occurs in Cerebral Hemispheres (adults)
  • Occurs in Pons (children

Imaging: Infiltrative

  • DO not have ENHANCING
  • CAN PROGRESS to WHO III, IV
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19
Q

What is Astrocytoma WHOIII?

A

Anaplastic astrocytoma

Major feature is MITOSES, increased cellularity, atypia

Imaging

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20
Q

What is Astrocytoma WHOIII?

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A

Anaplastic astrocytoma

Major feature is MITOSES, increased cellularity, atypia

Imaging: May be enhancing

21
Q

What is a glioblastoma?

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A

Astrocytoma WHO IV

Imaging: RING ENHANCING MASS, craggy appearance
-The ring is blood vessels

DDX: ABSCESS, METS, MS, Lymphoma

Histology: Very cellular, pleomorphic with palisading necrosis/glomeruloid vessels (multiple layers)

Two age peaks: Young adults and Older individuals

  • Young as a result of astrocytoma progression
  • Old is de novo GBM: VERY POOR Prognosis
22
Q

What is are the mutations associated with de novo GBM?

Study These Flashcards
A

EGFR amp

PTEN mutation

23
Q

What are the mutations associated with low grade astrocytoma prgoression?

Study These Flashcards
A

TP53 mutation

24
Q

What are common features of GBM?

Study These Flashcards
A

LOH 10q

p16INK41 deletion

25
Where are oligodendrocytes found?
Myelinating cells of CNS | GFAP NEGATIVE
26
What are the two grades of oligos?
WHO II, WHO III
27
What is a oligodendroglioma?
WHO II Imagin: May or may not enhance Path: ROUND CELLS with pale cytoplasm: FRIED EGG -Thin walled microvas in background - Have microcalcs
28
What is anaplastic oligodendroglioma?
WHO III Imaging : same as WHO II Path: More pleomorphism but have FRIED EGG - More MITS, and NECROSIS
29
What is the cytogenic assessment of oligodendros?
1p and 19q deletions - Important response to therapy - Have a good survivalability with PVU (procarbazine, vincristine, CCNU)
30
What are ependyomas?
GFAP positive Only WHO II, WHO III
31
What are ependyomas?
WHO II Imaging may or may not enhance Path: Perivascular Fibrillar nuclear free zone, surrounding aggregates of uniform nuclei -PERIVASCULAR PSEUDOROSETTES
32
What is a anaplastic ependyoma?
WHO III Same as WHO II but has more pleomorphism and MITS OCCUR in SPINAL CORD MORE COMMONLY IN ADULTS
33
What are tumors of the DURA and ARACHNOID?
Meningioma Arise from arachnoid are are attached to teh dura RARE IN CHILDREN HERALD NEUROFIBROMATOSIS KIDS: 4th ventricle ADULTS: lateral vents More common in women (progresterone positive) Can be small but lethal due to location (foramen magnum is lethal IMAGING: Enhance uniformly and brightly, DURAL TAIL Boat shaped, oval nuclei with eos cytoplasma Meningothelial whorls Psammoma bodies
34
What is WHOI meningioma?
Few mits, well circumscribed, DO NOT INFILTRATE
35
What is WHO II meningioma?
``` 4-20 mts/HPF, brain INVASION Increased ugliness - Increased cellularity - Small cell - Macronucleoli -Sheeting -SPontaneous ```
36
Who is WHO III meningionma?
ANAPLASTIC | >20mits/HPF,
37
Who is WHO III meningionma?
ANAPLASTIC >20mits/HPF Papillary/rhabdoid morphology Might have MONOSOMY 9p21
38
What are embryonal tumors?
CHILDREN/ YOUNG ADULT Small round blue cell tumor (sheets of small cells with hyperchromatic nuclei) SEED CSF NEUROBLASTOMa Rare Medulloblastoma: External granular layer of Cerebellar cortex, VERMIS
39
What is a medulloblastoma?
MOST COMMON Embryomal tumor - Forms from granular layer of cerebellum cortex - Should disappear, usually in VERMIS Morph variants: - Classical - Nodular/desmoplastic - Medullo with extensive nodularity - Anaplastic/large cell variant (older children aggressive) Treatment: Complete resection ``` Cytogenetics: 17p loss - PTCH, SMOH, SONIC HH -WNT - Gain 1q, 2p, 4p, 7, 19 Loss: 10,11 ``` - nmyc: Cellular anaplasia - LOH 9q (gorlins) - APC gene: DNA methylation
40
Cerebral Neuroblastoma?
``` RARE but BAD Loss of 3p Loss of Chr 10 P53 mutation rare Poor prognosis overall ```
41
What are chorid plexus tumors?
PAPILLOM>CARCINOMA - KIDS lateral Vent - Adults: 4th vent Occasionally causes hydrocephalus due to CSF production
42
What is a suprasellar mass that presents with visual, endocrine, hypothalamic syndromes?
Craniopharyngioma From remnants of Rathekye's pouch (hypopharynx Wet keratin epithelium (adamantinomatus/squamous) Calficied to help make diagnosis Can be removed unless involves optic chiasm, parenchyma of hypothalaus, floor of 3rd ventricle
43
What is a suprasellar mass that presents with visual, endocrine, hypothalamic syndromes?
Craniopharyngioma From remnants of Rathekye's pouch (hypopharynx Wet keratin epithelium (adamantinomatus/squamous) Calficied to help make diagnosis Can be removed unless involves optic chiasm, parenchyma of hypothalaus, floor of 3rd ventricle
44
What are the most common tumors in adults?
Glioblastoma/fibrillary astrocytoma
45
What is the most common tumor in children?
Pilocystic astrocytoma/medulloblastoma
46
What are signs of supratentorial mass?
HA, Seizures, Increased ICP
47
What are some infratentorial signs?
Raised ICP, Cranial Nerve defects, Cerebellar signs
48
What are some spinal cord signs?
Pain MOtor deficit/Sensory deficit Bladder/bowel problems

Path II (11 decks)

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