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Block 8 Week 2 > Usera: CNS Neoplasms > Flashcards

Usera: CNS Neoplasms Flashcards

1
Q

Ciliated cells that line the ventricular system and the spinal cord

A

ependymal cells

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2
Q

Schwann cells of the CNS

A

oligodendrocytes

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3
Q

stellate cells that are very important in supporting neurons

A

astrocytes

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4
Q

macrophages of CNS

A

microglia

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5
Q

Most common CNS tumors (70-80% of all CNS tumors)

A

astrocytomas

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6
Q

What area of the brain do astrocytomas usually occur in?

A

cerebral hemispheres

**can occur anywhere

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7
Q

Astrocytomas range in grade from (blank) to (blank)

A

1; 4

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8
Q

List the astrocytomas from Grade 1 through Grade 4

A

Pilocytic astrocytoma
Diffusely infiltrating astrocytoma
Anaplastic astrocytoma
Glioblastoma multiforme

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9
Q

Who grade I (i/iv)
Often cystic and Well circumscribed
Unique histologic appearance, benign behavior
Typically in children and young adults
Usually in the cerebellum, but can occur elsewhere
No p53 mutation

A

Pilocytic astrocytoma

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10
Q

Who typically gets pilocytic astrocytomas?

A

children and young adults

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11
Q

Where do pilocytic astrocytomas occur?

A

in the cerebellum

**can occur elsewhere

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12
Q

What are 2 histological features you would notice if looking at a pilocytic astrocytoma?

A

dense, “hair-like” fibrillary meshworks
Rosenthal fibers (large red fibers)
little to no nuclear atypia

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13
Q

Who grade II (ii/iv)
Poorly defined, infiltrating tumor. Expands and distorts normal brain architecture
Surgical implications?
Increased cellularity with Mild to moderate nuclear atypia
No mitotic figures
Variable prognosis, but usually indolent lesion
p53 mutation common

A

Diffusely infiltrating astrocytoma

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14
Q

Histological features of diffusely infiltrating astrocytoma?

A

increased cellularity with mild/moderate nuclear atypia;

no mitotic figures

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15
Q

Who grade iii (iii/iv)
Similar to grade ii, but with increased, cellularity nuclear atypia and mitotic figures
Median survival 3 years
p53 mutation common

A

Anaplastic astrocytoma

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16
Q

How is a diffusely infiltrating astrocytoma (grade II) different from an anaplastic astrocytoma (grade III)?

A

anaplastic astrocytomas have

  1. increased cellularity
  2. increased nuclear atypia
  3. mitotic figures
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17
Q 
Who grade iv (iv/iv)
Most common CNS neoplasm
Highly aggressive, ~6-15 month survival
Marked nuclear pleomorphism and atypia
p53 mutation common
A

Glioblastoma multiforme

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18
Q

What four histological features are indicative of glioblastoma multiforme?

A

Atypia
Mitotic figures
Endothelial proliferation
Necrosis

19
Q

Glioblastoma multiforme will often cross the (blank) of the brain and may be called a (blank) lesion

A

midline; butterfly

20
Q

*Who grade ii (ii/iv)
5-15% of gliomas
More common 4th-5th decades
Cerebral hemispheres:
Infiltrating, Cystic, hemorrhagic, frequent calcifications
*Low proliferative rate
Genetics: loss of 1p, 19q associated with good response to chemo/radiation

A

Oligodendroglioma

21
Q

What Who grade do oligodendrogliomas get?

A

Who grade II

22
Q

What is one feature you might see in the cerebral hemispheres with a patient with an oligodendroglioma?

A

calcifications

23
Q

What do oligodendrogliomas look like histologically?

A

fried-egg nuclei and chicken-wire vasculature

24
Q

What chromosome deletion is a positive predictor of response to chemo/radiation in patients with oligodendroglioma?

A

1p, 19q

25
Q

Benign tumor of adults (female predominance 3:2)
Frequently PR+
Arise from meningothelial cells of the arachnoid
Associated with loss of chromosome 22
Many histologic subtypes that vary in biologic behavior

A

meningiomas

26
Q

Meningiomas are frequently positive for what receptor?

A

progesterone receptor

27
Q

What chromosome deletion is often associated with meningiomas?

A

chromosome 22

28
Q

Are meningiomas benign or malignant?

A

benign, but can become malignant

29
Q

2 distinct histological features of a meningioma?

A 
whorled pattern of growth
psammoma bodies (starry night calcifications)
30
Q

Arise from ependymal cells lining ventricular system
Children and adults
Associated with nf2
0-20 yrs: paraventricular (4th ventricle most common)
Spinal cord most common site in adults

A

Ependymoma

31
Q

Ependymomas arise from (blank) cells which line the ventricular system

A

ependymal

32
Q

Ependymomas are associated with (blank)

A

neurofibromatosis type II

33
Q

Where do people ages 0-20 most frequently get ependymomas?

A

4th ventricle

34
Q

Where do adults most commonly get ependymomas?

A

spinal cord

35
Q

Histologic features of ependymomas?

A

rosettes (empty lumen surrounded by ciliated cells) and pseudorosettes (tumor cells extend toward a blood vessel in the center of the lumen)

36
Q

Cerebellar tumor in children
Derived from external granular cell layer
Associated with 17p- and myc amplification
aggressive, poor prognosis
radiosensitive
“small round blue cell tumor” with both neuronal and glial phenotypes
Homer-wright rosettes (neuronal)
Gfap+ (glial)

A

medulloblastoma

37
Q

Where do medulloblastomas occur? Who gets them?

A

cerebellum; children

38
Q

Medulloblastomas are associated with amplification of (blank) and (blank)

A

17p and MYC

39
Q

Medulloblastomas have both neuronal and glial features. What is one neuronal feature? What is one glial feature?

A

homer-wright rosettes

GFAP+

40
Q

Children most often get brain tumors (blank)

A

infratentorially (under the tentorium)

41
Q

Ebv-related high-grade b-cell lymphoma (NHL) associated with immunosuppression
AIDS, post-transplant
2% extranodal lymphomas, 1% intracranial tumors
Frequently multifocal
Bcl-6+

A

Primary CNS lymphoma

42
Q

Primary CNS lymphomas are associated with (blank) and are (blank) positive

A

EBV; BCL-6

43
Q

Most common CNS malignancy; 25-50% of all intracranial malignancy

A

metastases

44
Q

Which carcinomas are most likely to metastasize to the CNS?

A

lung
breast
melanoma

Block 8 Week 2 (10 decks)

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