Flashcards in Week 4: Path-Neoplasms of central nervous system Deck (12)
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1
Indicate the relative incidence of brain tumors in adults and children
-1.4% of all cancers
-20-25% of pediatric cancers
-much more common in children, 2nd most common type of neoplasm
-6th most common type in adults
2
Indicate the different in localization of brain tumors with respect to the tentorium in children and adults
Children: 70% below tentorium
adults: 70% above tentorium
3
Define Malignancy for brain tumors
-histologically: anaplasia, mitotic activity, necrosis
-clinically: depends on site, where excision may not be possible
-infiltration (but circumscribed expansile can still have a negative effect)
4
List three ways that brain tumors spread within and outside the nervous system
1. via meninges
2. via CSF
3. Into subcortical matter
5
Describe the 4 main growth patterns of brain tumors with three examples of each
1. Mass with local expansion: meningioma, schwannoma, ependymoma
2. mass with local infiltration: malignant meningioma, astrocytoma, metastatic carcinoma
3. diffuse infiltration: pontine glioma, astrocytoma, glioblastoma multiforme
4. multifocal: primary lymphoma, glioblastoma multiforme, metastases
6
Define the 4 tiered WHO grading system for gliomas
-Grade I: discrete, exemplified by juvenile pilocytic astrocytoma. Well circumscribed with good prognosis. Typical biphasic appearance with Rosenthal Fibers
-Grade IV: glioblastoma multiforme-mitotically active, atypia. Necrosis, endothelial proliferation. 9-18 mo prognosis.
7
Describe the characteristics of meningiomas. Histologically.
-from arachnoid granulations
-look epithelial
-whorly pattern
-may see psammoma bodies (Ca2+)
8
Describe the characteristics of glioblastoma multiform
-necrosis with palisading tumor cells
-malignant high grade tumor
9
Describe the characteristics of ependymoma.
-intraventricular tumor
-with rosettes
-small round sheets of cells
10
Describe the characteristics of medullablastoma.
-in the cerebellum
-histology: small round sheets of cells (mostly nucleus, little cytoplasm)
-children
11
Describe the characteristics of swanomma. Compare it with neurofibroma.
- benign tumor of Schwann cells - compresses adjacent nerve
- can be surgically excised from nerve of origin
- occurs in NF2 (especially vestibular nerve)
Neurofibroma:
- benign tumor of Schwann cells and fibroblasts
- expands nerve of origin - can not be surgically excised from nerve of origin
without sacrificing the nerve
- occurs in NF1 - rarely becomes malignant
12
