Week 4: Path-Neoplasms of central nervous system Flashcards Preview

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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

juvenile pilocytic astrocytoma

-well circumscribed, cystic
-Rosenthal fibers: bright red
-biphasic
-hairlike processes
-like cerebellum but can occur elsewhere
-most common glioma in children
-more common in patients with neurofibromatosis type 1-often involves optic nerve

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