6/15- Neuro-oncology I Flashcards

1
Q

What are the processes of life/death in balance physiologically?

A

Necrosis/apoptosis:

  • Degeneration
  • Inflammation
  • Stroke
  • Trauma

Growth:

  • Neoplasm
  • Developmental
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2
Q

Brain tumors are 2nd only to ____ in malignancies of childhood?

A

Brain tumors are 2nd only to leukemia in malignancies of childhood?

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3
Q

At the most fundamental level, cancer is a set of disorders characterized by _________?

A

At the most fundamental level, cancer is a set of disorders characterized by mutations of genes regulating cell growth, differentiation, and death

(as cell proliferation, differentiation, and programmed cell death are under genetic control)

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4
Q

Tumor progression results from __________?

A

Tumor progression results from the sequential acquisition of new mutations which confer selective advantage

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5
Q

How are nervous system tumors named?

A

(Like other tumors)

According to the similarity of the tumor cells to architecture of normal tissues during development

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6
Q

CNS tumors are ____ (graded/staged) but not ____ (graded/staged). Definitions?

A

CNS tumors are graded but not staged

Staging = gross size and spread of tumor (local, nodal, systemic…)

Grading = only and ever histological (although may be used to estimate/predict tumor behavior; grades 3/4 are more likely infiltrative, but neuro-tumors are not officially staged)

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7
Q

Cellular constituents of the nervous system (3 broad categories)?

A
  • Neuroectodermal elements
  • Mesenchymal elements
  • Neural crest
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8
Q

Cellular constituents of the nervous system (details)?

A

Neuroectodermal elements

  • Neurons
  • Astrocytes
  • Oligodendroglia
  • Ependymocytes

Mesenchymal elements

  • Meninges
  • Microglia and lymphocytes
  • Blood vessels

Neural crest

  • Schwann cells
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9
Q

T/F: These are normal neurons?

A

True

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10
Q

What immunomarkers can be used for neurons?

A
  • Synaptophysin (reddish)- stains synapses
  • Neu-N (dark, more well-defined)
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11
Q

What is this?

A

Neu-N (immunomarker for neurons)

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12
Q

What is this?

A

Synaptophysin (immunomarker for neurons)

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13
Q

What is this?

A

Glia in the neuropil

  • Oligodendrocyte has smaller, denser nucleus (maker of myelin in the CNS) than astrocyte
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14
Q

Whit is this?

A

Reactive astrocytes (marks process of gliosis)

  • Increased protein synthesis
  • Prepares to form scar-like tissue
  • Eosinophilic cytoplasm in astrocyte may be reactive or neoplsatic
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15
Q

What immunomarker can be used for glia?

A

Glial Fibrillary Acidic Protein (GFAP)

  • Center of the picture is astrocyte highlighted by GFAP (star-shaped with many processes branching out to touch synapses, forming tight junctions around endothelial cells of BVs..)
  • GFAP is stronger in astrocytes than ependymal cells and oligodendrocytes
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16
Q

What immunomarker can be used for oligodendrocytes?

A

No good immunomarkers (have tried myelin-based proteins, but hasn’t worked yet)

  • On pic, can see them lining up to support neurons
  • Make myelin (CNS)
17
Q

What is shown on the left? right?

A

Left: normal oligodendroyctes

Right: oligodendroglioma

Key difference is that there are more cells on the right (hypercellular); this would be a well-behaved (low-grade) tumor

When cut this way, look like “fried-egg” cells (characteristic of oligodendrocytes); have that halo around them

18
Q

What is this?

A

Ependyma

  • Line the ventricles and central canal of SC
19
Q

What is a good immunomarker for ependyma?

A

No good immuno; however, EM shows microvilli and cilia (more epithelial characteristics than other cells)

20
Q

What can be used to mark meningothelial cells?

A

EMA: epithelial membrane antigen

(have desmosomes- dura is very tough)

21
Q

How do nervous system tumors produce symptoms?

What are these symptoms?

A

Compressing or invading adjacent neural tissue

  • Therefore, focal signs and symptoms are common in pts with these tumors
  • May result in seizures (especially in cortex) or other deficits
  • In addition to focal effects, CNS tumors produce increased ICP, with its attendant signs and symptoms
22
Q

In addiction to classification along histological lines, tumors should be organized by _________?

A

In addiction to classification along histological lines, tumors should be organized by gross localization:

  • Dura, subarachnoid, intraparenchymal (also “intra-axial”) or intraventricular
23
Q

What is Nissl substance?

A

Found in Rough ER; marker for neurons (?)

24
Q

In children, brain tumors tend to occur where? Examples?

A

In the posterior fossa:

  • Medulloblastoma (primitve neuroectodermal tissue; small blue cells that may look relatively normal)
  • Diffuse intrinsic glioma of the pons, DIG (pontine glioma)- will take out ipsilateral CNs and long tracts (contralateral Sx)
  • Ependymoma
  • Pilocytic astrocytoma
25
Q

____ (low/high) grade tumors are more serious?

A

High grade tumors are more serious?