Brain Neoplasms I

Question 1

What are the differences between the locations of neoplasms in adults vs. kids?

Answer 1

supratentorial in adults

infratentorial in kids

Question 2

What are the common brain tumors of children?

Answer 2

astrocytomas (pilocytic), medulloblastomas, and ependymomas

Question 3

What are the common brain tumors of adults?

Answer 3

astrocytomas, glioblastomas, oligodendroglioma, ependymomas, nerve sheath tumors, and metastases

Question 4

Childhood astrocytomas; age, sites, prognosis

Answer 4

first decade; CEREBELLUM or hypothalamus, best survival rates

Question 5

Histologic features of childhood astrocytomas

Answer 5

pilocytic- unlike many astrocytomas, there are clearer boarders.
you will see cystic regions and more dense regions
fibrillary processes
ROSENTHAL FIBERS (hyper-pink sausage shapes in a fibrillary backround)

Question 6

What are sites, age, and prognosis of medulloblastomas?

Answer 6

site: cerebellar vermis
age: first decade and early 20s
prognosis: around 80% cure; lower in high risk groups

Question 7

Histologic features of medulloblastoma

Answer 7

immature looking cells (very purple)
HOMER-WRIGHT ROSETTES: white in the middle
infiltrative

Question 8

Childhood ependymoma: site, age, prognosis

Answer 8

site: 4th ventricle (though possilbe in any ventricle)
age: 1st decade
prognosis: 86%- midway btw pilocytoma and medulloblastoma

Question 9

Histologic features of childhood ependymomas

Answer 9

also look kind of fibrillary, though more anaplastic tumors may show high cell density, pelomorphism and mitotic activity
PERIVASCULAR PSEUDOROSETTES (surround blood vessels.  immediately around the vessels is pink stuff, not cells)

Question 10

What is the least common type of childhood tumor? Presentation? Location? Prognosis?

Answer 10

choroid plexus papilloma/carcinoma
usually presents in the lateral ventricles (4th ventricle in adutls) with hydrocephalus
prognosis excellent for choroid plexus papillomas
prognosis “guarded” for choroid carcinomas