Brain Tumors Flashcards
Most CNS tumors originate where?
**metastatic from another site **
bladder, lung, breast, kidney, liver, and melanoma
Most common primary brain tumors? (2)
Giloblastoma multiforme (GBM)
menigioma
How do you distinguish a primary brain tumor from a metastasis to the brain?
PBT:
- Poorly circumscribed
- Usually single
- Location varies by specific type
Metastasis:
- generally well circumscribed
- often multiple
- Usually located in the junction between gray and white matter
Most common CNS tumors in children? (2)
- Medulloblastoma
- Astrocytoma
CNS tumors are 2nd most common neoplasm in children
Any treatment that follows the primary treatment is called what?
adjuvant treatment
WHO Grade I
generally low proliferative potential– possible to cure following resection alone
WHO Grade II
generally infiltrative but low proliferative activity
(cells are starting to move into places that they shouldn’t be)
WHO Grade III
general histological evidence of malignancy (nuclear atypia and much mitotic activity)
WHO Grade IV
cytologically malignant, mitotically active, necrosis prone. Rapid pre and post operative disease progression
pilocytic astrocytoma
Grade I
Low proliferative potential
A child patient presents with a primary brain tumor that is in the posterior fossa (common to cerebellum), and you hear from the oncologist that the patient has a good prognosis. What do they likely have? WHO Grade?
pilocyclic astrocytoma
(Grade I)
Morphologic features:–often cystic–bipolar cells with long hair-like processes–rosenthal fibers–biphasic: loose areas and dense areas
Rosenthal fibers are associated with what what type of primary brain tumor? What color do they appear on H and E?
pilocytic astrocytoma
rosenthal fibers are eosinophilic (red) and composed of several proteins including GFAP
diffuse astrocytoma
Low proliferative potential but infiltrative
Grade II
anaplastic astrocytoma
shows more cellular regions–more pleomorphism, more mitoses
Grade III
GFAP
glial fibrillary acidic protein
Principle intermediate filament in mature astrocytes
If elevated, indicates damage to astrocytes
Difference between primary GBM and secondary GBM
secondary GBM begins as a anaplastic astrocytoma
primary GBM is direct diagnosis
pseudopalisading necrosis
a key feature of a primary GBM
glioblastoma
Grade IV
- variation in appearance in different areas
- necrosis
- vascular proliferation
A patient presents with seizures and an MRI indicates a sharply circumscribed hemispheric masses, and biopsy reveals a highly vascularized tumor, round nuclei with cytoplasmic halos and some calcification. What type of neoplasm?
Oligodendroglioma
Medulloblastoma
WHO grade IV
Clinical features: Usually in children, usually in cerebellum–Very radiosensitive!– isochromosome (17)(q10) = poor prognosis
Morphologic features: Well-circumscribed Histologic features: Small, dark, elongated, anaplastic cells–Homer-Wright rosettes
A child patient presents with headach, and morning vomitting that gets worse with time. In addition, the patient is having trouble with motion sickness and back pain. What should you be worried about?
Medulloblastoma
(Remember to look for isochromosome 17 i17, which if present is a poor prognosis)
Meningioma
Second most common primary brain tumor
Clinical features:–benign tumor of arachnoid cells–slow-growing, benign–cured by resection
Morphologic features:–attached to dura, compresses brain–syncytial pattern–psammoma bodies
syncytial pattern
sworreling
psammoma bodies
calcium deposits
