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Neurology > Brain Tumors > Flashcards

Brain Tumors Flashcards

1
Q

What is the incidence of brain tumors?

A

1-2 / 10,000

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2
Q

What percent of brain tumors are primary? Secondary?

A

1’ =50%

2’ = 50%

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3
Q

What are the origins of brain tumors? (4)

A
  • Meningeal
  • Cells intrinsic to the brain (Gliomas/neuronal/others)
  • CNS lymphoma
  • Metastases
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4
Q

What is the order of incidence of mets in the brain?

A
  1. Lung
  2. Breast
  3. GU
  4. Osteosarcoma
  5. Melanoma
    6 GI

(LUBGOM)

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5
Q

Where are mets in the brain usually located? What are their characteristics?

A

Multiple, well circumscribed; usually present at the gray white junctions

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6
Q

What cells give rise to glioblastoma multiforme?

A

Astrocytes

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7
Q

What cells give rise to astrocytomas?

A

Astrocytes

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8
Q

What cells give rise to meningioma?

A

Meningothelial cells

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9
Q

What cells give rise to medulloblastomas?

A

Neural cell precursors

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10
Q

What cells give rise to schwannomas?

A

Schwann cells

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11
Q

Which usually has multiple lesions: primary brain tumors, or secondary?

A

Secondary

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12
Q

True or false: mets to the brain are usually well circumscribed masses

A

True

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13
Q

How often do primary tumors of the brain metastasize?

A

Rarely

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14
Q

True or false: even benign tumors of the brain are problematic

A

True–limited space in the skull

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15
Q

What are the s/sx of increased ICP? (6)

A
  • *-HA
  • Vomiting
  • Papilledema**
  • Ocular palsies
  • AMS
  • Back pain
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16
Q

What is the drug of choice for emergent increased ICP?

A

Mannitol

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17
Q

What percent of childhood cancers are brain cancers?

A

20%

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18
Q

The majority of adult brain tumors are found where? Children?

A 
Adults = supratentorial
Child = infratentorial (posterior fossa)
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19
Q

What are the 4 major childhood primary brain tumors?

A
  1. Pilocytic
  2. Medulloblastoma
  3. Ependymoma
  4. Craniopharyngioma
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20
Q

What are the top four adult brain cancers?

A
  1. Glioblastoma
  2. Meningioma
  3. Hemangioblastoma
  4. Schwannoma
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21
Q

Are astrocytomas benign or malignant tumors?

A

Malignant

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22
Q

What are the gross characteristics of astrocytomas?

A

Large, multicolored (red) mass with a central area of necrosis and hemorrhage

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23
Q

What are the histological characteristics of Glioblastoma multiforme? (4)

A
  • Hypercellular
  • Hyperchromatism
  • Pleomorphism
  • Palisading around necrosis
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24
Q

Histological slide of the brain with hypercellularity, hyperchromatism, pleomorphic cells, and palisading cells around a central area of necrosis = ?

A

Glioblastoma multiforme

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25
Q

What is the prognosis for Glioblastoma multiforme?

A

Poor

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26
Q

Is Glioblastoma multiforme benign or malignant?

A

Malignant

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27
Q

Where in the brain are Glioblastoma multiforme usually found?

A

Cerebral hemispheres, and can cross corpus callosum

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28
Q

What are butterfly gliomas?

A

Glioblastoma multiforme that crosses the corpus callosum

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29
Q

What is the stain that can be used to highlight Glioblastoma multiforme?

A

GFAP

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30
Q

What is GFAP? Where is it found?

A

Glial fibrillary acidic protein

intermediate filament that is expressed by numerous cell types in the CNS, including astrocytes, and ependymal cells

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31
Q

How can you identify meningiomas grossly?

A

White capsule that surrounds it

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32
Q

What are the histological characteristics of meningiomas?

A

Spindle cells in a Tight whorling tumors cells

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33
Q

Spindle cells in a Tight whorling tumors cells = what?

A

Meningiomas

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34
Q

Are meningiomas benign or malignant?

A

Benign

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35
Q

Where are meningiomas usually found?

A

Convexities of the hemispheres

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36
Q

What cells give rise to meningiomas?

A

Arachnoid cells external to brain parenchyma, that may have a dural attachment

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37
Q

True or false: meningiomas are often asymptomatic

A

True

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38
Q

What is the treatment for meningiomas ?

A

Resection

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39
Q

What are the 4 tumors that has psammoma bodies?

A
  1. Papillary thyroid carcinoma
  2. Papillary serous cystadenomas
  3. Meningiomas
  4. Papillary renal cell CA
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40
Q

What are the gross characteristics of hemangioblastomas?

A

large, exophytic red mass

41
Q

What, generally, are hemangioblastomas composed of?

A

Vascular structures

42
Q

What are the histological characteristics of hemangioblastomas?

A

Closely arranged, thin-walled capillaries with minimal interleaving parenchyma + foamy cells

43
Q

Are hemangioblastomas malignant or benign?

A

Benign

44
Q

Where are hemangioblastomas usually found in the brain?

A

Cerebellum

45
Q

What diseases are associated with hemangioblastomas?

A

VHL syndrome if found with retinal angiomas

46
Q

What is the hematological disorder that can be brought about 2/2 hemangioblastomas? Why?

A

Polycythemia 2/2 EPO production

47
Q

Closely arranged, thin-walled capillaries with minimal interleaving parenchyma + foamy cells = ?

A

hemangioblastomas

48
Q

Polycythemia 2/2 to a brain tumor point to what type of brain tumor?

A

hemangioblastomas

49
Q

What is the genetic cause of VHL syndrome?

A

VHL suppressor gene on chromosome 3

50
Q

What is the genetic cause of tuberous sclerosis?

A

TSC1, TSC2 genes which code for hamartin, tuberin respectively

51
Q

What are the gross characteristics of Schwannomas?

A

“Fish flesh”–soft tan appearance

52
Q

What is the antoni A pattern of Schwannoma?

A

Palisading nuclei surrounding pink areas

53
Q

What is the antoni B pattern of Schwannoma?

A

Looser stroma, fewer cells, and myxoid changes

54
Q

Where are Schwannoma usually found in the brain?

A

Cerebellopontine angle

55
Q

What is the stain that can be used for Schwannoma?

A

S100

56
Q

S100 is used to stain for what brain tumors? (3)

A

Schwannoma, neurofibromas, melanoma

57
Q

Which CN is usually affected with Schwannomas?

A

CN VIII

58
Q

Bilateral Schwannomas = what inherited disease?

A

NF2

59
Q

Are Schwannomas benign or malignant?

A

Benign

60
Q

What are the CT findings with oligodendroglioma?

A

Calcifications with a central mass

61
Q

What are the gross characteristics of oligodendrogliomas?

A

Thickened corpus callosum and diffuse involvement

62
Q

How fast do oligodendrogliomas grow?

A

Slowly

63
Q

What are the histological characteristics of oligodendrogliomas?

A

Small, round nuclei with a perinuclear halo

Chicken wire vasculature

64
Q

Small, round nuclei with a perinuclear halo + Chicken wire vasculature= ?

A

oligodendrogliomas

65
Q

What age group do oligodendrogliomas usually present?

A

Middle aged

66
Q

“Fried egg” cells with round nuclei and clear cytoplasm = ?

A

oligodendrogliomas

67
Q

True or false: oligodendrogliomas usually have calcifications on a noncontrast CT

A

True

68
Q

What is the most common pituitary adenoma?

A

Prolactinoma

69
Q

What is the classic visual field deficit associated with pituitary adenomas?

A

Bitemporal hemianopia

70
Q

What is the effect of a secreting prolactinoma on GnRH?

A

Decreases

71
Q

What stimulate prolactin release, and which inhibits?

A 
Stimulate = TSH
Inhibits = dopamine
72
Q

What is the typical appearance of a pilocytic astrocytoma?

A

Cystic structure

73
Q

What is the prognosis for pilocytic astrocytomas?

A

Good

74
Q

What are the histological characteristics of pilocytic astrocytomas?

A

Small

75
Q

What are the rosenthal fibers that can be found in pilocytic astrocytomas?

A

Thick, elongated, worm-like or corkscrew eosinophilic bundles

76
Q

Where in the brain are pilocytic astrocytomas usually found?

A

Cerebellum

77
Q

What is the stain that is useful for highlighting pilocytic astrocytomas?

A

GFAP

78
Q

Are pilocytic astrocytomas usually malignant or benign?

A

Benign

79
Q

What are the histological characteristics of pilocytic astrocytoma?

A

Rosenthal fibers

80
Q

Homer wright Rosettes are found in what brain tumor?

A

Medulloblastoma

81
Q

What are Homer wright Rosettes?

A

Small, blue cells cells

82
Q

Are Medulloblastoma malignant or benign?

A

Malignant

83
Q

What are the cells that give rise to Medulloblastomas?

A

Neuroectodermal cells

84
Q

What are the mass effect problems associated with Medulloblastomas? (2)

A

Compression of 4th ventricle

Spinal drop mets to the spinal cord

85
Q

What are the histological characteristics of medulloblastomas?

A

Homer-Wright rosettes

86
Q

What are the histological characteristics of Ependymomas?

A
  • Perivascular pseudorosette

- Rod shaped blepharoplasts found near nucleus

87
Q

Where are Ependymomas usually found in the brain?

A

4th ventricle

88
Q

What is the major sequelae of Ependymoma? Why?

A

Hydrocephalus–usually invades the 4th ventricle

89
Q

What is the prognosis for Ependymomas?

A

Poor

90
Q

What are the blepharoplasts found in Ependymomas?

A

Modified centriole

91
Q

Are craniopharyngiomas malignant or benign?

A

Benign

92
Q

What are the mass effect problems associated with craniopharyngiomas?

A

Bitemporal hemianopsia

93
Q

What is the most common childhood supratentorial tumor?

A

craniopharyngiomas

94
Q

What cells give rise to craniopharyngiomas?

A

Cells from Rathke’s pouch

95
Q

True or false: calcification is common with craniopharyngiomas?

A

True

96
Q

Closely arranged, thin-walled capillaries with minimal interleaving parenchyma + foamy cells = what brain tumor?

A

Hemangioblastoma

97
Q

Rosenthal fibers are found in what brain tumor?

A

Pilocytic tumors

98
Q

-Perivascular pseudorosette + Rod shaped blepharoplasts found near nucleus = what brain tumor?

A

Ependymoma

Neurology (23 decks)

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