Brain Tumors Flashcards
most common form of glioma
astrocytic tumor
GBM are set apart from anaplastic astrocytoma on the basis of
necrosis, anaplasia of non-neural elements, later age of onset, rapid course
It is a tumor-like formation that has its basis in maldevelopment; it is not a true neoplasm
hamartoma
Progression to a more malignant grade of astrocytoma or to a glioblastoma may be triggered by?
1) defects in the p16-retinoblastoma gene signaling pathway
2) loss of chromosome 10
3) overexpression of the epidermal growth factor gene
most vulnerable to vasogenic edema
white matter
It has been the most common initial manifestation of primary and metastatic neoplasm
seizure
variegated appearance, hypercellularity with pleomorphism
Glioblastoma
Characteristic gene in older patients with tumors that begin entirely as glioblastomas
EGFR gene
Stupp protocol
Temozolomide 75 mg/m2 concurrently with RT and, after a hiatus of 4 weeks, given for 5 days every 28 days for 6 cycles
Favored sites of occurrence of anaplastic astrocytoma
cerebrum, cerebellum, hypothalamus, optic nerve, optic nerve and chiasm, pons
Glial fibrillary acidic protein (GFAP)
Astrocytoma
This neoplasm has a small round nucleus and a halo of unstained cytoplasm
Oligodendroglioma
Characterised by one or more streaks of calcium but with little or no surrounding edema
Oligodendroglioma
Silver carbonate stains
Oligodendroglioma
Most common glioma of the spinal cord
Ependymoma
The most common site cerebral site of ependymoma
fourth ventricle
Most frequent acquired genetic defect of meningioma
Neurofibromatosis 2 gene on chromosome 22q
Psammoma bodies
Meningioma
Most common form of meningioma
Meningothelial/Syncytial
tumor attributed to the reticulum cell forming a pinkish, gray, soft, ill-defined infiltrative mass
Primary CNS Lymphoma
The only treatment found to eradicate Ocular Lymphoma
Radiation Therapy
A valveless system of veins that run the length of the vertebral column from the pelvic veins to the large venous sinuses of the skull
Batson vertebral venous plexus
Type of leukemia with highest incidence of nervous system involvement
Acute Lymphocytic Leukemia
characterised with apathy, drowsiness, depression of consciousness and behavioural disorder occurring within several days after the last administration of MTX and cranial radiation.
Necrotizing Leukoencephalopathy
Most common neurologic complication of all types of lymphoma
Extradural compression of the spinal cord or cauda equina
It is a systemic disease with prominent nodular pulmonary lesions, dermal and lymph node changes and in approximately 30% of cases, involvement of the CNS.
Lymphomatoid granulomatosis
It is a multifocal neoplasm of large anapaestic monoclonal lymphocytes that infiltrate the walls of blood vessels and surrounding areas
Angioblastic or intravascular lymphoma
most common solid tumor of childhood
Neuroblastoma
Frequency of occurrence of choroid plexus papilloma
lateral>fourth ventricle>third ventricle
This tumor has been described to have the histologic features of medulloblastoma but occur supratentorially
Primitive Neuroectodermal Tumor
Tumor most often associated with Von-Hipel-Lindau disease
Cerebellar Hemangioblastoma
Most common type of pineal tumor
Germinoma
Where is the most common location of arachnoid cysts?
overlying the sylvan fissure or temporal pole
Hallmark of Neurofibromatosis Type 2
bilateral acoustic neuromas
Gene defect in familial schwannomatosis
mutations in the SMARCB1 gene on chromosome 22
Immunoperoxidase stain
Pituitary adenoma
T/F: In pituitary adenoma, the longer the duration of amenorrhea and the higher the serum prolactin level, the larger the tumor.
True
Rochon-Duvigneau Syndrome
III, IV, VI and first division of the V with ophthalmoplegia
Jacod-Rollet Syndrome
apex of the orbit
Foix-Jefferson Syndrome
Cavernous sinus (same as Rochon-Duvigneau Syndrome)
Gradenigo-Lannois Syndrome
V, VI
Vernet Syndrome
IX, X, XI nerves with disturbance of deglutition
Collet-Sicard Syndrome
IX, X, XI, XII
Villaret Syndrome
Collet-Sicard and Horner Syndrome
Garcin Syndrome
loss of function of all 12 cranial nerves
The encephalomyelitis associated with carcinoma has been associated with this carcinoma in most of the reported cases?
small-cell type carcinoma of the bronchus
anti-Hu
paraneoplastic encephalomyelitis
anti-Yo
cerebellar degeneration
anti-NR1
Anti-NMDA encephalitis
anti-glutamate receptor
Hodgkin Disease
Opsoclonus-Myoclonus-Ataxia Syndrome is usually a manifestation of what neoplasm in children?
Neuroblastoma
Anti-Ri
Breast cancer
anti-Ma
Testicular tumors
anti-CRMP-5
Paraneoplastic Optic Neuropathy
T/F: In approximately 25% of all patients with cancer, the brain or its coverings are involved by neoplasm at some time in the course of the illness.
True
T/F: only some brain tumors cause papilledema and many others do not.
True
T/F: A first seizure during adulthood is always suggestive of brain tumor.
True
T/F: the most common type of low-grade astrocytoma is composed of well-differentiated fibrillary astrocytes.
True
Most common glioma of the spinal cord
Ependymoma
Tumor cells present in primary CNS lymphoma
B Lymphocytes
2nd most common cranial nerve affected by schwanomma.
Trigeminal nerve
T/F: Headache due to increased ICP in patients with brain tumors abates with recumbency.
False
Most frequent acquired genetic defect of meningiomas
Truncating mutation in the neurofibromatosis 2 gene on chromosome 2q
Approximately how many percent of metastasis are in the cerebral hemispheres?
80%
T/F: Intrathecal and intraventricular chemotherapy are thought to be of value in the treatment of parenchymal metastasis.
False
In what veins are the earliest evidence of leukemia seen?
Pial veins
A solid green-colored mass of myelogenous leukemic cells
Chloroma
Most common neurologic complication of all types of lymphoma
Extradural compression of the spinal cord or cauda equina
T/F: systemic lymphoma rarely metastasizes to the brain.
True
Cranial nerve predilection of non-Hodgkin Lymphoma
Eight nerve
T/F: Medulloblasts has been identified in the fetal and adult human brain with medulloblastoma.
True
Most common solid tumor of childhood
Neuroblastoma
Paraneoplastic complication associated with neuroblastoma.
Polymyoclonus with opsoclonus and ataxia
Approximately 70% of ependymoma arises in which ventricle?
Fourth ventricle
The diagnosis of this tumor can be deduced from the appearance on CT or MRI of a cerebellar cyst containing an enhancing nodular lesion on its wall.
Hemangioblastoma
Considered as the primary gene defect in familial schwannomatosis
SMARCB1 gene mutation
T/F: By the time craniopharyngioma has attained a diameter of 3 to 4cm, it is always cystic and partly calcified.
True
Most often cell seen in pituitary adenoma
Chromophobe cell
Most helpful procedure in diagnosis and prognosis in brainstem glioma
Contrast-enhanced MRI
This is a soft, jelly-like, gray-pink growth that arises from the remnants of the primitive notochord.
Chordoma
Most common associated cancer in limbic encephalitis
Carcinoma of the bronchus (small cell type)
Syndrome associated in most cases with the anti-Hu antibody
Paraneoplastic Sensory Neuronopathy
Most specific paraneoplastic syndrome associated with CRMP- antibody
Paraneoplastic Optic Neuropathy
Most serious radiation complication of RT for brain tumors
Late-delayed
T/F: unprovoked assaults or outburst of intense rage or blind fury are very unusual.
True
Lesion characterized by a combination of gelastic seizures and precocious puberty.
Hamartoma of the hypothalamus
T/F: SUDEP is predominantly an issue of adulthood more than of childhood.
True
Most common symptomatic cause of Panayiotopoulos syndrome
Cortical heterotopia
Most common type of reflex epilepsy
Visual
T/F: A lateral tongue injury is characteristic on an epileptic attack.
True
Part of the brain most vulnerable to vasogenic edema
White matter
Only treatment found to eradicate ocular lymphoma
Radiation therapy
Most common neurologic complication of all types of lymphoma
Cauda equina syndrome
Approximately how many percent of the four groups of pineal tumors are germinoma
50%
A 15-yr old with multiple angiomatoses of the retina, renal and pancreas. What brain tumor will likely develop?
Hemangioblastoma
Most common location of brain metastasis
Gray-white junction
Most common location of central neurocytoma
Foramen of monro (intraventricular)
Primary lymphoma that most commonly spreads to the nervous system
Non-Hodgkin’s Lymphoma
Presents with mirror-image lesions in deep gray matter including the thalamus and basal ganglia
Lymphoma
Most common tumor of the filum terminale and cauda equina
Myxopapillary ependymoma
Most common intramedullary spine tumor in children
Astrocytoma
Columns of spindle-shaped cells with nuclear palisading, characteristically in Antoni A areas in schwanomma.
Verocay bodies
Most common type of primary neoplasm in patients presenting with brain metastasis with no known primary tumor
Non-small cell carcinoma
Neoplasm with highest tendency for CNS metastasis
Malignant melanoma
Any indirect effects of systemic malignancy including vascular disorders, side effects of chemotherapy, metabolic disorder or nutritional deficiency
Paraneoplastic syndrome
Syndrome of peripheral nerve hyperexcitability
Isaac’s syndrome
A cerebellar hemisphere occupied with an indistinct mass of “tiger stripe” appearance as a result of alternating layers of dysmorphic cerebellar cells is characteristic of
Lhermitte-Duclos disease
Group of tumor cells arranged in a circle around a fibrillary center in medulloblastoma
Rosettes
Refers to a neoplastic infiltration of the subarachnoid space
Meningeal carcinomatosis
Finding that distinguishes glioblastoma multiforme from lower grade astrocytomas
Necrosis
Most common intracranial site of germ cell tumors
Pineal gland
Most common location of pilocytic astrocytoma
Cerebellum
Most common location of SEGA
Wall of the lateral ventricle near the foramen of Monro
Pathognomonic microscopic finding in chordoma
Physaliphorous cells
Characteristically feature well-defined group of cells known as zellballen
Paraganglioma
Most common location of choroid plexus papilloma in children
Lateral ventricle
Most common location of choroid plexus papilloma in adults
4th ventricle
Choroid plexus papilloma is associated to what syndrome?
Li-Fraumeni syndrome
Occur in both de novo and secondary GBM
LOH at chromosome 10q and loss of PTEN gene
Paraneoplastic disorder associated with neuroblastoma
Opsoclonus-myoclonus
Subgroup of medulloblastoma with the worst prognosis
Group 3
