Brain tumors book Flashcards
Which are most common overall?
In a general community hospital setting, metastatic brain tumors are more common.
A child with craniospinal irradiation for ALL has a higher risk for developing an astrocytoma compared to other children T/F
TRUE Craniospinal irradiation is a risk factor for the subsequent development of astrocytoma and other tumors.
Radiation to the head and neck is a risk factor for subsequent development of meningioma T/F
TRUE Radiation to the head and neck, even in small amounts, is a risk factor for the subsequent development of meningioma.
Homer-Wright rosettes are relatively uncommon in medulloblastoma T/F
TRUE Homer-Wright rosettes have a high diagnostic value but are seen in a minority of tumors. Most medulloblastomas show diffuse sheets of small blue cells without rosettes
*Most primary cerebral lymphomas are:
B cells
Low grade tumors have as many but different chromosomal abnormalities as high grade tumors do
T/F
FALSE
The more malignant the tumor, the more numerous and complex the chromosomal and molecular changes.
*A 5 year old boy had multifocal brain lesions. The histoloy revealed a dense collection of large atypical mononuclear cells around a blood vessel, consistent with a CNS lymphoma. The most likely underlying factor is:
Genetic immunodeficiency
Cerebral lymphomas in children are rare. The presence of a cerebral lymphoma in a child strongly suggests a genetic immunodeficiency.
Which of the following are the most ubiquitous neurocarcinogens?
Nitroso compounds
Which of the following is not a feature of pilocytic astrocytoma?
Brisk mitotic activity -
Brisk mitotic activity is not a feature of pilocytic astrocytomas. Drop metastasis have been reported with some hypothalamic pilocytic astrocytomas. PAs may be located in the spinal cord. In their most common location, the posterior fossa, they may obstruct CSF flow causing hydrocephalus. GEDs are a cellular marker of PAs.
What finding distinguishes glioblastoma multiforme from lower grade astrocytomas?
Necrosis
Which lesions extend across the corpus callosum?
Glioblastoma
Cerebral lymphoma
Schilder’s disease
Which present as a ring enhancing lesion?
Acute multiple sclerosis plaques
Metastatic tumors
Glioblastoma
A 3 year old boy with a history of headaches and morning vomiting for 10 days presents to the ER after a bad episode of vomiting. He is afebrile. The diagnostic studies might include all of the following except:
A. Fundoscopic examination
B. CSF for viral PCR
C. GI endoscopy
D. MRI
B. CSF for viral PCR - The symptoms suggest increased intracranial pressure. A spinal tap is contraindicated
The most common intracranial site of germ cell tumors is:
The pineal gland -The most common site is the pineal gland followed by the suprasellar region.
A previously healthy 53 year old man had an insidious onset of headaches, obtundation, and facial paralysis. CSF shows 33 lymphocytes, glucose 36, and protein 72. The most likely diagnosis is:
Meningeal carcinomatosis- The clinical presentation and CSF profile are consistent either with meningeal carcinomatosis or with tuberculous meningitis. Tuberculous meningitis would be expected to have fever and symptoms of infection. Insidious presentation in a 50 year old healthy person is more consistent with carcinomatosis from an occult primary.
