Brain Tumour Pathology Flashcards
name some localised lesions that can causes raised intracranial pressure
> haemorrhage
tumour
abscess
what generalised pathology can cause raised intracranial pressure?
oedema post trauma
of are the effects of space occupying lesions?
increased amount of tissue causes an increase in the intracranial pressure.
this causes an internal shift (herniation) between the intracranial spaces.
what herniation can occur due to space occupying lesions?
> right left/ left right
cerebrum moves inferiorly over the edge of tentorium
cerebellum moves inferiorly into foramen magnum
name 6 types of brain herniation
> cingulate > central > uncal > cerebrotonsillar > upward > transcalvarial
what can a cerebellar tonsillar herniation cause?
brainstem death as the tonsil are moved downwards and inwards crushing the brainstem
what effects do tumours have on near by brain tissue?
the tumours squeezes and causes ischaemia
what are the symptoms of a squeeze on the cortex and brainstem?
> morning headaches
> sickness
what sign would suggest a squeeze on the optic nerve
papilloedema
what happens as intracranial pressure increases?
> pupillary dilation
falling GCS score
brainstem death
name a tumour originating from a glial cell
gliomas
from what cell does a medulloblastoma originate?
embryonic neural cells
from what cell does a meningioma originate?
arachnoidal cell
what tumours do nerve sheath cells develop into?
> schwannoma
> neurofibroma
what are pituitary gland tumours called?
adenoma
what cell do lymphoid tumours grow from?
lymphoma
what tumour develops from capillary vessel cells?
haemangioblastoma
what cancers commonly metastasise to the brain?
> breast > lung > kidney > colon > melanoma
are glial cell tumours malignant?
yes
name a childhood malignant tumour
medullablastoma
in adults or children are the majority of tumours above the tentorium?
adults
describe a glioma tumour
> diffuse edges: not encapsulated
> malignant but not metastasising to outside the CNS
name 3 gliomas
> astrocytoma (glioblastoma)
oligodendroglioma
ependymoma
what is the function of the astrocytoma?
its long processes support other cells structurally and biochemically
describe a low grade astrocytoma
> bland cells on microscopy
slow growing and diffuse
slow progression of symptom
describe a glioblastoma
> most malignant astrocytoma > cellular atypical tumour > necrosis under microscope > fast growing tumours > large cell with multiple nuclei
describe a medullablastoma
> tumour of primitive neuroectoderm
sheets of small undifferentiated cells
located in posterior fossa
. children especially
describe a meningioma
> benign but locally aggressive so invade skull
slow growing
often resectable
what do meningioma’s develop from?
> from arachnocytes that make up the coverings of the brain
what may be seen on microscopy of a meningioma?
> bland cells forming small groups
sometimes calcification called psammoma
can resemble an arachnoid granulation
what is an acoustic neuroma?
an 8th vestibular nerve schwannoma at the angle between pons and cerebellum causing unilateral deafness.
benign lesion
describe a pituitary adenoma
> benign tumour in pituitary fossa
secretes pituitary hormone
can grow superiorly and impinge on the optic chiasm
describe a CNS lymphoma
> high grade neoplasm
usually diffuse large Bcell lymphoma
deep and central site of the brain
does not spread outside the CNS
why is a CNS lymphoma difficult to treat?
drugs do not cross the blood brain barrier
what is a haemangioblastoma?
> space occupying tumour of the blood vessels
where is a haemangioblastoma often located?
in the cerebellum
