Brain Tumour Pathology

Question 1

name some localised lesions that can causes raised intracranial pressure

Answer 1

> haemorrhage
tumour
abscess

Question 2

what generalised pathology can cause raised intracranial pressure?

Answer 2

oedema post trauma

Question 3

of are the effects of space occupying lesions?

Answer 3

increased amount of tissue causes an increase in the intracranial pressure.
this causes an internal shift (herniation) between the intracranial spaces.

Question 4

what herniation can occur due to space occupying lesions?

Answer 4

> right left/ left right
cerebrum moves inferiorly over the edge of tentorium
cerebellum moves inferiorly into foramen magnum

Question 5

name 6 types of brain herniation

Answer 5

> cingulate
> central
> uncal
> cerebrotonsillar
> upward
> transcalvarial

Question 6

what can a cerebellar tonsillar herniation cause?

Answer 6

brainstem death as the tonsil are moved downwards and inwards crushing the brainstem

Question 7

what effects do tumours have on near by brain tissue?

Answer 7

the tumours squeezes and causes ischaemia

Question 8

what are the symptoms of a squeeze on the cortex and brainstem?

Answer 8

> morning headaches

> sickness

Question 9

what sign would suggest a squeeze on the optic nerve

Answer 9

papilloedema

Question 10

what happens as intracranial pressure increases?

Answer 10

> pupillary dilation
falling GCS score
brainstem death

Question 11

name a tumour originating from a glial cell

Answer 11

gliomas

Question 12

from what cell does a medulloblastoma originate?

Answer 12

embryonic neural cells

Question 13

from what cell does a meningioma originate?

Answer 13

arachnoidal cell

Question 14

what tumours do nerve sheath cells develop into?

Answer 14

> schwannoma

> neurofibroma

Question 15

what are pituitary gland tumours called?

Answer 15

adenoma

Question 16

what cell do lymphoid tumours grow from?

Answer 16

lymphoma

Question 17

what tumour develops from capillary vessel cells?

Answer 17

haemangioblastoma

Question 18

what cancers commonly metastasise to the brain?

Answer 18

> breast
> lung
> kidney
> colon
> melanoma

Question 19

are glial cell tumours malignant?

Answer 19

yes

Question 20

name a childhood malignant tumour

Answer 20

medullablastoma

Question 21

in adults or children are the majority of tumours above the tentorium?

Answer 21

adults

Question 22

describe a glioma tumour

Answer 22

> diffuse edges: not encapsulated

> malignant but not metastasising to outside the CNS

Question 23

name 3 gliomas

Answer 23

> astrocytoma (glioblastoma)
oligodendroglioma
ependymoma

Question 24

what is the function of the astrocytoma?

Answer 24

its long processes support other cells structurally and biochemically

Question 25

describe a low grade astrocytoma

Answer 25

> bland cells on microscopy > slow growing and diffuse > slow progression of symptom

Question 26

describe a glioblastoma

Answer 26

``` > most malignant astrocytoma > cellular atypical tumour > necrosis under microscope > fast growing tumours > large cell with multiple nuclei ```

Question 27

describe a medullablastoma

Answer 27

> tumour of primitive neuroectoderm > sheets of small undifferentiated cells > located in posterior fossa . children especially

Question 28

describe a meningioma

Answer 28

> benign but locally aggressive so invade skull > slow growing > often resectable

Question 29

what do meningioma's develop from?

Answer 29

> from arachnocytes that make up the coverings of the brain

Question 30

what may be seen on microscopy of a meningioma?

Answer 30

> bland cells forming small groups > sometimes calcification called psammoma > can resemble an arachnoid granulation

Question 31

what is an acoustic neuroma?

Answer 31

an 8th vestibular nerve schwannoma at the angle between pons and cerebellum causing unilateral deafness. benign lesion

Question 32

describe a pituitary adenoma

Answer 32

> benign tumour in pituitary fossa > secretes pituitary hormone > can grow superiorly and impinge on the optic chiasm

Question 33

describe a CNS lymphoma

Answer 33

> high grade neoplasm > usually diffuse large Bcell lymphoma > deep and central site of the brain > does not spread outside the CNS

Question 34

why is a CNS lymphoma difficult to treat?

Answer 34

drugs do not cross the blood brain barrier

Question 35

what is a haemangioblastoma?

Answer 35

> space occupying tumour of the blood vessels

Question 36

where is a haemangioblastoma often located?

Answer 36

in the cerebellum