Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Neuroradiology > Brain tumours > Flashcards

Brain tumours Flashcards

1
Q

List the intraventricular brain tumors

A
  • Ependymoma (children, toothpaste lesion)
  • Pilocytic astrocytoma (children, large cystic lesion with central mural nodule)
  • Subependymoma (adults, usually in 4th and lateral ventricles), doesn’t enhance
  • Central neurocytoma (adults, lateral ventricles attached to septum pellucidum, heterogeneous mass with variable enhancement)
  • SEGA tumors (benign, young patients with TS, larger than 1 cm, calcification and marked contrast enhancement)
  • Choroid plexus tumors (papilloma, carcinoma)
  • Metastases
  • Meningioma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

List primary brain tumours that diffusion restrict

A

1) GBM
2) Medulloblastoma
3) Lymphoma

DDx: Infarct, abscess, demyelination

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Define pseudoprogression and pseudoresponse

A

Pseudoprogression - apparent increase in T2 signal in the first 3 months, usu due to radiation or chemo (caution unless clearly outside of XRT field)

Pseudoresponse - apparent decrease in enhancement, typically due to VEGF inhibitors which are anti-angiogenic and alter blood brain barrier; can occur as early as 24-48 hours- persistent findings for 4 weeks are needed to call response

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

MRS for glioblastoma

A

Decreased NAA, decreased Cr, decreased myoinosital

Increased choline, increased lactate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Most commonly tumours to bleed

A

GBM, mets - melanoma, thyroid, choriocarcinoma, RCC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Tumours that are hypointense on T2

A
  • Hypercellular tumours (medullo, lymphoma, germinoma, some GBMs)
  • Mucinous mets
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Tumours that are hyperintense on T1

A

Mets - melanoma
Fatty tumours - dermoid/ teratoma
Hemorrhagic mets (RCC, thyroid, melanoma, chorio)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Ependymoma location in adults versus kids

A

Post fossa of children, spinal cord in adults
“Toothpaste” tumours
Adult spinal tumour can occur anywhere in intramedullary cord - main ddx is astrocytoma (younger patients), difficult to distinguish b/w these on imaging

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is Lhermitte-Duclos imaging appearance and associations

A

Dysplastic cerebellar gangliocytoma - WHO I
Part hamartoma, part neoplasm
Almost always associated with Cowden syndrome (multiple hamartomas, increased risk Ca)
Tiger-striped lesion cerebellum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

ATRT imaging findings

A

Embryonal tumour - grade 4
Infants/younger patients
Can look like medulloblastoma, heterogeneous, enhancing, +/- edema
Post fossa solid tumour, but also occur supratentorial (ddx: medulloblastoma, embryonal tumours with multi-layerered rosettes i.e. ETMR)

Associated with malignant rhabdoid tumour of kidney

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Hemangioblastoma imaging features

A

WHO Grade 1 - DDX cystic tumour post fossa
Occurs in cerebellum, medulla, or spinal cord
Ass with VHL (in 30% of cases)
Cystic mass, enhancing mural nodule
Prominent flow voids, +/- syrinx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

PXA imaging features (pleomorphic xanthoastrocytoma)

A 
WHO Grade II - astrocytoma variant
Rare tumour childhood and adolescents
Chronic epilepsy
Cyst with mural nodule in temporal lobe, dural thickening and enhancement
DDx ganglioglioma (more heterogeneous)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Ganglioglioma

A

Mass in temporal lobe
Similar appearance to PXA
Also in young patient with epilepsy
Won’t see dural thickening like in PXA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Imaging appearance of central neurocytoma

A

Lobulated mass with cystic foci and calcs attached to septum pellucidum, young adults, good prognosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Chorioid plexus papilloma/carcinoma

A

Most common BT in babies**
Hyperintense on T2, enhancing, cauliflower-like
Can see in adults, usu in 4th ventricle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Classic location for SEGA

A

Enhancing mass, lateral ventricle near Foramen of Munro

17
Q

Subependymoma demographics and imaging features

A

Middle age and older adults
Often incidental
4th ventricle most common, or at foramen of munro lateral ventricle
Don’t enhance, so can easily be missed

18
Q

CNS lymphoma imaging features

A

Primary: Periventricular, enhancing mass, diffusion restriction, in BG and frontal lobes, can cross CC
Melt away with chemo/rads
Can be heterogenous if immunocompromised, with ring enhancing lesion most commonly seen in BG
DDx: toxoplasmosis (look at perfusion, or do thallium, or PET)

Secondary lymphoma typically involve meninges, may cause leptomeningeal carcinomatosis and dural masses

19
Q

3 most common primary tumours to met to brain

A

Lung, breast, melanoma

20
Q

Multiple meningiomas is associated with _____ or _____

A

NF2 or prior rads

21
Q

Most common tumours to met to dura

A

Breast (#1), lymphoma, small cell lung Ca, melanoma

22
Q

Key intracranial manifestations of VHL

A

Hemangioblastomas and endolymphatic sac tumours (along posterior petrous ridge)

23
Q

DDx CPA angle mass

A 
Schwannoma (#1) 
Meningioma
Arachnoid cyst 
Epidermoid cyst 
Aneursym
Intra-axial neoplasm
24
Q

Differences between arachnoid cyst and epidermoid on imaging

A

Arachnoid - follows CSF on all sequences, FLAIR suppression

Epidermoid - diffusion restriction, does no suppress on FLAIR

25
Q

DDx Suprasellar Mass

A

Most common:
Children - craniopharyngioma, optic pathway glioma**(associated with NF1), germinoma
Adults - pituitary macroadenoma extending into suprasellar space, meningioma, Rathke’s cleft cyst, also craniopharyngioma (bimodal distribution)

Other: epidermoid and dermoid cysts, aneurysm (do not miss diagnosis!), hypothalamic hamartoma (kids-tuber cinereum), mets (breast Ca), lymphoma, sarcoid and TB

26
Q

Most common intracranial germ cell tumour

A

Germinoma

80% pineal gland, 20% pituitary

27
Q

Clinical and imaging findings in hypothalamic hamartoma

A

Occurs in children
Gelastic seizures, precocious puberty
Mass in tuber cinereum, non-enhancing, iso T1/T2

28
Q

What is Parinaud syndrome?

A

Compression of tectal plate/rostral midbrain (usually from tumour in pineal region)
Results in upward gaze paralysis, nystagmus

29
Q

Imaging appearances of pineal germinoma

A

Avidly enhancing lesion, engulfs pineal glad, central calcification (engulfs)
Ddx. teratoma
Occurs in teenagers

30
Q

Imaging appearances of pineoblastoma

A

Explosive calcification along margins, poorly defined mass, enhancing with diffusion restriction, obstructive hydro, mets and seeding

look for associated retinoblastoma (trilateral retinoblastoma) - both on light sensing pathway

Neuroradiology (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions