Brainscape's Knowledge GenomeTM

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


See full index

Head and neck radiology > Central nervous sytem neoplasms and tumor-like masses > Flashcards

Central nervous sytem neoplasms and tumor-like masses Flashcards

1
Q

how many % of the CNS neoplasms are malignant

A

32%

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

most of the malignanct CNS neoplasms are

A

glioblastoma

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

most of the non malignant CNS neoplasms are

A

meningiomas

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

headaches occur even though there is lack of pain receptors in the brain

A

there are nociceptors in the meninges and vessels, which are sensitive to stretch and therefore to any changes in ICP

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

headaches from neoplasm are usually worse at what position

A

supine

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

headaches from neoplasm are more commonly associated with intracranial hypotension or hypertension?

A

hypertension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

neuroepithelial tumors cell of origin

A

astrocytic, oligodendroglial, ependymal, choroid plexus, neuronal, pineal, embryonal

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

peripheral nerve tumors cell of origin

A

nerve sheath (schwannoma)

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

meningeal tumors cell of origin

A

meningothelial, mesenchymal, melanocytic

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

hematopoietic tumors cell of origin

A

lymphocytic, histiocytic

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

germ cell tumors cell of origin

A

germ cells, such as germinoma

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

sellar region tumors cell of origin

A

craniopharyngioma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

non invasive marker of tumor vascularity, utilized in MR perfusion

A

cerebral blood volume

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

noncontrast technique that magnetically labels arterial blood water flowing into the region of interest

A

arterial spin labelling

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

measures chemical shift of nonwater molecules in a region of interest (single or multi voxel) as a noninvasive marker of tumor metabolism

A

spectroscopy

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

main metabolites peak in the brain

A

choline at 3.2 ppm, creatine at 3.0 ppm, NAA at 2.0 ppm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

choline/creatine ratio of ___ is suggestive of high-grade tumor

A

> 2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

PET is less sensitive inside the CNS because

A

due to a high natural background uptake of glucose by normal brain tissue, especially gray matter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

PET may be useful in the CNS in certain circumstance, such as

A

distinguishing residual/recurrent tumor from radiation-induced changes in the white matter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

alternative radiotracers used in PET aside from FDG

A

C-11 methionine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

description of a mass

A

should be expansile, demonstrate volume gain, displace normal brain structures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

metabolite marker for astrocytes

A

myoinositol (3.5), decreased with higher grade

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

metabolite marker for cellularity

A

choline (3.2), increased with higher grade

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

metabolite marker of energy

A

creatine (3.0), decreased with higher grade tumors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

metabolite marker of hypoxia

A

lactate (1.3) increased with higher tumor grade

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

metabolite marker of necrosis

A

lipids (0.9 - 1.4), increased with higher grade

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

intra-axial mass means

A

pia mater, including both the parenchymal and ventricular comparetments, paralelling the use of “intramedullary” in the spinal cord

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

extra-axial masses are characterized by

A

“white matter buckling”, or inward compression of the cortical gray matter and underlying white matter fronds (there may also be a visible intervening CSF cleft)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

intra-axial masses are characterized by

A

tend to expand the white matter and thicken its fronds, with a “claw sign” of normal brain parenchyma wrapped around the margins of the mass

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

intratumoral hemorrhage is common in what tumors

A

highly vascular neoplasms such as glioblastoma or oligodendroglioma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Protrusion of an anatomic structure from its normal position

A

Herniation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

More common form of herniation and involves partial displacement of cerebral hemispheres across the midline into the contralateral cranial component

A

Subfalcine herniation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

When subfalcine herniation is severe, it can compress or compromise what vessel

A

Anterior cerebral arteries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Less common form of herniation and involves the partial displacement of the medial temporal lobe into the basal cisterns and tentorial hiatus

A

Uncal herniation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

When uncal herniation is severe, it can compress what structures

A

Ipsilateral posterior cerebral artery, contralateral midbrain, ipsilateral oculomotor nerve (“blown pupil”)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

form of hydrocephalus seen with tumor locations that can obstruct CSF flow within the ventricular system, for example, near the foramen of Monro or the aqueduct of Sylvius

A

noncommunicating hydrocephalus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

form of hydrocephalus that is seen with diseases that interfere with CSF reabsorption at the arachnoid granulations and less commonly with choroid plexus tumors that can cause CSF overproduction

A

communicating hydrocephalus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

intra-axial tumors are commonly neuroepithelial or non neuroepithelial

A

neuroepithelial

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

extra-axial tumors are commonly neuroepithelial or non neuroepithelial

A

non neuroepithelial

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

examples of nonenhancing intra-axial mass

A

diffuse astrocytoma, oligodendroglioma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

examples of enhancing intra-axial mass

A

glioblastoma, metastases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

examples of enhancing intra-axial mass in child

A

pilocytic astrocytoma, embryonal tumors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

examples of hyperattenuating intra-axial mass

A

primary cns lymphoma, embryonal tumors,

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

examples of cortical masses

A

DNET, Ganglioglioma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

examples of ventricular masses

A

ependymal tumors, central neurocytoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

choroid plexus masses

A

choroid plexus tumors, meningioma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

pineal region masses

A

pineal parenchymal tumors, germ cell tumors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

characterized by high nucleus-to-cytoplasm ratios and lower free water content, which results in lower signal intensity on T2 and ADC images

A

hypercellular neoplasms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

high SI in T1 usually indicates the presence of

A

fat (lipids), blood (methemoglobin) or protein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

hemorrhagic metastases (MR CT BB)

A

melanoma, renal cell ca, choriocarcinoma, thyroid carcinoma, breast carcinoma, bronchogenic carcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

calcified intracranial masses (CA COME)

A

craniopharyngioma, astrocytoma, aneurysm, choroid plexus tumor, oligodendroglioma, meningioma, ependymoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

parenchymal enhancement is an indicator of

A

the integrity of blood brain barrier

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

parenchymal enhancement in neoplasm indicates

A

fenestrated capillaries in low grade tumors or high-grade microvascular proliferation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

vascularized granulation tissue develops within how many hours following surgery and enhances after administration of contrast

A

48 to 72 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

in post-op imaging of brain tumor, it must be obtained within 48 to 72 hours post op using MRI because

A

to minimize the formation of reactive granulation tissue, which can be confused for residual tumor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

current standard therapy for glioblastoma is

A

Stupp protocol: maximal safe resection, followed by fractionated radiation and temozolomide chemo for 6 weeks, followed by adjuvant temozolomide for 6 cycles/months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

term for a transient radiation-induced enhancing lesions that appears during treatment of glioblastoma, less than 6 months after radiation, difficult to distinguish from true progression

A

pseuoprogression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

term for a more severe permanent tissue injury that happens later, months to years postradiation

A

radiation necrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

75% of all gliomas are

A

astrocytoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

major groups of astrocytomas and gliomas based on growth pattern

A

circumscribed and diffuse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

type of gliomas that demonstrate more well-defined margins on microscopic examination and tend to be more amenable to a surgical care

A

circumscribed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

type of gliomas that demonstrate more ill-defined margins on microscopic examination, regardless of the macroscopic appearance on cross-sectional imaging

A

diffuse or infiltrative gliomas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

most common pediatric CNS tumor

A

pilocytic astrocytoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

most common location of pilocytic astrocytoma

A

cerebellum 60%, optic pathways/hypothalamus 30%, brainstem

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

pilocytic astrocytoma is associated with

A

NF1 and found in 15% of optic gliomas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

less common and more aggressive variant of pilocytic astrocytoma

A

pilomyxoid astrocytoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

pilomyxoid astrocytoma is commonly seen in

A

suprasellar region

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

it is a slow growing tumor located at the foracmen of monro and is associated with tuberous sclerosis

A

subependymal giant cell astrocytoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

peripherally located cerebral tumor that often involves the cortex/meninges

A

pleomorphic xanthoastrocytoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

classic presentation of pilocytic astrocytoma

A

nonenhancing cyst with enhancing mural nodule in the cerebellum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

diffuse gliomas are subdivided into

A

isocitrate dehydrogenase mutant versus wildtype

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

majority of diffuse and anaplastic astrocytomas are

A

IDH mutant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

presents as an expansile parenchymal lesions, hypodense on CT and hyperintense on T2, without significant enahncement (intact BBB). these are also commonly seen in older age (>40 years), imaging markers of increased cellularity (decreased diffusion), mitotic activity (increased choline) or tumor vascularity (increased perfusion)

A

low-grade diffuse astrocytoma and high-grade anaplastic astrocytoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

most common primary intra-axial tumor of CNS

A

glioblastoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

vast majority of glioblastoma are

A

IDH-wildtype

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

other molecular marker of glioblastoma

A

methylation (inactivation) of the gene promoter for O6-methylguanine DNA methyltransferase repair enzyme (MGMT) that counteracts the effects of temozolomide chemotherapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

these tumors typically presents as a heterogeneous enhancing parenchymal mass with surrounding vasogenic edema

A

glioblastoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

difference of ring enhancement between glioblastoma and abscess

A

thick and irregular, with restricted diffusion- glioblastoma

thin and smooth- abscess

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

incomplete ring of enhancement (“horseshoe” or “open ring” sign) should prompt consideration of a

A

tumefactive demyelinating lesion, rather thatn neoplasm or abscess

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

ring enhancing lesions (MAGIC DR)

A

metastasis, abscess, glioma (esp glioblastoma),infarct (subacute or healing phase), contusion/hematoma (subacute), demyelinating disease, radiation necrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

diffuse or infiltrative glioma that crosses the corpus callosum to involve both cerebral hemispheres

A

butterfly glioma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

expansile lesion within the corpus callosum cannot be attributed to vasogenic edema, because

A

callosal fibers are too tightly packed for the interstitial fluid to be transmitted across them

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

low grade brainstem gliomas are seen in

A

midbrain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

diffuse infiltrative glioma in young children with highly aggressive behavior are usually seen in ____, despite absent or minimal enhancement

A

pons

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

describes the widespread infiltrative growth of a diffuse glioma, more commonly astrocytoma than oligodendroglioma, to involve at least 3 lobes of the brain

A

gliomatosis cerebri

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

demosntrates a diffuse growth pattern, just like their astrocytic counterparts, with neoplastic cells infiltrating beyond the macroscopic margins of the tumor. these cells have a “fried egg” appearance due to round nuclei surrounded by clear cytoplasm. additional histologic features include microcalcifications and a dense network of branching capillaries ( chicken wire)

A

oligodendrogliomas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

types of oligodendrogliomas

A

IDH mutated and 1p/19q codeleted

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

presents as an expansile infiltrative parenchymal lesion, typically hypodense on CT and hyperintense on T2. most commonly located in the frontal lobes and often extend peripherally to involve the cortex. more likely to exhibit calcifications on CT, more vascular

A

oligodendrogliomas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

codeleted 1p/19q chromosome show more or less favorable prognosis?

A

more favorable

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q

intact 1p/19q chromosome show more or less favorable prognosis?

A

less favorable

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
91
Q

methylated MGMT gene promotor show more or less favorable prognosis?

A

more favorable

92
Q

accounts of approximately 7% of all gliomas, tends to present in the pediatric population. arise form the ependymal cells lining the ventricular system and the central canal of the spinal cord. often presents as a fourth ventricular mass in children, less commonly as an intramedullary mass in adults

A

ependymomas

93
Q

true or false: ependymomas tend to originate within the brain parenchyma rather than in the lateral-third ventricles when they present supratentorially

A

true

94
Q

supratentorial ependymomas are classified as

A

ependymoma, RELA fusion positive

95
Q

tumors that present as perivascular pseudorosettes histologically

A

ependymoma

96
Q

typically pressents are heterogeneous enhancing mass with calcifcation, cystic change and/or hemorrhage within the 4th ventricle in a child. they are soft plastic tumors that frequently extrude out of the foramina of Luschka laterally or Magendie inferiorly

A

ependymoma

97
Q

tumor that arises from underneath the ependymal lining of ventricular system that lies a thin subependymal glial plate

A

subependymoma

98
Q

most common locations of subependymoma

A

inferior fourth ventricle, lateral-third ventricle, spinal cord

99
Q

formed embryologically by invagination of leptomeninges into the lateral ventricles through the choroidal fissure, choroid plexus epithelum and stroma

A

choroid plexus

100
Q

choroid plexus epithelium are derived from

A

ependymal cells

101
Q

stroma are derived from

A

arachnoid mater

102
Q

intensely enhancing mass with lobulated margins that are usually centered at the atrium or trigone of the lateral ventricle, arising from the choroid plexus glomus and less commonly in the 4th ventricle

A

choroid plexus tumors

103
Q

nonglial tumors of neuroepithelial origin include

A

neuronal tumors, embryonal tumors and pineal tumors

104
Q

nonglial tumors that are rare, with varying degress of neuronal differentiation

A

neuronal and mixed-neuronal-glial tumors

105
Q

benign mixed neuronal-glial (aka glioneuronal) tumor with excellent prognosis, associated with medically refractory partial complex seizures in children and young adults

A

dysembyoplastic neuroepithelial tumors (DNET)

106
Q

identified histologically by presence of cortical dysplasia and columns of bundled axons lined with oligodendroglial-like cells (“specific glioneuronal unit”). there are cortical neurons “floating” in a mucinous background

A

dysembryoplastic neuroepithelial tumors

107
Q

tumors that appears nonenhancing multicystic (“bubbly”) mass at the cerebral cortex in a young patient, usually at the temporal lobe

A

dysembryoplastic neuroepithelial tumors

108
Q

pure neuronal tumor composed of neoplastic gangliomn cells

A

gangliocytoma

109
Q

mixed glioneuronal tumor with neoplastic glial cells

A

ganglioglioma

110
Q

typical imaging pattern is a partially enhancing mass at the cerebral cortex in a young patient. it is the most common neoplastic etiology for temporal lobe epilepsy

A

gangliocytoma and ganglioglioma

111
Q

true or false: gangliocytoma and ganglioglioma may arise from gray matter anywhere within the CNS, including hypothalamus, cerebellum and spinal cord

A

true

112
Q

usually present in young adults with symptoms related to local mass effect. classic imaging pattern is nonenhancing mass that expands the cerebellar folia and causes a “striated cerebellum” appearance on MRI. frequently associated with Cowden syndrome

A

Dysplastic cerebellar gangliocytoma (Lhermitte-Duclos Disease)

113
Q

they can present as a heterogeneous mixed-cystic-solid mass (“cyst and nodule” appearance) involving te cerebral cortex. it may cause desmoplastic reaction with thickening and enhancement of overlying meninges, analogous to PXA. they tend to present in infancy with rapidly progressive macrocephaly

A

desmoplastic infantile astrocytoma and ganglioglioma (DIA and DIG)

114
Q

rare grade 1 tumors with mixed glial and neuronal elements

A

papillary glioneuronal tumor (PGNT) and rosette forming glioneuronal tumor (RGNT)

115
Q

in this tumor, the glial cells form a pseudopapillary arrangement with interpapillary neuronal cells. it presents as a cerebral mixed solid-cysitc mass with predilection for the temporal lobe, similar to ganglioglioma

A

papillary glioneuronal tumor

116
Q

in this tumor, glial component resembles a pilocytic astrocytoma, while neuronal component forms neurocytic rosettes and perivascular pseudorosettes. it also presents as a mixed cystic-solid mass, but is most commonly located in the middle, around the fourth ventricle or the cerebral aqueduct

A

Rosette-forming glioneuronal tumor

117
Q

ventricular tumor of unclear cell origin. histologically, they can resemble oligodendrocytes, hence these tumors were initially mistaken for intraventricular oligodendrogliomas

A

central neurocytoma

118
Q

common in 20 to 40 y.o as an intensely enhancing mass arising from the septum pellucidum or lateral ventricular wall, near the foramen of monro. On T2, they gave a heterogeneous appearance (“bubbly”)

A

central neurocytoma

119
Q

histologically similar tumor to central neurocytoma that occurs in the brain parenchyma

A

extraventricular neurocytoma

120
Q

highly malignant tumors of neuroepithelial origin, which are too poorly differentiated to be categorized as glial or neuronal tumors. tend to appear as hypercellular hyperattenuating masses in children (age <20 y.o)

A

embryonal tumors

121
Q

most common CNS embryonal tumor as well as the second most common pediatric CNS tumor. it is a critical member of pediatric posterior fossa differential diagnosis. arise from the cerebellar vermis in children less than 10 y.o

A

medulloblastoma

122
Q

when medulloblastoma arise in older children and adults, they have a tendency to be located where

A

within the cerebellar hemisphere

123
Q

four histologic subtypes of medulloblastoma

A

classic, desmoplastic/nodular, medulloblastoma with extensive nodularity (MBEN) and large cell/anaplastic

124
Q

histologic subtype of medulloblastoma that most likely show CSF dissemination, seen in a third of medulloblastoma

A

large cell/anaplastic

125
Q

classically presents as hyperdense mass at the cerebellar vermis in a young child

A

medulloblastoma

126
Q

pediatric fossa tumors (GAME)

A

brainstem glioma, pilocystic astrocytoma, medulloblastoma, ependymoma

127
Q

these are 1/3 of emryonal tumors, that can present as a heterogeneous hyperattenuating mass anywhere in the CNS, usually in infants or very young children (<4 y.o). genetically defined by alterations of INI1, which can be tested by immunohistochemistry

A

atypical teratoid/rhabdoid tumor (AT/RT)

128
Q

when cases do not meet criteria for medulloblastoma, AT/RT or other defined entities, “CNS embryonal tumor, not otherwise specified (NOS)” has replaced ____ as a new moniker

A

CNS primitive neuroectodermal tumor (PNET)

129
Q

most common primary intra-axial posterior fossa mass of adulthood, usually presenting in middle age (40-60 years)

A

hemangioblastoma

130
Q

they are circumscirbed enhancing tumors that can secrete fluid and produce internal or adjacent cysts. it has increased vascularity

A

hemangioblastomas

131
Q

fewer that 10% of hemangioblastomas arise outside the posterior fossa, often in the setting of

A

Von Hippel Lindau syndrome

132
Q

histologic subtype of medulloblastoma with classic histology, best prognosis, seen in the lateral location (peduncle)

A

WNT activated

133
Q

histologic subtypes of medulloblastoma with classic or large cell/anaplastic histology that is midline in location (vermis) with poor prognosis

A

SHH-activated TP53-mutant, “group 3” and “group 4”

134
Q

histologic subtype of medulloblastoma with desmoplastic/nodular, MBEN histology, lateral in location (hemisphere), with good prognosis

A

SHH-activated TP53-wildtype

135
Q

most common non-hodgkin lymphoma of adults and can arise in vitually any compartment of the body, including the brain parenchyma

A

Diffuse large B-cell lymphoma

136
Q

Primary CNS lymphoma is tx by

A

chemotherapy

137
Q

this drug can shrink the PCNSL tumor transiently and sometimes dramatically (“ghost tumor”, withholding steroid therapy before biopsy may help to maximize sensitivity

A

glucocorticoids

138
Q

in immunocompetent patient, classic imaging pattern of this tumor is a homogeneously enhancing mass that abuts the CSF spaces and wraps around the ventricles or sulci (“rimphoma”) with homogeneous hyperdensity on CT and corresponding hypointensity on T2/ADC

A

PCNSL

139
Q

50% of brain metastasesm are secondary to

A

lung cancer

140
Q

leptomeningeal metastasis from a primary CNS tumor is called

A

drop metastases

141
Q

responsible for myelination in the CNS

A

oligodendrocytes

142
Q

responsible for myelination in the peripheral nerves including cranial nerves III to XII

A

schwann cells

143
Q

these are benign extra-axial neoplasms which arise from vestibular nerve in the vast majority of the cases

A

schwannoma

144
Q

schwannoma can also less commonly involve what cranial nerve and other areas

A

CN5, brain parenchyma, peripheral nerves that innervate vessel walls (nervi vasorum)

145
Q

these are focal encapsulated tumors with spindle-saped neoplastic schwann cells on histopathology, which may be organized in a more cellular Antoni A pattern with nuclear palisading (“Verocay bodies”), versus a less cellular Antoni B pattern with cystic degeneration (“ancient change”)

A

schwannoma

146
Q

tumor that often arise within and gradually expand the bony internal auditory canal, while growing medially into the CPA cistern, yielding an “ice cream cone” appearance

A

schwannoma

147
Q

it is a misnomer and is characterized by multiple schwannomas and meningiomas, not neurofibromas

A

NF2 and schwannomatosis

148
Q

bilateral vestibular schwannomas are diagnostic of

A

NF2

149
Q

Schwannomatosis is associated with mutations in what tumor marker

A

SMARCB1 tumor suppresor gene

150
Q

most common extra-axial tumors and also the most common primary CNS tumors (36%). more freq in females, present in older adults. they arise from arachnoid cap cells in the arachnoid mater, which abuts the dura mater on the side of the skull. half of the cases present as dural-based masses along the cerebral convexity or the falx cerebri (parasagitta)

A

meningioma

151
Q

classic, but nonspecific appearance of a meningioma is

A

enchancing dural-based mass, with adjacent dural thickening and osseous changes

152
Q

if angiography is performed as a work-up for meningioma (pre-operative emblozation), there is radial arrangement of the vessels with an early dense tumor blush that persists well into venous phase. this angiographic finding has been called ____ because it shows up early and stays late

A

“mother in law sign”

153
Q

it is not uncommon for a meningioma to evoke vasogenic edema in the adjacent brain parenchyma, especially when it is supplied by what vessel; this alone is not a sign of brain invasion or higher-grade tumor

A

ICA rather than ECA

154
Q

CPA mass (AMEN)

A

arachnoid cyst, meningioma, epidermoid cyst, neuroma /schwannoma

155
Q

an avidly enhancing mass located in the atrium/trigone of a lateral ventricle should prompt consideration of _____ in a child and ____ in an older adult

A

choroid plexus papilloma in child, intraventricula meningioma in older adult

156
Q

dural-based meningothelial mass

A

meningioma

157
Q

mesenchymal dural based mass

A

hemangiopericytoma

158
Q

metastatic dural-based mass

A

breast, prostate, lung

159
Q

hematopoietic dural-based mass

A

leukemia, lymphoma

160
Q

inflammatory, dural based mass

A

sarcoidosis, TB

161
Q

previously known as “angioblastic meningioma”. it arises from modified pericapillary smooth muscle cells (pericytes of Zimmerman) with peak incidence at 30-50 years

A

hemangiopericytoma

162
Q

histologic examination of this tumor show “staghorn vessels”

A

hemangiopericytoma

163
Q

unlike meningioma, these tumors show a narrow base of attachment to the dura in 33% of cases

A

hemangiopericytoma

164
Q

between meningioma and hemangiopericytoma, bone destruction and flow void are more common in

A

hemangiopericytoma

165
Q

hyperostosis and calcifications are more common in meningioma or hemangiopericytoma

A

meningioma

166
Q

elevated myoinositol can be seen in hemangiopericytoma or meningioma

A

hemangiopericytoma

167
Q

alanine peak is seen in hemangiopericytoma or meningioma

A

meningioma

168
Q

tumor from ependymal lining

A

ependymoma

169
Q

tumor from central neurocytoma

A

septum pellucidum

170
Q

tumor from subependymal plate

A

subependymoma

171
Q

tumor from choroid plexus epithelium

A

choroid plexus tumor

172
Q

tumor from choroid plexus stroma

A

meningioma and metastasis

173
Q

meningeal melanocytoma and melanoma can be seen where

A

leptomeninges, uvea of the eye

174
Q

small usually subcentimeter “pine-cone”- shaped structure which has been historically described as the “third eye” or the principal seat of soul

A

pineal gland

175
Q

it is an endocrine organ that secretes melatonin into the bloodstream, therefore it lacks blood-brain barrier and normally enhances on post contrast images

A

pineal gland

176
Q

pineal gland is located in the

A

midline, at the posterior margin of 3rd ventricle, just below the splenium of the corpus callosum and just above the tectum of midbrain

177
Q

circumscribed slow growing pineal tumors that tend to present in adults with symptoms related to local mass effect. they can be cystic or solid in morphology

A

pineocytoma

178
Q

more atypical aggressive lobulated enahncing pineal masses that also tend to present in adults

A

pineal parenchymal tumor of intermediate differentiation (PPTID)

179
Q

highly malignant undifferentiated embryonal tumors of the pineal gland that tend to present in children. they are enhancing and hypercellular in appearance, for example, hyperdense on CT and hypointense on T2/ADC

A

pineoblastoma

180
Q

most common type of neoplasm in the peineal region

A

germ cell tumor

181
Q

most common intracranial GCTs and have a strong preference for males over females. they are hypercellular with sheets of polygonal germ cells and may be complicated by CSF dissemination

A

germinoma

182
Q

tends to wrap around or engulf normal pineal calcifciations

A

germinoma

183
Q

these pineal gland tumor tend to displace or “explode” calcifications

A

pineal parenchymal tumor

184
Q

primary treatment modality for germinomas

A

radiation

185
Q

a heterogeneous midline mass in a newborn should prompt consideration of a

A

congenital teratoma

186
Q

other tumors that can project into the pineal region include ____ and ____ arising from the splenium superiorly or tectum inferiorly. there is also from the subcommissural organ

A

tentorial meningioma and exophytic gliomas, papillary tumor of the pineal region

187
Q

midline depression at the top of sphenoid body that holds the pituitary gland. aka turkish saddle

A

sella turcica

188
Q

sella turcica is separated from the suprasellar cistern superiorly by the _____

A

diaphragm sellae

189
Q

with aging, the diaphragm sellae can weaken and permit subarachnoid space to herniate inferiorly from the suprasellar cistern in the sella turcica, making this appearance

A

empty sella appearance

190
Q

pituitary stalk and posterior pituitary are derived from

A

neuroectoderm and are extensions of diencephalon

191
Q

anterior pituitary is derived from

A

surface ectoderm, specifically from primitive stomodeum

192
Q

during development, primitive stomodeum from surface extoderm forms an epithelial diverticulum, aka ____ or _____, which extends from the pharynx into the cranial vault to meet the neurohypophysis and form the adenohypophysis anteriorly

A

craniopharyngeal dyct or Rathke pouch

193
Q

one of the 3 most common primary neoplasms, not listed in the CNS WHO classifcations (considered endocrine)

A

pituitary adenomas

194
Q

3 most common primary CNS neoplasms

A

meningiomas (36%), adenomas (16%), glioblastoma (15%)

195
Q

microadenomas measure

A

< 1cm

196
Q

macroadenomas meaure

A

> 1 cm

197
Q

most common pituitary adenoma that may produce amenorrhea/galactorrhea in women or decreased libido in men

A

prolactinoma

198
Q

second most common pituitary adenoma and may produce acromegaly or gigantism

A

GH-secreting adenomas

199
Q

this adenoma may cause symptoms from local mass effect. usually the primary concern is visual loss from compression of the optic nerves, chiasm or tracts superiorly

A

macroadenomas

200
Q

compression of the pituitary gland or stalk may produce

A

hypopituitarism or hyperprolactinemia

201
Q

most pituitary adenomas will arise ___, because lactotrophs and somatotrophs are located also here

A

laterally

202
Q

when pituitary macroadenoma suddenly enlarges due to hemorrhage, this acute syndrome is called

A

pituitary apoplexy

203
Q

arise from squamous epithelium remnants of the craniopharyngeal duct, aka Rathke pouch. it can occur anywhere between nasopharynx, 3rd ventricle, but is most commonly centered in the suprasellar region

A

craniopharyngioma

204
Q

most common neuroepithelal CNS tumor of childhood. they are characterized by heterogeniety as described by 90% rule: 905 show cystic change, show calcifications and show solid or nodular enhancement

A

adamantinomatous craniopharyngiomas

205
Q

nonneoplastic cysts that result from a persisten cleft in the Rathke pouch that fails to involute

A

Rathke cleft cysts

206
Q

less common type of craniopharyngioma that occurs in older adults as a solid enhancing mass

A

papillary craniopharyngioma

207
Q

rare neuroendocrine tumor of the adenohypohysis that closely resembles a nonfunctioning macroadenoma

A

spindle cell oncocytoma

208
Q

these are rare glial tumors that arise from the neurohypophysis or infundibulum

A

pituicytoma and granular cell tumor

209
Q

suprasellar masses (SATCHMO)

A

sarcoidosis, adenoma/aneuryms, teratoma/germinoma, TB, craniopharyngioma, rathke cleft cyst, hypothalamic glioma, hamartoma, histiocytosis, meningioma, metastasis, optic pathway glioma

210
Q

thin-walled meningothelial cysts located in the arachnoid space and are thought to result from a congenital duplication or splitting of the embryonic arachnoid during development

A

arachnoid cysts

211
Q

acquired arachnoid cysts may be from

A

chronic sequelae of prior inflammation

212
Q

50% of arachnoid cysts are seen in the

A

middle cranial fossa

213
Q

difference between epidermoid and dermoid cyts

A

epidermoid cyst resemble CSF density and signal, except for marked hyperintensity on DWI, dermoid cyst can present with internal fat density and signal due to sebum, no solid enhancement

214
Q

accidental rupture or spillage of the dermoid cyst may cause

A

chemical meningitis

215
Q

benign, slow growing cysts, lined by squamous epithelium that produces large amounts of keratin. they arise from abnormal inclusion of surface or external ectoderm that can produce cyst with lining that resemble norml skin epithelium

A

epidermoid and dermoid cysts

216
Q

epidermoids are more located ___, while dermoids are ____

A

epidermoids lateral, dermoids midline

217
Q

how to differentiate epidermoid cyst from arachnoid cyst

A

epidermoid cysts show restricted diffusion

218
Q

rarely, epidermoids can be highly proteinaceous and demonstrate an atypical appearance on CT (hyoerdense) or MRI (T1 hyperintense); this atypical presentation is called

A

white epidermoid

219
Q

endodermal inclusion cysts, whose lining resemble bronchial or respiratory epithelium, hencethey are filled with mucin and are highly proteinaceous

A

colloid cysts

220
Q

colloid cysts are found at ____, where they can cause acute hydrocephalus and sudden death

A

anterosuperior roof of the 3rd ventricle near the foramen of Monro

221
Q

these cysts may present chronically with paroxysmal headaches and /or neurologic deficits, excacerbated by tilting the head forward (Brun phenomenon), due to ball-valve action of the cyst

A

colloid cysts

222
Q

nonneoplastic masses of true adipose tissue that result from maldifferentiation of the embryonic meninx primitiva into fat rather than normal subarachnoid space. most common in interhemispheric fissure (probably associated with callosal dysgenesis), suprasellar cisterna dn quadrigeminal cistern

A

lipomas

223
Q

ectopic nodules of misplaced neurons due to arrested migration during development. these clumps can be mistaken for tumor and are most often found in a periventricular or subependymal location

A

gray matter heterotopia

224
Q

when gray matter heterotopia is seen in the hypothalamus, usually the tuber cinereum between the optic chiasm and mammillary bodies, it is often called

A

hamartoma

225
Q

these lesions may present with unusual symptoms such as gelastic seizures (laughing fits) or precocious puberty

A

hamartoma of tuber cinereum

Head and neck radiology (15 decks)

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