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Pathomorph - CREDIT 2 > Ch 22 - CNS tumors > Flashcards

Ch 22 - CNS tumors Flashcards

1
Q

What are gliomas?

A
  • tumors of the brain parenchyma

- resemble the different types of glial cells

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2
Q

What are the types of the gliomas?

A
  • astrocytomas
  • oligodendrogliomas
  • ependymomas
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3
Q

How is the consistency of ependymomas compared to astrocytoma and oligodendrogliomas?

A

the most common types are highly infiltrative or “diffuse gliomas,” including astrocytic and oligodendroglial, and mixed forms. In contrast, ependymomas tend to form solid masses

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4
Q

What are the most common types of astrocytomas?

A
  • diffuse astrocytomas

- piloctic astrocytomas

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5
Q

Diffuse astrocytomas frequency?

A
  • 80% of adult gliomas

- most frequent in the 4th through 6th decades of life

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6
Q

Where are the diffuse astrocytomas usually found?

A

cerebral hemispheres

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7
Q

What are the most common presenting signs and symptoms of diffuse astrocytomas ?

A
  • seizures
  • headaches
  • focal neurologic deficits related to the anatomic site of involvement
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8
Q

Which groups are the diffuse astrocytomas stratified in to:

A
  1. well-differentiated astrocytoma (grade I/IV)
  2. anaplastic astrocytoma (grade III/IV)
  3. glioblastoma (grade IV/IV)
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9
Q

Read about diffuse astrocytoma:

A

page 842

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10
Q

Pilocytic astrocytoma:

A
  • relatively benign tumors
  • affect children and young adults
  • often a cyst associated with the tumor, and recurrence from incompletely resected lesions is often associated with cyst enlargement, rather than growth of the solid component
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11
Q

Where are the pilocytic astrocytoma most commonly located?

A 
- cerebellum
may also involve:
- third ventricles
- optic pathways
- spinal cord
- occasionally cerebral hemispheres
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12
Q

Can the tumors that involve the hypothalamus be resected completely?

A

no. this is why they are problematic

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13
Q

pilocytic astrocytoma (morphology)

A
  • often cystic, with a mural nodule in the wall of the cyst
  • if solid: it is very well circumscribed - bipolar cells with long, thin “hair-like” processes that are GFAP-positive
  • rosenthal fibers and microcysts are often present
  • necrosis and mitoses are rare
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14
Q

Rosenthal fibers =

A

eosinophilic granular bodies

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15
Q

Oligodendroglioma frequency:

A
  • 5%-15% of gliomas

- most commonly detected in the 4th and 5th decades of life

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16
Q

What are the complaints of patients with oligodendrogliomas?

A
  • antecedent neurologic complaints

- seizures

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17
Q

Where are the oligodendrogliomas most commonly found?

A
  • cerebral hemispheres, mainly in the frontal and temporal lobes
18
Q

What are the most common genetic findings in patients with oligodendrogliomas?

A

the most common genetic findings are deletions of chromosomes 1p and 19q, alterations that typically occur together
- they are usually highly responsive to chemotherapy and radiotherapy

19
Q

Oligodendrogliomas (morphology):

A
  • gelatinous, gray masses
  • may show cysts, focal hemorrhage, and calcification
  • sheets of regular cells with spherical nuclei containing finely granular-appearing chromatin surrounded by clear halo of cytoplasm
  • typically contain a delicate network of anastamosing capillaries
  • calcification present in 90% of the tumors
20
Q

Describe anaplastic oligodendrogliomas:

A
  • aggressive subtype
  • higher cell density
  • nuclear anaplasia
  • mitotic activity
21
Q

Where does the ependymoma most often arise?

A

next to the ependymal lined ventricular system, including the central canal of the spinal cord

22
Q

Where does the ependymoma most likely occur during the first 2 decades of life?

A

near the fourth ventricle

23
Q

What is the most common location of ependymoma in adults?

A

the spinal cord

24
Q

How are the ependymoma in the fourth ventricle?

A
  • solid or papillary masses extending from the ventricular floor
  • cells with regular, round to oval nuclei
  • abundant granular chromatin
  • dense fibrillary background between the nuceli
  • rosettes canals or perivascular pseudorosettes (more on page 844)
25
Q

Describe anaplastic ependymoma:

A
  • increased cell denstiy, high mitotic rates, necrosis, and less evident ependymal differentiation
26
Q

What is central neurocytoma?

A
  • low-grade neoplasm
27
Q

Where are central neurocytoma found?

A
  • within and adjacent to the ventricular system (most commonly the lateral or third ventricles)
28
Q

What characterizes central neurocytoma?

A
  • evenly spaced, round, uniform nuclei and often islands of neuropil
29
Q

Neuropil:

A

a dense network of interwoven nerve fibres and their branches and synapses, together with glial filaments.

30
Q

What are gangliogliomas?

A
  • tumors mixed with a mixture of glial elements, usually low-grade astrocytoma, and mature-appearing neurons
  • slow-growing
  • seizures
31
Q

Dysembryonic neuroepithelial tumor:

A
  • low-grade childhood tumor
  • grows slowly
  • seizure disorder
32
Q

Where are the dysembryonic neuroepithelial tumor typically located?

A
  • superficial temporal lobe and consist of small round neuronal cells
  • well differentiated “floating” neurons within pools of mycopolysaccharide-rich myxoid fluid
33
Q

What is the most common embryonal (primitive) neoplasms?

A

medulloblastoma, accounting for 20% of pediatric brain tumors.

34
Q

Where does the medulloblastoma predominantly occure?

A

in children and exclusively in the cerebellum

35
Q

Are neuronal and glial markers almost always expressed in medulloblastoma?

A

yepp

36
Q

Is medulloblastoma exclusively readiosensitive?

A

yepp

37
Q

Primitive neurectodermal tumors (PNETs):

A

tumours similar to medulloblastoma and with poor degree of differentiation and found elsewhere in the nervous system

38
Q

Where are medulloblastoma located in children?

A

in the midline of the cerebellum

39
Q

In who does the lateral tumors occur more often in?

A

adults

40
Q

Medulloblastoma (morphology):

A
  • well circumscribed
  • gray, and friable
  • may be seen extending to the surface of the cerebellar folia and involving leptomeninges
  • extremely cellular, with sheets of anaplastic (“small blue”) cells
41
Q

focal neuronal differentiation is seen in the form……

A

of the Holmer Wright or neuroblastic rosette

42
Q

STOPPED

A

PAGE 845

Pathomorph - CREDIT 2 (9 decks)

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