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Block 8 Week 2 > CNS neoplasm-Usera > Flashcards

CNS neoplasm-Usera Flashcards

1
Q

What are the categories of CNS neoplasms (6)?

A
  • Glial neoplasms
  • Meningiomas
  • Ependymoma
  • Medulloblastoma
  • CNS lymphoma
  • Metastasis
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2
Q

What are the 4 types of neuroglia in the CNS?

What do each do?

A
  • ependymal cells (line ventricles and central panel of spinal cord)
  • oligodendrocytes (myelinate)
  • astrocytes (support, metabolic function, glutamate neurotransmision, calcium homeostasis)
  • microglia (macrophages of CNS)
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3
Q

What are the 2 types of neuroglia in the PNS? What do each do?

A

Satellite cells

Schwann cells

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4
Q

How can you tell an astrocyte from an oligodendrocyte?

A

Astrocytes-> loose chromatin (cause they are actively transcribing genes)
Oligodendrocytes-> dense chromatin

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5
Q

(blank) are the most common CNS tumors.

A

astrocytomas (70-80%)

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6
Q

Astrocytomas usually involve the (Blank) hemispheres, but can occur elsewhere

A

cerebral

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7
Q

How do you grade astrocytomas?

A

Grade 1-4

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8
Q

What grade is a glioblastsoma multiforme?

A

Grade 4

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9
Q

What grade is diffusely infiltrating astrocytoma?

A

Grade 2

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10
Q

What grade is anaplastic astrocytoma?

A

Grade 3

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11
Q

What grade is pilocytic astrocytoma?

A

Grade 1

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12
Q 
What grade is a pilocytic astrocytoma?
What does it look like?
Is it malignant or benign?
Who typically gets them?
Where do you usually find them?
Is there a p53 mutation?
A 
1
well circumscribed and cystic
benign
children and young adults
cerebellum (but can occur elsewhere)
-no
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13
Q

What is the histological appearance of a pilocytic astrocytoma?

A
  • Dense, “hair-like” fibrillary meshworks.

- rosenthal fibers

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14
Q

What does a pilocytic astrocytoma look like on a sagittal CT?

A

cystic space with mural nodule

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15
Q 
What grade is a diffusely infiltrating astrocytoma?
What does it look like?
Does it have a p53 mutation?
What is its prognosis?
Does it have mitotic figures?
A
  • II
  • poorly defined, infiltrating tumor with increased cellularity with mild to moderate nuclear atypia
  • YES
  • variable, but usually indolent lesion
  • no
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16
Q 
What grade is anaplastic astrocytoma?
What does it look like?
Does it have mitotic figures?
What is the median survival?
Does it have a p53 mutation?
A
  • III
  • similiar to grade II, but with increased, cellularity and nuclear atypia
  • YES
  • 3 years
  • yes
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17
Q 
What grade is glioblastoma mutiforme?
Is it common?
Is it aggressive?
What does it look like?
Is  p53 mutation common?
What is the prognosis?
A 
IV
yes
-highly aggressive
-marked nuclear pleomorphism and atypia
-yes
-6-15 month survival
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18
Q

If you see pseudopalisating necrosis, what kind of glial neoplasm is this?

A

glioblatoma multiforme

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19
Q

What is the mneumonic for glial neoplasms and what does it tell us?

A

Atypia
Mitotic figures
Endothelial proliferation
Necrosis

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20
Q

Most glial neoplasms dont cross the midline but (blank) do.

A

glioblastoma multiformis

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21
Q

What grade is an oligodendroglioma?
What percent of gliomas are oligodendroglioma?
What age do you get oligodendrogliomas?

A

II
5-15%
4th-5th decades

22
Q

Where do you see oligodendrogliomas and what would you describe them as?

A

-cerebral hemispheres (FRONTAL LOBE)

Infiltrating, cystic, hemorrhagic, frequent CALCIFICATIONS

23
Q

What genes are associated with a good response to chemo/radiation with oligodendrogliomas?

A

1p, 19q

24
Q

Oligodendrogliomas can be what grades?

A

II, III, IV

no such thing as a grade I

25
Q

What can oligodendrogliomas often present with?

A

seizures

26
Q

What is the histological appearance of oligodendrogliomas?

A

fried egg appearance with chicken wire vasculature

27
Q

Are meningiomas present in adults or children?
What kind of receptors do they commonly have?
Are the benign or malignant?

A

adults
estrogen/progesterone
benign

28
Q

What chromosome loss is associated with meningiomas?

A

loss of chromosome 22

29
Q

What can meningiomas form in the dura and why is this dangerus?

A

Can form mass in dura that presses on cortex and induces seizures

30
Q

What is the histological appearance of meningiomas?

A

looks like starry night and has Psammoma bodies (whirled pattern of growth)

31
Q

Where can you get meningiomas?

A
  • parasagital
  • olfactory groove
  • supraseller
  • clivus
  • foramen magnum
  • cerebellar
32
Q

Where do ependymomas derive from?
Who gets them?
What disease is associated with it?

A

ependymal cells lining ventricular system

  • children and adults
  • NF2
33
Q

Where do you most commonly see ependymomas in people ages 0-20?

A

4th ventricle

34
Q

Where do you most commonly see ependymomas in adults?

A

spinal cord

35
Q

What do ependymomas present as histologically?

A

pseudorosets and rosets

36
Q

Who does medulloblastomas present in, children or adults?
What are medulloblastomas derived from?
What genes are associated with medulloblastoma and what do they indicate?
Is it suscpetible to radiation?

A
  • children
  • neuroectoderm and granular cells of cerebellum
  • 17p and MYC amplification… aggressive and poor prognosis
  • yes
37
Q

How do medulloblastomas present histologically?

A

as small round blue cell tumors w/ homer-writght rosettes (look like suns)

38
Q

What protein is present in medulloblastomas?

A

GFAP (glial fibrillary acidic protein)

39
Q

If you see a child with a tumor in the cerebellum, what should you be thinking?

A

either its malignant and its medulloblastoma or its benign and its a pilocytic astrocytoma

40
Q

(blank) typically have supratentorial tumors.

(blank) typically have infratentorial tumors.

A

adults

children

41
Q

What virus is asociated with High grade B cell lymphoma?

A

EBV

42
Q

(blank) percent of extranodal lymphomas are primary CNS lymphomas
(blank) percent of intracranial tumors are primary CNS lymphomas.

A

2%

1%

43
Q

Are primary CNS lymphomas typically multifocal or unifocal?

A

multifocal

44
Q

What is a good marker for primary CNS lymphoma? What does this tell us?

A

BCL-6+

says tumor cells are B cells that are derived from the germinal center of a lymphoid follicle

45
Q

Where do primary CNS lymphomas typically occur first?

A

perivascularly

46
Q

How can you look for EBV in your primary CNS lymphoma?

A

with EBER and ISH

47
Q

What do lymphomas look like histologically?

A

dishesive and around vasculature

48
Q

What is the MOST common CNS malignancy?

A

metastases

49
Q

What are the most common carcinomas associated with CNS malignancy?

A
  1. lung
  2. breast
  3. melanoma
  4. RCC
  5. GI
50
Q

Metastases make up (blank) percent of all intracranial malignancy

A

50%

51
Q

T or F

brain tumors are relatively rare compared to other cancers that metastasize to the brain

A

T

Block 8 Week 2 (8 decks)

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