CNS Neoplasms - Usera Flashcards
What makes up 70-80% of all CNS tumors?
astrocytomas
What parts of the brain do astrocytomas normally involve?
cerebral hemispheres
What is a grade 1 astroyctoma?
pilocytic astrocytoma
What is a grade 2 astroyctoma?
diffusely infiltrating astrocytoma
What is a grade 3 astroyctoma?
anaplastic astrocytoma
What is a grade 4 astroyctoma?
glioblastoma multiforme
What is this? cystic, well circumscribed in the cerebellum dense, "hair like" fibrillary meshwork little/no nuclear atypia Rosenthal Fibers
pilocytic astrocytoma
Does a pilocytic astrocytoma have a p53 mutation?
no
in what age group does pilocytic astrocytoma usually occur?
children and young adults
What is the adult tumor that arises from astrocytes?
GBM
T/F: diffusely infiltrating astrocytomas are poorly differentiated
true
T/F: diffusely infiltrating astrocytoma has high mitotic figures
false; none
What is this? poorly defined distorts brain architecture increased cellularity with mild to moderate nuclear atypia no mitotic figures
diffusely infiltrating astrocytoma
Does diffusely infiltrating astrocytoma have a p53 mutation?
yup
What is the prognosis for DIA?
variable, but usually indolent lesion
What is this?
High mitotic figures, cellularity, and nuclear atypia with a p53 mutation
Anaplastic astrocytoma
what is the median survival of anaplastic astrocytoma?
3 yearz
what is the most common CNS neoplasm?
GBM
What does AMEN stand for in GBM?
Atypia
Mitotic figures
Endothelial proliferation
Necrosis
T/F: GBM shows high mitotic figures but no nuclear pleomorphism
false; shows both
Does GBM have a p53 mutation?
yes
GBM characteristically crosses the (blank), forming a butterfly lesion
corpus callosum
Describe the histologic appearance of GBM?
regions of necrosis surrounded by PSEUDOPALLISADING tumor cells
T/F: all astrocytomas, including GBM, are GFAP +
true
T/F: oligodendromas are GFAP+
false; only astrocytomas
what is the lowest grade of oligodendroma?
2
when is an oligodendroma most common?
4-5th decade of life
What is this?
infiltrating, cystic, hemorrhagic, frequent calcifications of the cerebral hemispheres
oligodendroma
Oligodendroma has a (hi/low) proliferative rate
low
Loss of 1p and 19q is associated with a (good/bad) response to chemo in OGD
good
what grade is an anaplastic oligodendroma?
grade 3
oligodendromas that have many features similar to GBM are what grade?
4
What is this?
fried egg nuclei with chicken wire vasculature
oligodendroma
T/F: meningiomas are benign
true
Do meningiomas happen more in females or males? how do we remember this?
females 3:2
PR+ and ER+
Meningiomas are associated with loss of chromosome (blank)
22
Meningiomas arise from the meningoepithelial cells of the (blank)
arachnoid
what are the common locations of meningiomas?
parasagittal olfactory groove suprasellar Clivus Foramen magnum Cerebellar
Da fuck are these found in?
WHORLED pattern of growth
Psamomma bodies
meningiomas (psamomma looks like boobs since this happens more in women)
Where do we find normal ependymal cells?
lining the ventricular system
T/F: ependyomas happen in both children and adults
true
Ependyoma is associated with which genetic dz?
NF2
From ages 0-20 yrs, what is the most common location for an ependyoma?
paraventricular or 4th ventricle
A tumor in the spinal cord in an adult is most likely what type of cancer?
ependyoma
A cerebellar tumor in kids that was derived from the external granular cell layer (aka NEUROECTODERM) and associated with 17p- and MYC amplification is most likely…
medulloblastoma
17p- and MYC amplification has what effect on prognosis of medulloblastoma?
poor, agressive
T/F: medulloblastoma is not radiosensitive and requires special imaging procedures
false
What is this? small round blue cell tumor neuronal and glial phenotypes Homer-Wright rosettes in the neuronal phenotype GFAP+ in the glial phenotype
medulloblastoma
(Medulloblastoma/ependyoma) shows perivascular PSEUDOrosettes
ependyoma
primary CNS lymphomas are high-grade B cell NHL associated with which virus?
EBV
Do normal people get primary CNS lymphomas?
nope, need to be immunosuppressed
AIDS, post-transplant
T/F: primary CNS lymphomas are multifocal
true
Primary CNS lymphomas are BCL (2/6) pos
BCL-6
What are the most common mets to the brain?
- lung
- breat
- melanoma
- RCC
- GI
Mets to the brain make up what percent of all intracranial malignancy?
25-50%
where do mets normally present?
at the grey-white junction as well circumscribed lesions
Pimary tumors in adults occur (above/below) the tentorium
above
primary tumors in children occur (above/below) the tentorium
below
