CNS Patho II Flashcards
Give 3 considerations of diagnosing CNS tumors
Age
- Children more likely Primary; Adults think of Mets
Location
- Midline
- Supra/Infratentorial
- Ventricles
- Meninges
Clinical History
- other cancers, breast, lung
- Immunosuppression - think infections
- Syndromes - Neurofibromatosis;
Children Tumors to take note [4] and their locations!!!
Medulloblastoma (infratentorial) - neuron tumor
- think posterior fossa: cerebellum + brainstem
- top malignant kids
Ependymoma (ventricles)
- 3rd most common
GCT (midline)
Pilocytic Astrocytoma (glial tumors anywhere)
- top benign kids
Midline tumors [3]
- not ventricle or meninges
Pituitary Tumor!
GCT (children!)
Pineal Gland tumor
Ventricular tumors [2]
Choroid Plexus Tumor
Ependymoma
Supratentorial tumor [2]
Glioma
CNS Neuroblastoma
Infratentorial tumors [2]
Glioma
Medulloblastoma
Meningioma
- Origin
- Genetic association
- 4 histo properties
- 2 sharing w another cancer
from arachnoidal cells, meningothelial
associated w NF2 syndrome; loss of Merlin TSG;
Histology: Whorls, Psamomma bodies, Fibrous, nuclear inclusions;
- like thyroid papillary carcinomas;
Name all neuroglias of CNS and PNS
CNS 4
- ependyma
- microglial
- oligodendrocytes
- astrocytes
PNS 2
- Schwann cells
- Satellite
Gimme 2 Astrocytoma and their properties
Lowest grade
- Pilocytic Astrocytoma [most common benign children]
- NF1
- Children; long fibrillary cytoplasmic proccesses;
Highest grade
- Glioblastoma Multiforme
- IDH mutant is btter prognosis;
Property of Oligodendroglioma
characteristic branching, small, chicken wire-like blood vessels, fried egg appearance
Neuronal Tumors
Supratentorial
- CNS Neuroblastoma
Infratentorial
- Medulloblastoma [2nd most child tumor; top malignant]
Medulloblastoma properties and histology
Give a Cx regarding its location
2nd most common tumor; top malignant
Infratentorial
Cerebellum location // brainstem
ROSETTES; SHEETS OF SMALL CELLS
( its a Small-blue-round-cell tumor)
The presence of rosettes is rarely if ever pathognomic of a specific tumor, though identification of ROSETTES is often helpful in the histologic diagnosis of medulloblastoma/PNET, retinoblastoma, ependymoma, central neurocytoma, and pineocytoma.
- can cause non-communicating hydrocephalus
- can cause ataxia, nystagmus …
Which cancers can cause non communicating hydrocephalus and histology
Ependymoma
- Rosettes too
Medulloblastoma
- infratentorial - @ cerebellum
- rosettes too
Midline tumors and their properties [4]
which age group
- give 1 for children 1 for adults;
Pituitary Tumors (adenoma common)
- bitemporal hemianopia (optic chiasm compression)
- think in adults
another pituitary one is Craniopharyngioma, cystic, tooth forming;
GCT - think in children
Pineal tumor
Primary lymphomas in CNS
- What conditions and type;
- presentation
EBV, HIV, IC
B cell, non HK
presents possibly as multiple lesions
- possibly REL in CT
