CNS Space Occupying Lesions Flashcards

1
Q

Astrocytoma

Radiological appearance in adults

A
  • Supratentorial
  • Infiltrative border
  • Causes midline shift
  • Ring shaped lesion surrounded by area of edema
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2
Q

Astrocytoma

Gross appearance in adults

A
  • Vague ie cant tell it apart from normal surrounding parenchyma
  • Affects supratentorial cerebrum
  • Hemorrhagic?
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3
Q

Astrocytoma

Microscopic appearance in adults

A

Fibrillary cytoplasmic background with vascular proloferation

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4
Q

Astrocytoma

Gross appearance in children

A
  • Infratentorial
  • Polycytic
  • Well circumscribed
  • Gelatinous
  • Cystic
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5
Q

Astrocytoma

Microscopic appearance in children

A
  • Elongated, loosely knit stellate, bipolar astrocytes
  • Fibrillar background
  • Microcysts
  • Rosenthal fibers
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6
Q

Grade 1

A

Pilocytic astrocytoma

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7
Q

Grade 2

A

Diffuse astrocytoma and nuclear atypia

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8
Q

Grade 3

A

Anaplastic astrocytoma with nuclear atypia and mitosis

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9
Q

Grade 4

A

Glioblastoma with nuclear atypia, mitosis ans microvascular proliferation, hemorrhage

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10
Q

Glioblastoma epidemiology and prognosis

A

Most aggressive of all brain tumors

> 60

Prognosis <1yr

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11
Q

Glioblastoma gross appearance

A

Ill defined

Infiltrative

Hemorrhage, necrosis

Midline shift

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12
Q

Glioblastoma microscopic appearance

A

Pseudopalisade (lines of atypical cells around areas of necrosis)

Necrosis

Vascularization

Atypia

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13
Q

Oligodendroma

Affects which part of brain

A

Cerebrum

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14
Q

Oligodendroglioma

Microscopic appearance

A
  • Uniform round oligodendrocytes with round nuclei
  • Surrounded by clear halo
  • CALCIFICATION
  • Range from grade 1-3
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15
Q

Ependymoma

Gross appearance

A

Well differentiated

Invades adjacent CNS tissue

Projects into cerebellum—>obstruct ventricular system—>HYDROCEPHALUS

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16
Q

Ependymoma

Microscopic appearance

A

PSEUDOROSETTE

Eosinophilic cells

Fibrillary background

Central bv

17
Q

Spinal ependyoma prognosis

A

Benign

18
Q

Spinal ependymoma

Affects which part of CNS

A

Cauda equina (filum terminale)

19
Q

Spinal ependymoma

Microscopic appearance

A

Myxopapillary formation

“Myxoid areas”

20
Q

Schwannoma microscopic appearance types

A

Antoni A

Antoni B

21
Q

Antoni A (schwannoma)

A
  • More cellular

- Cellular lines alternating with hypocellular areas—>palisading nuclei surrounding VEROCAY BODY

22
Q

Antoni B (schwannoma)

A

Looser stroma with less cells

Myxoid changes

23
Q

Acoustic schwannoma affects which area

A

CEREBELLO-PONTINE angle

Facial vestibule cochlear folliculonodular

24
Q

Schwannoma affects

A

Spinal roots

Posterior peripheral nerves

Vestibular branch of CN8

25
Q

Neurofibroma affects

A

Dorsal nerve roots

Peripheral nerves

26
Q

Glial origin tumors

A
  1. Astrocytoma +Glioblastoma (pseudopalisade and necrosis)
  2. Oligodendroglioma (calcification with round eosinophilic nuclei surrounded by clear halo)
  3. Ependymoma (Psuedorosette with fibrillary body)

Spinal ependymoma (myxoid area with myxopapillary formation)

  1. Shwannoma (antoni A—> palisading nuceli and verocay body,, B—> myxoid change with loose stroma)
  2. Neurofibroma
  3. Malignant peripheral nerve sheath tumor
27
Q

Meningioma

Origin

A

Meningothelial cells of arachnoid granulations

28
Q

Meningioma

Occurs in which regions most

A
  1. Parasagittal
  2. Wing of sphenoid
  3. Olfactory nerve
29
Q

Meningioma

Age affected, prognosis

A

20-30

BENIGN

30
Q

Gross appearance of meningioma

A

Dura based there4 easily inoculated

Nodular

Exerts pressure on adjacent brain tissue

31
Q

Microscopic appearance of meningioma

A

Meningothelial cells (fibroblast like) arranged in whirls

PSAMOMA BODIES (concentric calcification)

32
Q

Medulloblastoma

Brain part affected

A

-Vermis of
cerebellum—>hydrocephalus?

-Meningeal infiltration, csf seeding, subarachnoid dissemination

33
Q

Microscopic appearance of medulloblastoma

A

Small blue undifferentiated blast cells

HOMER-WRIGHT ROSETTES

34
Q

Ganglioneuroma affects…

A

Mediastinum

35
Q

Primary lymphoma of cns occurs in which population group

A

AIDS due to ebv infection

36
Q

Primary lymphoma of CNS most common type

A

NHL B cell type

Poor prognosis

37
Q

Metastatic tumors originate from

A
Breast
Lung
Kidney
Colon
Melanoma
38
Q

Characteristic of metastatic tumors

A

Affect boundary (junction) of grey-white matter