CNS TUMOR PART 2 Flashcards by Omar Gazar

بسم الله الرحمن الرحيم
____________________
Pilocytic astrocytoma
Is grade …
ageL .,…. and ……
It is the most common CNS neoplasm in childern
causing ,,,.,and,,,, symtopms
site in ,,,,,,,,,
Behavior is ……..and…..and……prognosis

Grade1
Children and young adults
Headache and ataxia
Cerebellum
3rd ventricle - spinal cord - cerebral hemispheres or Optic Nerve .
Bening slowly growing with good prognosis

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Most common CNS neoplasm in children ?

Piocytic astrocytoma

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Genetic profile of piloastrocytoma

BNM
1-Alteartions of BRAF

2- inactivation of Neurofibramatiosis type 1
3-Mitogen activated protein kinase pathway MAPK Path activated
_++++++++++++++=
No IDH Mutation

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describe pilocytic astrocytoma grossly

May be
1-Cystic with mural nodule in the wall of the cyst
or
2-Well cirumscribe solid mass

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Rosenthal fibers appear in ?

Pilocytic astrocytoma

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Pilocytic astrocytoma in microso ?
,,,,,,,,phasic pattern
,,,,,,BODIES
More often in loose regions
Necrosis and mistosi are raer

Low to moderate cellulari
Biphasic pattern

with Rosenthal fibers apperance

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with Rosenthal fibers apperance stian + with

Glial fibrillary acid protien

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Immature higly celleular
Higly mitotic active
- higly malignant
poorly differentiated neoplasms dissemiating along CSF “resembling Developing nervous system” and belongs to
“small round blue cell tumor “

Embryonal neoplams grade 4
grade 4

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mention examples of embryonal neoplams

Medullablastoma
AT RT atypical teratoid Rhabdoid tumor
Embryonal tumor with multilayer rosettes
CNS primitive neuroectodermal tumor PNETs

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Menignioma
Behavior ?
20% of all 1ry intracranial tumors
Usually SS?
Age ? sex?
grade?

benign
___________
Solitary - slowly growing
in female more in adults more
grade 1

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Origin of Meniginoma ?

Arise from arachanoid meningothelial cells
Attached to dura
may extend to overlying bone

Ionizing radiation
Hormones

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Menignoma sporadic and solitary common
Describe genetic profile

MCN
Merlin inactivation
+
Loss of one copy of Chormosome 22

______________________________-
NF2 INCREASES THE Probability of Meningioma
prognosis depends on ?
Sixe - location - surgical accessibility and histological grade

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describe gross picture of the menigioma

Greyish white
Well cirumscribed
Dura based
Hyperostosis
cut surface whorlly shaped
brain compression

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Gritty sensation in cutting menigoma why?

Psammoma bodies

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Mention micrpscopic types of Menigomas

sftp
Synctial
Fibroblastic
transitonal
psammomtous

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Synctial mengiona is ?

menngioma with cells in whorls and no cell membrane visible

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Fibroblastic menigiona

Menigoma with elongated cells surrouned bundles of collagen

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Transitional Meningioma

Between synctial and Fibroblastic so ! ?
Whotls + bundle of fibroblastic tissue of collagen

Psammaotus ?! meenigoma

Psammoma bodies

Atypical meningoma is interdeiate between beiningan and malignant states with increased mitotic activiy and brain invasion how do you know it?
What is its features ?

-Increased Cellularity
-Small cells with Increasd Nucelar cytoplasmic ratio
-Prominet Nuclei
-Cellular growth as sheet
Foci of spon atnerous necrosis

Anaplatsic maligant meniegona
Grade….
maligant cytology resmbing ?
Marked increasi in ?

Grade 3
Carcinoma melanoma sarcoma of high grade
Mitotic activity

Tumors of the cranial and paraspinal nerve - schwanomas
8%=
85%
30%
______________
90% are ,ss?
4% arise in the setting of ?
The peak incidne in ,,,, to ,,, decades

Intracrainal tumors
Cerebellopontine angle tumors
Spinal nerve root tumors
______________________
Soliraty sporadic
NF2
4 To 6th

Schwannoma Neurilemmoma
…..Nerve sheath tumor of ……. origin
derived from ,,,,,cellls which nomrally produce ,,,,,,,,
Gross ……….,………………,………….attached to nerve from outside and can be easily separated from it
Maligant change very rare

Beining of NEURAL CREST ORIGIN
Swhanc cells = myelin
________________________
Solitary well circumscribed encapsulated tumprs

peiroheral schannomas are ,,,,,,,
paraspinal tumors :-
Spinal nerve tumors = …..+signs of ………..
8th cranial nerve tumors leads to ? …..,….,….
Motor symptoms are ,,,, becauses ?

Asymptomatic
radiuclar pain + signs of nerve root compression
Hearing loss ,tinnutis +vertigo
__________________
uncommon becasue? Schwannmoas favor sensort nerve roots

Hallmark of NF2 IS ?

Bilateral Vestibular tumors

THe most common presentation of schwannomas ?

Pain ! paiiiiiin !

Primary central Nervous system lymphoma High grade diffuse .....lymphoma accounting for 2% of ,,,,,,,,,,, and 1% ,,,,,,,,,, in ummunosuppresed most common CNS neoplasm In non immunosupprede incidence increased after,,,,,,years Aggrssive with poor ? Lymphoma orginating outside CNS reasrly spreads to brain parenchyma

B cell Extranodal lymphoma + intracranial tumors ___________________ 60 years ____________ poor response to chemotherapy ___________________

Gross of primary cns lymphoma

Homgoenous firm Brownish gray in color with Hge and Necrosis

Micro of primary cns lymphoma

Sheets of anaplastic B Cells with prominetn nuceli Necrosis Reactive inflammatory infiltrate

The most common primary CNS germ cell tumor is

Germinoma

Germ cell tumors Primary brain germ cell tuomrs along the ....... in .....and ...... 1% of ........ age........

Midline pineal &suprasellar brain tumors first and second decades

Metatic carncimoc tumots mention

Lung breast Kideny GIT

tumor in skin gives to brain ?

Maligantn melanoma

acute leukimia gives?

menigeal deposits

Metastaitc tumors route ? or directly site 80% in 15% may in ?

HEMATOGENOUS ___________ Cerebral hemispherea at junction of white and grey matter cerebellm dura and leptomeingies

Metatstic spinal cord compression MSCC

Local back pain or refered pain in limb is the intial presenting symptom

Familiat tumor syndrome

due to inacticvation of tumor supressor genes as ? Tuberous sclerosis Von hipple lindu disease

Von hipple lindaue mode of tansmossion is ? casued by ...... mutation of VHL tmours spupreesor gene located on chromosome ,,,, VHL Protien plays a role in ,,,,,,,,

Autosomal dominant Germline 3p Cellular oxygen sensing

Hemangioblastoma of VHl disease in ?

Retina CEREBELLUM SPINAL CORD KIDENY PANCREAS

Hemangioma of VHL ?

Lungs Liver Pancreas cyst kideny pheochromcytoma renal cysts renal cell carcinoma

Symptoms of VHL ?

Hemagnioblastoma Hemangioma

الحمدلله رب العالمين

Verocay bodies found in ?

Schwannomma