CNS Tumors Flashcards
بسم الله الرحمن الرحيم وبه نستعين
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Mention supratentorial Tunomors
M2GS
Metastasis
Meningoma
Glioma
Schwannoma
Mention infratentorial tumors
PMEP
Pilocytic astrocytoma
Medulloblastoma
Ependymoma
Spinal CNS tuomrs ?
MGS
Menigona
Glioma(Ependymoma + astrocytoma )
Schwannoma
The approach of detection of CNS tumors is ? why ?
Combined Histo-Moleuclar
for more precise diagnosis in ?
diffuse glimoa and CNS embryonal tumors
Gliomas Including ?
age:astrocytoma
OligodenrogliOMA
ePNEYMOMA
Astrocytoma is grade
2 tumor
3 astrocytoma
4 Glioblastoma
Oligodendeoglioma is grade
2
3 anaplastic oligodendroglioma
Ependymoma is grade ?
Grade 1
grade 2
grade 3 anaplatic epednymoma
Diffuse glioma and IDH
Diffuse glioma results fom mutaton in Isocitrate dehydorgenase gene casuing 2 Isozymes IDH1 & 2 Subdividing diffisue glioma
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What is imp tk know that IDH is mutated ?
beacuse with mutated IDH there is better prognosis
Oligodendroglioma has ?
Also IDH Mutation as diffuse glioma
+ 1p 19 q codeletion
IDH mutation appears in ?
DOA
Diffues glioma
oligodendroglioma
astrocytoma
Account for 80 % of adult glionma ?
Diffuse astrocytoma
40-60 years
cerebral hemispeheres
c/p Of Diffuse astrocytoma
Seizures
Headache
Focal Neurological Defecits
Diffuse astorcytoma grades ?
2 : DIFFUSE ASTROOCYTOMA
3: Anaplastic astrocytoma
4: Glioblastoma
Describe grossly diffuse astrocytoma
Gryiesh white
No discerte borders
Soft gelatinous
Spreading infiltraing further than the borders so impossible to excision
Descibe microscopic of the Diffuse astrocytoma
MHP2
-Mild to moderate hypercellularity
-Decreased pelomorphism
-occasional mitotic activity
Glial fibrillary acid protein + astrocytic cells
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Neoplastic astroyctic nuceli in Fibirally background
Diffsue astroyctoma
asctorycit cells are + to IHC?
Glial fibirally acid protein
Mean survival of diffuse astrocytoma
5 years
static then progess to anaplatic astrocytoma pleommorprhism and cellularit and mitotsis aincreased
then glioblastoma secondary!
Describe microscopic Anaplastic astrocytoma
Hypercelullarity !
Hyperchromatic pleomprphic nuclei
Marked mitosis !
Commonest primary intracranial neoplasm in adults
Glioblastom grade 4 astrocytoma
most maliganat astrocytoma
when appear it is only a question of monthes to death
describe glioblastoma grossly
Firm whitsh area
Soft yellowish area of Necrosis
Reddish area of Necrosis
Cystic change
So called Multiform
Glioblastoma micrsopc vere characterisic ?
Presnece of Necrosis
Describe microscopic Glioblastom
Necrosis ! surrounded by ? Pseudopalasidaing Anaplastic cells
Mitosis marked
Vasuclar proliferation with Glomeruloid vessles ( Proliferated capillary endotehlial cells )
Compare between 3 grade of astrocytoma
Grade 1 :
diffuse astrocytoma:- Nuclara atypia
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Grade 2: Anaplatsic astroyctoma
Nuclear atypia + Mitotic activity
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Grade 3: Glioblastoma :
Nuclear atypia + mitotic activit
cc: Necrosis + Vascular proliferation
oligodendroglioma
slow grwong glioma
(…to….) of gliomas
adults …to …. years
With Symptoms of ……..
site…….
Gentic analysis : /////+.///////
pRGnosis ?
5-15 %
Neurlogical symptoms as seizures
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cerebral hemispheres
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IDH Mutant + 1p/19q codeletion
with better prognosis than astrocytoma
describe oligodendroglioma Grossly?
gRYISH PINK
Soft gelatinous
Infiltarting brain and naerby tissue
With Hge + cYSTIC degenration + mCIRO gelatning calcifications
Describe oligodendrogliona micro
Uniform fried egg appearcnce of analpastic cells
Anastomosing capillary network
Astroyctic and oligodendro glial tumors have in common ?
Infiltrative paatren
Ependymoma
arise from ,,,,, cells lining ,,,, and ,,,,,,,
,,,,,,,(chidleten)
,,,,,,,,,,(adults)
CSF dissemination common
5-10% of gliomas
Ependymal cells
Ventricles + spinal cord
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4th ventricle child
Spinal cord in adults
5-10 % of all gliomas
Describe ependymoma grossly
Well cirumscribed
Soft spngy
Hge+ Necrosis + calcification
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oriign 4 ventricle or cental canal
Describe ependymoma micro
True rossetes when halo of clusters of cells surrounding central empty lumen
Pseudorosetters perivascular when a halo of clusters of cells surrounding a blood vessles
Ependmoma has 2 grades
Grade 2 less cellularity less mitosis rarly invasive
Grade 3
Increasd density and mitosis
and nectois with less evidenet ependymal differentiation
مفيش علافة بين الدرجة والنجاة
الله الذي يرسل الرياح فتثير سحابا فيبسطه في السماء كيف يشاء ويجعله كسفا فتري الودق يخرج من خلاله فإذا أصاب به من يشاء من عباده إذا هم يستبشرون وإن كانوا من قبل أن ينزل عليهم من قبله لمبلسين فانظر إلي آثار رحمة الله كيف يحي الأرض بعد موتها
إن الذي أحياها لمحي الموتي وهو علي كل شئ قدير
الحمدلله
