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House AMP > C.N.S. TUMORS > Flashcards

C.N.S. TUMORS Flashcards

1
Q

General characteristics of CNS tunors

• In childhood, tumors are likely to arise from the _______, while in adults are mostly ————-.

A

posterior fossa

supratentorial

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2
Q

The anatomic site of CNS tumors can have lethal consequences irrespective of the histological classification

T/F

A

T

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3
Q

CNS tumors do not have detectable premalignant stages

T/F

A

T

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4
Q

CNS tumors often metastasize

T/F

A

F

They rarely metastasize

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5
Q

Clinical features of CNS tumors

•_________,_________ , etc

•______,_____________ deficits

A

Seizures, headaches

Focal neurologic

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6
Q

Classification of CNS Tumors

• Coverings of the brain (_______)
• Cells intrinsic to the brain (______, ______ tumors,_______ tumors)
• Other cell populations (_______,_______ tumors)
• Metastases
• Sellar region tumors e.g. _______,______________ tumour (PitNET)

A

Meningioma

gliomas ; neuronal ; choroid plexus

lymphomas; germ cell tumors

craniopharyngioma, pituitary neuroendocrine tumour (PitNET)

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7
Q

Gliomas

3 types

List!!!!

A

• Astrocytoma
• Oligidendroglioma
• Ependymoma

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8
Q

Astrocytomas
Can either be _______ or _________

A

• Fibrillary

• Pilocytic

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9
Q

Astrocytomas: Fibrillary

•_____ to ____ decade
• Commonly found in ________
• Grades are ________ (II), _____________ (III), ________ (IV)

A

4th to 6th

cerebral hemisphere

Diffuse (II), Anaplastic (III), Glioblastoma (IV)

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10
Q

Astrocytomas: Pilocytic

• (Children or Adults?)
•location : __________
• Relatively (benign or malignant ?)

A

Children

Cerebellum

benign

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11
Q

Oligodendroglioma
• _____ and _______ decades
•location : ______ with predilection for _____ matter

A

Fourth and fifth

Cerebral hemispheres; white

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12
Q

Oligodendroglioma

• Common genetic finding is loss of ___________ for chromosomes _____ and ——-

A

heterozygosity

1p & 19q

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13
Q

Who has a better prognosis

Oligodendroglioma or Astrocytomas

A

Oligodendroglioma has a Better prognosis than astrocytomas

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14
Q

Ependymoma
•_______ decades of life
• Most often arise next to the _______________________________ including the _______ of the spinal cord.

• In adults, most common in the _____

A

First two

ependyma-lined ventricular system

central canal

spinal cord

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15
Q

Meningioma

• (Benign or Malignant?)
• Originate from _______ cells of the ______
• Usually (poorly or well?) demarcated
• Attached to the ___ with ______ of the underlying brain

A

Benign

meningothelial; arachnoid

Well

dura; compression

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16
Q

Meningioma

__________ pattern of cell growth and _______________ bodies.

A

Whorled

psammomatous

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17
Q

Meningioma

Subtypes:
•_________
• _________
• ___________

A

Syncytial

Fibroblastic

Transitional

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18
Q

Medulloblastoma
• (Children or Adults?)
• _________ location
• Largely (differentiated or undifferentiated?) tumor
•highly (benign or malignant?) .
• Exquisitely radio(sensitive or resistant?)

A

Children

Cerebellar

undifferentiated

malignant

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19
Q

Medulloblastoma

• _______ + _______ = high survival rate

A

Excision + Radiation

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20
Q

Nervous system tumors
• \___________
• _____________
• ________ tumors

A

• Schwannoma
• Neurofibroma
• Metastatic tumors

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21
Q

Schwannoma
• Benign or Malignant?

• Located often at the __________, attached to the ______ branch of the ________ nerve

A

Benign

cerebellopontine angle

vestibular; eigth cranial

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22
Q

Schwannoma

• Present with ______ loss/ ______

• Maybe associated with _____ gene mutation.

A

hearing; tinnitus

NF2

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23
Q

Schwannoma

Hypo/hypercelllular areas known as _______ and ___________

• In between are areas of nuclear _______ known as ______ bodies

A

Antoni A and Antoni B.

palisading

Verocay

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24
Q

Metastatic tumors to the CNS
• Lung, breast, skin (melanoma), kidney, GIT are least common.
• Sharply demarcated.

T/F

A

F( Most )

T

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25
Q

Sellar Region Tumors

Tumors of the pituitary gland

• _____________
• ___________________ tumor (pituitary ____________)

A

Craniopharyngioma

Pituitary neuroendocrine

adenoma

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26
Q

Craniopharyngioma

WHO grade ___
(Benign or Malignant?)

Usually _______ location but frequently extends into the ______ and neighbouring structures.

A

1
Benign

suprasellar

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27
Q

Craniopharyngioma

Two types: _______ craniopharyngioma & _________ craniopharyngioma

A

Papillary

Adamantinimatous

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28
Q

Craniopharyngioma

Clinical features: ______ disturbances, endocrine deficiencies e.g.

_________

hormone (_____ failure)

Diabetes insipidus, headachee etc

A

visual

Growth hormone (growth failure)

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29
Q

Craniopharyngioma

________ hormone is the most commonly affected hormone.

A

Growth

30
Q

Most common intraocular malignancy in children is ??

A

Retinoblastoma

31
Q

Retinoblastoma

Due to loss/inactivation of _____ gene (2-hit hypothesis) m

A

RB1

32
Q

Retinoblastoma

Classification
_______ (unilateral)
__________ (bilateral)
When associated with ————— (trilateral)

A

Sporadic

Inherited

Pineoblastoma

33
Q

Retinoblastoma

Classification
Sporadic (_____lateral)
Inherited (____lateral)
When associated with pineoblastoma (____lateral)

A

uni

Bi

Tri

34
Q

Retinoblastoma

Loss/inactivation of ______________ gene

A ____________ gene.

________ locus

A

both alleles of RB1

Tumor supressor

13q14.2

35
Q

Retinoblastoma

2 hit hypothesis

First mutation is ____________

2nd mutation is ________

A

somatic/germline.

somatic

36
Q

retinoblastoma

Earlier age of onset
Usually ___lateral involvement

May have other malignancies e.g. _____________

A

bi

osteosarcoma

37
Q

Germline mutations in RB1 lead to _________________ retinoblastoma

A

inherited/familial

38
Q

Retinoblastoma

Clinical features: _________ (white reflex), _____,_______, ___ pain, detachment.

On histology, ______ and ———— are seen.

A

Leukocaria

glaucoma, strabismus

eye

rosettes and fleurettes

39
Q

Retinoblastoma

Two types of rosettes:

_______________ rosettes
_____________ rosettes

A

Flexner-Wintersteiner

Homer Wright

40
Q

Retinoblastoma

Treatment:

————
___________

A

Chemotherapy Enucleation

41
Q

CNS tumors: By the cell type

Pineal tumors

Tumors of the ______ and ______
nerves(e.g., schwannoma, neuroma, neurofibroma)

Mesenchymal nonmeningeothelial
tumors(e.g., _____,______,_______,________)

Germ cell tumors (e.g., _______)

A

Pineal

hemangiomas, hemangioblastoma, lipoma, hamartoma

teratoma

42
Q

Primary CNS tumors do not metastasize to organs outside the CNS.

T/F

A

T

43
Q

Drop metastases (intra____, extra______ ,____ metastases ) and ________ metastases may occur.

Typically manifest as _____ along the _______ and ________ that can cause back pain with neurologic symptoms (e.g., limb weakness)

Can be detected by ________

A

dural; medullary; spinal

leptomeningeal

nodules

spine and cauda equina

lumbar puncture

44
Q

Most common primary brain tumor in adults is ??

A

Glioblastoma

45
Q

Glioblastoma

Often crosses ________, forming a ______ glioma

A

corpus callosum

Butterfly

46
Q

Glioblastoma

Express a protein called _____ (__________________Protein)

A

GFAP

Glial Fibrillary Acidic

47
Q

2nd most common brain tumor in adults is ??

A

Meningioma

48
Q

Meningioma

Arise from _______ cells

A

arachnoid

49
Q

Meningioma

“_______” - external to brain

Can have ______ attachment (“tail”)

A

Extra-axial

dural

50
Q

Meningioma

Classically affects (male or female?) more than (males or females?)

Expresses ______ receptor

A

Female

Male

estrogen

51
Q

3rd most common adult primary brain tumor is ??

A

Schwannoma

52
Q

Cerebellopontine angle is where ______ never and ________ nerve emerge from

A

Facial nerve and vestibulocochlear nerve

53
Q

Schwannoma

Stain positive for protein ———

A

S-100

54
Q

Neurofibromatosis

Associated with ___________

Autosomal __________ disease

A

schwannomas

dominant

55
Q

Neurofibromatosis

Mutation _____/_____ genes Neurofibromas

_____ nodules

___________ spots

A

NF1 /NF2

Lisch

Café-au-lait

56
Q

Neurofibromatosis

Type 1:
(Most of Least?) common

————- spots, _________

A

Most

Café-au-lait

Neurofibromas

57
Q

Neurofibromatosis

Type 2:
_______________ (almost all patients)
Meningiomas
______ tumors

MISME: —————————

A

Bilateral schwannomas

Multiple

Multiple inherited schwannomas, meningiomas, and ependymomas

58
Q

Oligodendroglioma

Usually in _______ lobe

A

frontal

59
Q

Pituitary adenoma

Most commonly secrete _______, leading to ______,_______,________ etc

A

prolactin

Amenorrhea, galactorrhea, impotence

60
Q

Pituitary Adenoma

Bitemporal ________
<___mm = microadenoma
>____mm = macroadenoma

A

hemianopsia

10

10

61
Q

1: Can produce ____ , leading to _____________

Hemangioblastoma
Two key facts to know

A

EPO; polycythemia

von Hippel-Lindau

62
Q

Most common brain tumor children is ??

A

Pilocytic astrocytoma

63
Q

Pilocytic astrocytoma

(Low or High?) -grade astrocytoma

Contain _______ fibers

A

Low

Rosenthal

64
Q

Medulloblastoma

Highly (benign or malignant?) primary brain tumor
Usually occurs in (children or adults?)

Usually occurs in ________
Often in the midline ( ________)

A

malignant

Children

cerebellum

truncal ataxia

65
Q

Medulloblastoma

Is a Type of ___________________________________________ tumor (PNET)

A

primitive neuroectodermal

66
Q

Medulloblastoma

___% children survive to adulthood. Many with ___________________

Can compress _________ , leading yo hydrocephalus

A

75; complications of treatment

4th ventricle

67
Q

Nodules in dura of spinal cord: ___________

A

Drop metastasis”

68
Q

Craniopharyngioma: location

•____________: Anywhere pituitary gland → _______________

A

Suprasellar

base of 3rd ventricle

69
Q

Craniopharyngioma

Derived from ______________

Often ———- and _____

Contain _______ cells

A

remnants of Rathke’s pouch

calcified and cystic

epithelial

70
Q

Craniopharyngioma

Can compress the ________, causing ______________

A

optic chiasm

Bitemporal hemianopsia

71
Q

Craniopharyngioma

Enucleation: __________________ and __________________ between the globe and the orbit.

A

removing the eye from the orbit

separating all tissue connections

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