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Neuro Block 5 > CNS Tumors > Flashcards

CNS Tumors Flashcards

1
Q

What are the 3 types of gliomas?

A

astrocytomas
oligodendrogliomas
ependymoma

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2
Q

Are most tumors of the CNS primary or metastatic?

A

metastatic - 70%!

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3
Q

What is the most common primary brain tumor in adults?

A

glioblastoma multiforme

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4
Q

What are the general characteristics of a metastatic tumor to the brain?

A

generally well circumscribed
often multiple
usually located in junction between gray and white matter

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5
Q

What are the general characteristics of a primary brain tumor?

A

poorly circumscribed
usually single
location varies by type

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6
Q

Where do metastatic brain tumors often come from?

A

lung, bladder, breast, melanoma and others

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7
Q

What does pleomorphic mean?

A

It means the cells come in many different odd shapes - it’s generally not a good sign

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8
Q

How common are CNS tumors in children? Which are most common in children?

A

In general, CNS tumors are the 2nd most common neoplasia in children

medulloblastoma and astrocytoma are the most common types

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9
Q

As for the location in the CNS, where do adult CNS tumors occur and where to childhood CNS tumors occur?

A

children - 70% posterior foss

adults - 70% supratentorial

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10
Q

What does the WHO base it’s grading scale on?

A

mostly histological appearance

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11
Q

What are the 4 WHO grades?

A

1 - low proliferative potential, possible to cure wiht resection
2 - infiltrative, but low proliferative activity
3- evidence of malignancy = nuclear atypia and much mitotitc activity
4 - cytologically malignant, mitotically active, necrosis prone

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12
Q

What are the survival estimates for grade 2, 3, and 4?

A

2 = greater than 5 years
3: 2-3 years
4 = depends on treatment, but often not more than a year

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13
Q

What do gliomas arise from?

A

ASTROCYTES
oligodencrocytes
ependymal cells

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14
Q

what is the highest-grade astrocytoma?

A

glioblastoma

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15
Q

What are the most common symptoms of a glioma

A

it depends on location of tumor obviously, but headaches, seizures, memory loss and changes in behavior are common

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16
Q

What do you call a grade 1 astrocytoma?

A

pilocytic astrocytoma

low proliferative potential

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17
Q

Are pilocytic astrocytomas more common in chidlren or adults, and where in the brain d they usually occur?

A

children - frequently posterior fossa - cerebellum

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18
Q

What are the morphologic features of pilocytic astrocytomas?

A

ofen cystic
bipolar cells with long hair-like processes
rosenthal fibers**
biphasic

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19
Q

What genetic point is associated with pilocytic astrocytoma?

A

a BRAF and KIAA fusion/duplication - diagnosed with FISH

they have a worse prognosis

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20
Q

What is a grade 2 astrocytoma?

A

diffuse astrocytoma

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21
Q

What is the main characteristic of a diffuse astrocytoma?

A

it’s actually very slowly progressive, but it will almost always eventually become anaplastic

22
Q

Which type of diffuse astrocytoma is most likely to progress to a grade 3?

A

gemistocytic astrocytoma

23
Q

What is the grade 3 astrocytoma called?

A

anaplastic astrocytoma

24
Q

What are the characteristics of an anaplastic astrocytoma?

A

Starting to be much more cellular and pleomorphic. Often has GFAP (glial fibrillary acidic protein) as an intermediate filament

25
Q

What is a grade 4 astrocytoma?

A

a blioglastoma

26
Q

What are the usual signs and symptoms of a GBM?

A

slowly profressiv neuro defect, headache, symptoms of increased ICP - headaches, nausea, vomiting, cognitive impariemtn, seizures

27
Q

What age group in particular developes GBMs?

A

60-69 is the most common

28
Q

Are oligodendrogliomas usually in adults or kids?

A

adults

29
Q

How do patients with oligodendrogliomas usually present?

A

with seizures

30
Q

What is the mean survival for an oligodendroglioma?

A

5-10 years

31
Q

What genetic deletions actually IMPROVE survival of oligodendoglioma?

A

deletion of both 1p and 19q

32
Q

What are the morphological features of oligodendroglioma?

A
  • shaprly circumscribe hemispheric masses
  • round nuclei with cytoplasmic halos
  • delicate capillary network
  • most calcified
33
Q

What does the perinuclear halo seen in oligodendrogliomas look like?

A

a fried egg

34
Q

Who usually gets ependymomas? where?

A

children - usually near the 4th ventricle (but in adults there is a spinal cord variant)

35
Q

What is the prognosis for an ependymoma?

A

the tumor is slow growing, but prognosis is will porr - 4 years

36
Q

What are the main morphological features of ependymomas?

A

solid or papillary mass
round nuclei
dense fibrillary background
canals, pseudorosettes, rosettes

37
Q

What do pseudorosettes have in their center?

A

a blood vessel

38
Q

What WHO grade do medulloblastomas receive?

A

grade 4

39
Q

Are medulloblastomas more common in adults or children?

A

children

40
Q

where in the brain do medulloblastomas usually occur?

A

cerebellum

41
Q

What genetic variation is associated with poor prognosis ih medulloblatoma?

A

i(17q) - the short arm of chromosome 7 gets deleted and replaced with another long arm

42
Q

What are the histologic geatures of medulloblastoma?

A

small, dark, elongated, anaplastic cells with homer-wright rosettes

43
Q

What are the usual presenting symptoms with medulloblastoma?

A

headache, morning vomiting which gets worse with time, back pain and motion difficulties

44
Q

What gender developes medulloblastoma more often?

A

boys

45
Q

What is a meningioma a tumor of?

A

arachnoid cells - attached to dura

46
Q

What is the prognosis of meningiomas?

A

very god - they’re slow growing and benign, cured by resection

47
Q

What are the morphological characteristics of a meningioma?

A

attached to dura
forms in syncytial pattern
psammoma bodies (calcium deposits)

48
Q

Who typically gets primary brain lymphomas?

A

immunosuppressed patients

49
Q

How canyou diagnose a primary brain lymphoma?

A

easily detectable in the CSF

50
Q

Where is a common place for a schwannoma to be located? What symptoms?

A

around CN7 at the cerebellopontine angle

hearing loss, tinnitus

51
Q

What CNS tumor is associated with Flexner-Wintersteiner rosettes?

A

retinoblastoma

Neuro Block 5 (23 decks)

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