CNS Tumors

Question 1

4.4 Kinds of Tumors

Answer 1

Meningiomas
Gliomas - astrocytomas, oligodendrogliomas, glioblastoma, and ependymoma
Primitive Neuroectodermal Tumors: medulloblastoma
Metastatic Tumors

Question 2

Spread of CNS Tumors

Answer 2

Metastatic spread rare or absent: instead diffusely infiltrate adjacent brain

Question 3

3 Ways Childhood Brain Tumors Differ from Adult

Answer 3

Infratentorial
Primitive tumors more common (neuroectodermal)
Metastases/meningiomas rare

Question 4

Meningioma Radiologic View

Answer 4

Sharply demarcated, don’t infiltrate, just compress

Question 5

Meningioma Origin

Answer 5

Arachnoid cell subdural

Question 6

Meningioma Histological Signs (2)

Answer 6

Whorls of tumor cells, which will eventually degrade/calcify to form psammmoma bodies

Question 7

2.3 Kinds of Astrocytoma (and grades)

Answer 7

Pilocytic (good margin b/w it and brain): I
Diffuse Astrocytomas (more infiltrating):
Astrocytoma: II
Anaplastic astrocytoma: III
Glioblastoma: IV

Question 8

Treatment for Diff Astrocytoma Grades

Answer 8

I: Just resect and observe, usuall fine
II: Observe, maybe radiation
III and IV: Radiation and chemo

Question 9

Mural Nodule

Answer 9

Contrasting enhancing, sits inside cyst as sign of pilocytic astrocytoma

Question 10

4 Features of Malignancy to Decide Grade

Answer 10

Anaplasia
Mitoses
Microvascular proliferation
Necrosis w/ pseudopalisading

Question 11

Oligodendroglioma

Answer 11

Slow growing, w/ seizures. Grade II. “Fried egg appearance”

Question 12

LOH 1p/19q

Answer 12

Mut of oligodendroglioma that correlates to improved chemo response

Question 13

2 Histologic Features of Medulloblastomas

Answer 13

Sheets of primitive neuroectodermal cells (basophilic)

Homer-Wright rosettes (gather around central area of cytoplasm)

Question 14

Most Common Brain Metastases

Answer 14

Lung and breast

Question 15

Radiologic Features of Metastatic Tumor

Answer 15

Contrast enhacing ring around central area of necrosis

Question 16

Medulloblastoma

Answer 16

Poorly differentiates neoplasms, more common younger, and in cerebellum

Question 17

Grade I Pilocytic Astrocytoma

Answer 17

Tumors don’t infiltrate normal brain tissue so surgery can be a cure

Question 18

Glioblastoma Multioforme (3)

Answer 18

High grade, tumor crosses corpus callosum = butterfly

Causes vasogenic edea by increased permeability of bvs

Question 19

Radiologic Sign of Meningioma

Answer 19

Homogenous enhancement on MRI w/ contrast