CNS tumors Flashcards
What is the most common brain tumor type?
Glioma
besides metastatic disease
What tumors are included under gliomas?
astrocytomas
glioblastoma
ependymoma
oligodendocytoma
Where can diffuse type astrocytomas be developed? Adults v children?
cerebral white matter of hemispheres in adults, and in brainstem of children
What is the name for WHO grade II diffuse astrocytoma, and the survival?
astrocytoma- 5-10 years
What is the name for WHO grade III, and survival?
anaplastic astrocytoma- 2-3 years
What grade and survival does glioblastoma multiforme have? Is it a diffuse astrocytoma?
yes, WHO grade IV- <1 year
What is the key radiographical presentation that glioblastoma multiforme shows?
ring-enhancement from leaky neovascularization
What is the histiological presentation of GBM?
pseudopalisading necrosis, pleomorphism, mitoses and vascular endothelial proliferation
What is the molecular pathway of primary GBM?
spontanous, short duration and high grade in older individuals,
What is the molecular pathway of secondary GBM?
younger, p53, lower grade astrocytoma precipitant
How does a pilocytic astrocytoma present? Prognosis?
cerebellar cyst with mural nodule
good prognosis, subtype of glioma
What is the histological pattern?
biphasic with:
hairlike elongations- tighly packed cells
microscopic cysts
rosenthal fibers- eosinophillic
What other syndrome looks like pilocytic astrocytoma? How is it different?
Hemangioblastoma that is a vascular tumor arising sporadically or with Von-Hippel- Lindau
What diffuse CNS tumor often presents with foci of calcification? What are is characteristics and location?
oligodendroglioma: slow growing tumor typically in cerebral hemisphere
1p 19q favorable prognosis
What are common histological features of oligodendrogliomas?
uniform fried egg appearance with calcification
What is the name of the slow growing tumor that commonly grows within ventricles, and in younger adults?
ependymomas- 4th ventricle (children) and spinal cord (adults)
How does ependymomas histologically present?
pseudorosettes in perivascular regions
ependymal rosettes
What clinical consequences result from choroid plexus papilloma?
increased CSF production–> hydrocephalus
What example does Dr. Yachnis use for a PNET?
medulloblastoma- cerebellar PNET
What is the most common malignant Brain tumor of children?
medulloblastoma- cerebellar PNET
What cells does medulloblastoma arise from? What does it commonly obstruct?
primitive embryonic/fetal neuroepithelial cells,
vermis of cerebellum obstructing 4th ventricle
Histologically, how does MB present?
small blue cell tumor with Homer Wright rosettes
molding, leptomeningeal dissemination
What factors improves the prognosis of medulloblastomas?
9q22.3 PTCH gene mutation
cerebellum localization
What sites are the primary metastases to CNS?
lung then breast
