CNS Tumors Flashcards
CNS tumors are the ____ most common malignancy in children
CNS tumors are the 2nd most common malignancy in childhood, and the most common solid cancer of childhood
In adults 70% is ______tentorial
In children, 70% is _____tentorial
In adults 70% is SUPRAtentorial
In children, 70% is INFRAtentorial
WHAT TYPE OF TUMOR GROWTH IS THIS?
![](https://s3.amazonaws.com/brainscape-prod/system/cm/179/981/181/q_image_thumb.png?1455160618)
EXPANSILE
SHARP border between the tumor and surrounding tissue
WHAT TYPE OF TUMOR GROWTH IS THIS?
![](https://s3.amazonaws.com/brainscape-prod/system/cm/179/982/119/q_image_thumb.png?1455160671)
INFILTRATIVE
SINGLE TUMOR CELLS percolate thorugh brain parenchyma and surround normal structures
Primary tumors arise from brain ____ or ________.
classified according to cell type of origin
In adults, most common (3):
In children, most common (4):
Secondary tumors are….
PRIMARY tumors arise from brain parenchyma or its coverings
in ADULTS: MENINGIOMA, SCHWANNOMA, GLIOBLASTOMA
(msg)
in children: pilocytic, astrocytoma, ependymoma, medulloblastoma
(pame)
Secondary tumors are METASTATIC, spread to brain through the bloodstream
***more common that primary tumors
Astrocytoma:
Age groups affected:
Location:
Sx:
MOST COMMON GLIOMA
Age groups affected: ALL
Location: ANYWHERE
Sx: depends on location and grade
Astrocytoma: Grade 1
example:_____, (major locations, age group affected, MRI findings, major histological features)
Growth:
Prognosis and Rx:
Astrocytoma: Grade 1 - least malignant
example: PILOCYTIC astrocytoma
* @ cerebellum and brain stem of children and young adults*
* MRI: cyst with solid mural nodule that enhances on scan w/contrast*
* Histo: piloid cells, biphasic architecture (compact and microcytic areas), rosenthal fibers*
Growth: slow growing
Prognosis and Rx: low proliferative potential and possibility of cure follwoing surgical resection alone
What type of cell is represented in the H&E stain?
![](https://s3.amazonaws.com/brainscape-prod/system/cm/179/986/163/q_image_thumb.png?1455163358)
Pilocytic astrocytoma (Astro Grade 1)
Piloid cells with hair-like processes
What does the H&E stain represent?
![](https://s3.amazonaws.com/brainscape-prod/system/cm/179/986/397/q_image_thumb.png?1455163506)
Pilocytic astrocytoma (astro grade 1)
biphasic architecture = compact (left arrow) and microcytic (right arrow) areas
What does the H&E stain represent
![](https://s3.amazonaws.com/brainscape-prod/system/cm/179/986/472/q_image_thumb.png?1455163580)
Pilocytic Astrocytoma (grade 1)
Rosenthal fibers = eosinophilic corkscrew inclusions
Astrocytoma grading
Grade II: NO ……, infiltrative in nature and _____ level of proliferation
Grade III: _____ [benign/malignant] tumors, without _____ proliferation or _______. RX: _______ and/or ________
Grade IV: ie) __________, most malignant astrocytoma. _____ progression and prognosis _______.
![](https://s3.amazonaws.com/brainscape-prod/system/cm/179/986/832/q_image_thumb.png?1455163843)
Astrocytoma grading
Grade II: NO mitosis, necrosis or vascular proliferaiton. Infiltrative in nature with LOW level of proliferation
Grade III: MALIGNANT tumors, no microvascular proliferation, no necrosis . RX: adjuvant radiation and/or chemotherapy
Grade IV: GLIOBLASTOMA, most malignant astrocytoma. RAPID progression and poor prognosis/fatal outcome
Glioblastoma:
Arises in: _______
Infiltration:
Typical lesion on MRI: ______, because it can______
Contrast CT:
Gross:
Histo:
Prognosis:
![](https://s3.amazonaws.com/brainscape-prod/system/cm/179/987/272/q_image_thumb.png?1455164842)
Glioblastoma
Arises in: cerebral hemispheres
Infiltration: diffusely infiltrative, can be multicentric
MRI: BUTTERFLY LESION because it can cross the corpus callosum
Contrast CT: RING ENHANCING LESIONS w/ edema, mass effect
Gross: central/yellow necrosis, red/brown hemorrhage, cystic changes, poorly defined borders
Histo: ENDOTHELIAL cell hyperplasia, pleomorphic malignant astrocytes, HI mitosis, area of necrosis with pseudopalisading of cells at the periphery (pictured), GFAP positive
POOR PROGNOSIS
Oligodendroglioma:
rare _____ tumor/glioma of ______ with _____ prognosis in comparision to astrocytoma of comparable grade
Loc:
associated sx:
CT:
Histo: …quack…secondary structures=
![](https://s3.amazonaws.com/brainscape-prod/system/cm/179/988/185/q_image_thumb.png?1455165590)
Oligodendroglioma: rare MALIGNANT tumor (glioma) of OLIGODENDROCYTES with BETTER PROGNOSIS than astrocytoma of comparable grade
Loc: DENSELEY CELLULAR tumor in FRONTAL LOBE
associated sx: SEIZURES
CT: intratumoral calcification
Histo: perinuclear halos “FRIED EGG” appearance and CHICKEN WIRE CAPILLARY PATTERN; secondary structures PERINEURONAL SATELLITOSIS = tumor cells aggreagate around structurels like capillaries, neurons, pia, etc
![](https://s3.amazonaws.com/brainscape-prod/system/cm/179/988/185/a_image_thumb.png?1455165534)
Ependymoma:
Arises from _______ lining cells
Common site:
Common age:
Imaging:
Histology:
Ependymoma:
Arises from EPENDYMAL LINING CELLS
Common site: 4th ventricle, adults usually spinal
Common age: freq in children but may present in any age
Imaging: discrete, exophytic, contrast enhancing
Histology: PERIVASCULAR PSEUDOROSETTE, TRUE EPENDYMAL ROSETTE
What does the histology represent?
![](https://s3.amazonaws.com/brainscape-prod/system/cm/179/989/163/q_image_thumb.png?1455165845)
EPENDYMOMA PERIVASCULAR PSEUDOROSETTES
= tumor cells surround a blood vessel
well delineated, moderately cellular glioma with monomorphic nuclear morphology and perivascular pseudorosettes and ependymal rosettes