CNS Tumors

Question 1

Most CNS Tumors derived from

Answer 1

Neuroectodermal stem cells

Question 2

Risk factors for glioma vs meningiomas

Answer 2

both - high dose radiation with hereidtary

Glioma only - age, male, white

Meningioma - famel, exgoenous hormones

Question 3

Grading of astorcytomes

Answer 3

Pilocytic
Diffuse
Anaplastic
Glio

Question 4

Grading of oligodendrogliomas

Answer 4

No 1 or 4
Oligoendroglioma
Anaplastic oligodendroglioma

Question 5

Pilocytic astromcytoma

Answer 5

Driven by BRAF
Cerebellar
Children
Cyst with mural enhacing nodule 
Biphasic areas with rosenthal fibers

Question 6

Diffuse astrocytoma

Answer 6

Most over 20 y/o
Frontal/temporal lobes 
Non-enhancing on MRI
Angulated atypical nuclei
IDH1/2 or p53 mutations

Question 7

Anaplastic astrocytoma

Answer 7

Grade 2 plus mitoses
Enhacing mass on MRI
Forntal and temporal

Question 8

Gliobastoma

Answer 8

Grade 3 plus necorsis or microvascular proliferation
EGFR
Butterfly pattern transcallosal spread

Question 9

Oligodendroglioma

Answer 9

Seizures
Frontal lobe white matter
Round nuclei and fried egg artifact (hydropic)

1p/19q and IDH1/2 mutations

Question 10

Ependrmoma

Answer 10

Grade 2
Cerebellar in kids
Floor of 4th ventricle
Perivascular pseudorosettes

Question 11

Flexner-wintersteiners
Homer wright
Perivascular pseudo

Answer 11

F-W - central lumen empty - retino, medullo, pienoblastoma

H-W - central lmen full (medullo)

Perivcasular pseudo - central lumen is a blood vessel(ependymoma)

Question 12

Ganglioma

Answer 12

Grade 1
Under 50
Temporal lobe (with epilepsy)
SOlid mass or cyst with mural nodule

Mixture of glial and neuronal compenets

Question 13

Medulloblastoma

Answer 13

Grade 4 
Roof of 4th ventricle
Hydrocephalus 
Disseminates into CSF 
Radiosensitive

Question 14

Medulloblastoma genetics

Answer 14

17q
MYC
Increased beta-catenin (better prognossi)

Question 15

Meningiomas

Answer 15

F:M 2:1
Induced by radiation
Most grade 1 
22q deletion common (NF2 gene-merlin protein)
Dural tails and whorls

Question 16

Mestastasis

Answer 16

Most from lung

Multiple grey-white junction masses

Question 17

Schwannoma

Answer 17

Grade 1 
Cerebellopontine angle at auditory nerve 
Bilateral=NF2 (merlin)
Encapsulated
Antoni A and B with Verocay bodies

Question 18

Neurofibroma

Answer 18

Grade 1
Well delineated bu unencapsulatd masses of spinlde cells
Think NF1
Cna progress to MPNST