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MHD- Neuro > CNS Tumors > Flashcards

CNS Tumors Flashcards

1
Q

Differentiate expansile from infiltrative growth

A

Expansile growth: sharp border between tumor and surrounding tissue

Infiltrative growth: Single tumor cells percolate through the brain parenchyma and surround normal structures

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2
Q

How often do primary brain tumors metastasize outside of the CNS?

A

Almost never

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3
Q

What are the three most common primary CNS tumors in adults?

A

Meningioma, schwannoma, glioblastoma

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4
Q

What are the three most common primary CNS tumors in kids?

A

pilocytic astrocytoma (benign), ependymoma, medulloblastoma (highly malignant)

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5
Q

What is the most common glioma?

A

Astrocytoma

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6
Q

Where do astrocytomas appear in the brain?

A

Anywhere

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7
Q

What age group is affected by astrocytomas?

A

All age groups

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8
Q

Give an example of a grade I astrocytoma

A

Pilocytic astrocytoma

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9
Q

What is the prognosis of a pilocytic astrocytoma?

A

Possibility of cure following surgical resection alone

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10
Q

What is the identifying histologic cellular appearance of pilocytic astrocytomas?

A

Piloid cells with hair-like processes

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11
Q

What is the identifying architecture of pilocytic astrocytomas?

A

Biphasic- alternating areas of compact and microcytic areas

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12
Q

What are rosenthal fibers?

A

Characteristic red blobs found in pilocytic astrocytomas?

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13
Q

What are the cancerous cells in glioblastomas?

A

Malignant astrocytes

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14
Q

What is the characteristic appearance of glioblastoma on MRI?

A

Butterfly lesions- crosses the corpus callosum

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15
Q

How do glioblastomas appear on CT?

A

Ring-enhancing mass

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16
Q

What are the hyperplastic cells found in glioblastoma?

A

Endothelial cells- they are secreting VEGF and other growth factors.

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17
Q

Glioblastoma tumor cells (astrocytes) are positive for what on IHC?

A

GFAP

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18
Q

What is the prognosis for glioblastoma?

A

bad

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19
Q

What is the most common presentation of an oligodendroma?

A

Frontal lobe mass- may present with seizures

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20
Q

What are characteristic findings of an oligodendroglioma on CT?

A

intratumoral calcifications on CT

21
Q

Which tumors shows “fried eggs” cells and “chicken-wire” capillaries on HandE staining?

A

Oligodendrogliomas

22
Q

Describe the lumen of a homer-wright rosette (common in Medulloblastomas)

A

central pore is composed of delicate neuropil fibers

23
Q

From what cells do ependymomas arise?

A

Ependyma cells that line the walls of the ventricles and central canal of the spinal cord

24
Q

What is the most common side of an ependymoma?

A

4th ventricle –> hydrocephalus

25
Q

Where in the CNS do ependymomas typically arise in adults?

A

spinal cord

26
Q

Medulloblastomas arise from what type of cell?

A

Undifferentiated neuroectodermal cells

27
Q

Where do neuroectodermal cells arise?

A

cerebellum of children- highly malignant

28
Q

What is the treatment for medulloblastomas?

A

Sensitive to radiation therapy

29
Q

Describe the histology of a medulloblasotoma

A

Sheets of undifferentiated cells with scanty cytoplasm and dark staining nuclei

30
Q

Meningiomas arise from what type of cell?

A

usually arachnoid cells

31
Q

What is the malignancy of a meningioma? Prognosis?

A

Usually a benign tumor in adults- resection can be curative

32
Q

What are the characteristic histologic features of a meningioma?

A

Psammomas and whorls in middle aged girls

33
Q

What are craniopharyngiomas?

A

Benign tumors of childhood- often confused with pituitary adenomas-

34
Q

What are clinical presentations of craniopharyngiomas?

A

Endocrine dysfunction
Visual symptoms
Hydrocephalus

Calcifications are common

35
Q

How do craniopharyngiomas appear on CT?

A

Suprasellar mass with calcifications

36
Q

What are schwannomas?

A

Benign tumors of schwann cell origin. Involved cranial or spinal nerves (often CN VIII)

37
Q

Bilateral acoustic neuromas are found in what disease?

A

Neurofibromatosis type 2

38
Q

What is the stain used in Schwannomas?

A

S100 protein (any cell of neural crest origin stain with S100 protein)

39
Q

What is the most common source of a metastatic tumor in the CNS?

A

lung

40
Q

What is the gene mutated in NF-1?

A

Gene on 17q11.2

Neurofibromin-GTPase activating protein

41
Q

What are pathognomonic findings for NF-1?

A

Plexiform neurofibromas - “bag of worms”

42
Q

What familial tumor syndrome presents with multiple cutaneous neurofibromas and cafe au lait spots?

A

NF-1

43
Q

What gene is mutated in NF-2?

A

chromosome 22q12

a tumor suppressor gene (merlin)

44
Q

What clinical symptom is associated with NF-2?

A

bilateral acoustic schwannomas and multiple meningiomas

45
Q

Hamartomatous lesions involving multiple organs are characteristic of what familial tumor syndrome?

A

Tuberous Sclerosis

46
Q

What is the classic triad of tuberous sclerosis?

A

Adenoma sebaceum
Seizures
Mental Retardation

47
Q

What are the two masses in brain in someone with tuberous sclerosis?

A 
Tubers= glioneuronal hamartomas
SEGAS= subependymal nodules --> hydrocephalus
48
Q

What is the CNS lesion associated with VHL?

A

CNS hemangioblastoma: highly vascularized

49
Q

Who is the hottest dude in our class?

A

Steven once he gets his kid jewelry off next Wednesday.

MHD- Neuro (19 decks)

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