CNS tumors

Question 1

What are 2 tumor types more common in adults (>20 years old)

Answer 1

GBM

Oligodendroglioma

Question 2

What are 2 tumor types more common in children?

Answer 2

medulloblastoma

pilocytic astrocytoma

Question 3

What are CNS tumors more commonly located in:

1. adults
2. children

Answer 3

1. supratentorial (Cerebrum, Diencephalon)

2. intratentorial (Cerebellum, Brainstem)

Question 4

What type of cerebral edema is steroids helpful?

Answer 4

Vasogenic (increased blood brain permeability) extracellular

white matter > gray matter

Question 5

What type of cerebral edema has an intact blood brain barrier?

Answer 5

Cytotoxic - intracellular

steroids not helpful

Question 6

What grade is a tumor with “glomeruloid” endothelial proliferation and tumor necrosis?

Answer 6

WHO grade IV

Question 7

What is a common primary tumor in a child in the cerebellum

Answer 7

Juvenile pilocytic astrocytom

Question 8

What are the 3 glial cell types? What is the cellular marker?

Answer 8

Astrocytes
Oligodendroglia
Ependymomas

GFAP

Question 9

What type of CNS tumor has histological long hair like processes? GFAP positive

Answer 9

Pilocytic astrocytoma

Rosenthal fibers

Question 10

child

cystic with mural nodule

Answer 10

pathognemonic for pilocytic astrocytoma

Question 11

tumor with expansion and hypodensity of infiltrated regions NO Foci of brigh tsingal enhancement

Answer 11

Diffuse fibrillayr astrocytoma

Question 12

tumor with increased cellularity, cytologic atypia
Mitotic figures present,
MIB-1 stain in actively cycling cells

Answer 12

Anaplastic Astrocytoma

Question 13

Where is the most common location of GBM?

Answer 13

deep frontotemporal

Question 14

tumor with increased EGFR

presence of tumor necrosis, pronounced endothelial cell hyperplasia

Answer 14

GBM

Question 15

What type of GBM is characterized by:

1. older patients, EGFR mutations
2. younger pts, p53 mutations, PDGF-A receptor signal

Answer 15

1. Primary GBM

2. Secondary GBM

Question 16

What should you do if you find a Oligodendroglial tumor in a patient

Answer 16

Use FISH to see if a 1p/19q delection is present

that type of tumor is especially susceptible to chemotherapy

Question 17

tumor with chicken wire vasculature
fried egg cytology
calcifications

Answer 17

Oligodendroglial tumors

Question 18

Where are Ependymomas more commonly located in:

1. Children
2. Adults

Answer 18

1. 4th ventricle, lateral ventricles

2. spinal cord, 4th ventricles

Question 19

tumor with bimodal distribution (1-5 y, < 35 y)

true and pseudorosettes

Answer 19

Ependymoma

Question 20

Where are Choroid plexus papillomas located most commonly in:

1. children
2. Adults

Answer 20

1. lateral ventricles

2. 4th ventricles

Question 21

tumor with rosettes, pseudorosettes, one of the most common CNS tumors in children (cerebellum)
highly aggressive

Answer 21

Medulloblastoma

Homer Wright rosettes

Question 22

Tumor a/w Monosomy chromosome 22 (22q12 = NF gene)

thickened dural “tails” exntending from lesional border

Answer 22

Meningioma

Question 23

What is the cellular origin of Primary CNS lymphomas

Answer 23

most are B-cell origin
EBV positive

high grade and poorly responsive to chemo