CNS tumors Flashcards
Most common malignant adult neoplasm and where is it most commonly found
Glioblastoma multiforme
cerebrum/ corupus callosum
Most common benign adult neoplasm
where is if most commonly found
Meningioma
falx cerebri
sites of hemangioblastoma
retina
cerebellum
diagnostics of hemangioblastoma
sharply demarcated intraparenchymal mass
~60% cystic with non-enhancing wall
associations of hemangioblastoma
VHL
Imaging of Glioblastoma multiforme
garland like contrast enhancement with central necrosis
Morphology of glioblastoma multiforme
hypercellular white matter with extensive astrocytic aberration
microvascular proliferation
areas of necrosis and hemorrhage with surrounding pseudopalisading arrangement of tumor cells
associations of glioblastoma multiforme
overexpression of ERFR
Where are oligodendrogliomas most commonly found
what population do you most commonly see them?
frontal lobe
adults in their 40-50’s
Diagnostics of an oligodendroglioma
intraparenchymal tumor with calcifications
Classic morphology of oligodendrogliomas
small clear cytoplasm with large round nuclei (appearing as fried eggs) and chicken wire pattern of capillary anastomoses
Diagnostics of meningiomas
well defined space-occupying lesion resembling a snowball
Dura mater sign
Ginko leaf sign in the spinal cord
sunburst appearance
Morphology of meningiomas
psammoma bodies
onion peel arrangements of tumor cells with whorled pattern of concentrically arranged spindle cells
Associations of Meningiomas
NF2
Location of acoustic schwannomas
internal auditory meatus at the cerebellar pontine angle
Diagnostics of acoustic schwannomas
enhancing lesion by the internal auditory canal with possible extension into the cerebellopontine angle S100+
Morphology of acoustic schwannomas
biphasic pattern of Anoni A and B bodies
Describe Antoni A-bodies
spindle cells arranged in palisading patterns with interspersing nuclear-free zones (Verocay bodies)
describe Antoni B bodies
paucicellular pattern with unstained myxoid stroma
Association of bilateral schwannomas
NF2
Most common malignant pediatric tumor
medulloblastoma
where is medulloblastoma typically located
cerebellum
Diagnostics of medulloblastoma
contrast-enhancing mass on imaging
Morphology of medulloblastoma
sheets of small anaplastic blue cells with scant cytoplasm (primitive cells) with high mitotic figures Homer Wright Rosettes
associations of medulloblastoma
Turcot syndrome
Most common benign pediatric tumor
pilocytic astrocytoma
most common location of pilocytic astrocytoma
cerebellum
Diagnostics of pilocytic astrocytoma
well-demarcated cystic lesions
Morphology of pilocytic astrocytoma
bipolar cells composed of central basophilic nuclei with eosinophilic pilocytic processes (Rosenthal fibers)
Location of Epyndymoma
around the ventricles and floor of 4th ventricle
are Epyndymomas malignant or benign?
benign
Diagnostics of Epyndymomas
intraparenchymal tumor with calcifications and cystic components due to necrosis and/or hemorrhage
morphology of Epyndymomas
perivascular pseudorosettes
rod-shaped blepharoblasts near the nucleus
Association of Epyndymoma
NF2
Origin of craniopharyngiomas
rathkes pouch
are craniopharyngiomas benign or malignant?
benign
diagnostics of craniopharyngiomas
suprasellar calcified cysts with lobulated contouring
Morphology of craniopharyngiomas
cyst filled with viscous brown/ yellow cholesterol cysts, resembling motor oil
cords of palisading squamous epithelium with wet keratin
clinical features of tuberous sclerosis
hamartomas
seizures
ash leaf spots
shagreen patches
cysts on liver, kidney and pancreas
intellectual disability
cause of tuberous sclerosis
mutation of TSC1 on chromosome 9 (codes hamartin) or mutation of TSC2 on chromosome 16 (codes tuberin)
clinical presentation of Sturge-Weber Syndrome
port wine stained facial angioma in V1 and V2
leptomeningeal angiomas
early-onset glaucoma
infantile epilepsy
intellectual disability
What conditions are associated with NF1
scoliosis
pheochromocytoma
Wilms tumor
pathology of NF1
mutation of NF1 gene on chromosome 17 that codes for neurofibromin
pathology of NF2
mutation of NF2 gene on chromosome 22 that codes for merlin
clinical presentation of NF2
bilateral acoustic schwannomas
multiple meningiomas
multiple cerebral and spinal tumors
associations of NF2
Meningiomas
Schwannomas
Associations of VHL
hemangioblastomas
bilateral renal cell carcinomas
pheochromocytoma
clinical presentation of VHL
cysts in the pancreas, liver and kidneys
hemangioblastomas in the retina, cerebellum, brain stem and spine
pathology of VHL
deletion of VHL gene on chromosome 3, which knocks out the tumor suppressor gene
explain the sequelae of increased HIF-1a in VHL
- deletion of VHL leads to increased HIF-1a
- increased HIF-1a leads to increased VEGF, EPO, PDGF and TGF-a
- leads to angiogenesis
- polycythemia and growth stimulation
