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Neuro II Exam 1 > CNS Tumors - Fremont-Smith > Flashcards

CNS Tumors - Fremont-Smith Flashcards

1
Q

low grade astrocytoma nutations

A

TP53
isocitrate DH

exception - pilocytic astrocytoma

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2
Q

loss of 22q

A

meningioma

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3
Q

1p and 19q codeletion

A

oligodencroglioma

good chemo response

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4
Q

isochromosome 17q

A

medulloblastoma

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5
Q

anaplastic astrocytoma-glioblastoma

A

EGFR amplification

PTEN alteration

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6
Q

NF1

A

17q

also with pheochromocytoma and GIST tumors

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7
Q

NF2

A

22q

vestibular and PN schwannoma, meningioma

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8
Q

tuberous sclerosis

A

TSC1/9q
TSC2/16p

renal AMLs, lung LAM, cardiac rhabdomyoma

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9
Q

li fraumeni syndrome

A

TP53/17p

astrocytoma

breast ca, bone and soft tissue sarcoma

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10
Q

bilateral optic nerve astrocytoma

A

neurofibromatosis type 1
von-recklinghausen

auto dom

chromosome 17q - neurofibromin protein

also - cafe au lait spots

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11
Q

primary CNS tumor

A

uncommon but fatal

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12
Q

multiple mets to brain

A

melanoma

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13
Q

grade 1 astrocytic tumor

A

pilocytic astrocytoma

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14
Q

grade 4 astrocytic tumor

A

glioblastoma

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15
Q

medulloblastoma

A

embryonal tumor

more in young kids cerebellum
-because more mitosis in young brain

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16
Q

primary CNS tumors of adults

A 
meningioma 34%
glioblastoma 16.7%
pituitary 13.1%
astroctoma 7%
medulloblastoma 1%
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17
Q

meningioma

A

dura
-extra-axial

excision cures it

from meningothelial cells of arachnoid

more in women

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18
Q

genetic of meningioma

A

loss of chromosome 22q - LOF merlin

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19
Q

multiple meningioma

A

in NF2

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20
Q

prognosis of meningioma

A

majority - good

-benign

21
Q

post radiation

A

meningioma

22
Q

hyalinzed whorls and calcified areas

A

meningioma

23
Q

gliomas

A

astromcytomas, oligodendrogliomas, ependymomas

not from specific cell type
-arise from progenitor cell that differentiates down one cellular lineage

24
Q

pilocytic astrocytoma

A

grade 1

most frequent glial tumor in children

well circumscribed - ring lesion

solid and cystic

good prognosis

25
Q

cyst and solid lesion of brain

A

pilycytic astromcytoma

recurrent - cyst comes back, solid does not

26
Q

GFAP positive

A

tumor astrocytes - disorganized

reactive astrocytes - gliosis - more organization

27
Q

diffuse astrocytoma

A

grade 2

infiltrating

seizures, HA, focal signs

tendency to progress

survival 5-7 years

malignant cells

28
Q

glioblastoma

A

has necrosis

29
Q

glioblastoma

A

grade 4

most frequent glial tumor in adults

malignant

seizures, HA, focal deficits

supratentorial

survival - 1 year

30
Q

primary vs. secondary glioblastoma

A

primary - loss of heterozygosity at 10q
-right to glioblastoma - 95% cases

secondary - progress from low grade

  • IDH1 and IDH2 point mutations
  • better prognosis - grow slower
31
Q

imaging of glioblastoma

A

leaky vessels

-contrast to viable areas

32
Q

supratentorial, cortical, and white matter

A

oligodendroglioma

majority frontal

33
Q

oligodendroglioma

A

frontal lobe
40-50yo

HA and seizures

often calcified

codeletion - 1p and 19q - good response to chemo

34
Q

good response to chemo

A

oligodendroglioma with codeletion 1p and 19q

35
Q

fried egg and GFAP with calcifications histo

A

oligodendroglioma

36
Q

medulloblastoma

A

malignant - in children

posterior fossa - majority in vermis

disseminates along SA space

50-70% 5 year prognosis

37
Q

external granular layer of cerebellum

A

medulloblastoma

small blue cell tumor

38
Q

homer wright rosettes

A

medulloblastoma

group of tumor cell around a fibrillary center

39
Q

prognosis medulloblastoma

A

highly malignant

leptomeningeal dissemination

CSF - high protein and low glucose - with tumor cells
-CSF cytology - to monitor spread of tumor

40
Q

thick layer of tumor around spinal cord - or matted together cauda equina

A

medulloblastoma

41
Q

primary CNS lymphoma

A

frequent in AIDS - but not anymore

digguse large B cell lymphoma

immunocompromised - EBV positive

42
Q

corticosteroids

A

cause apoptosis of primary CNS lymphomas

43
Q

mets to brain

A

majority of brain tumors

men - carcinoma of lung

women - breast carcinoma

44
Q

highest rate of mets to bain

A

melanoma

45
Q

meningeal carcinomatosis

A

tumor to virchow robins space

high protein CSF
low glucose CSF
few lymphocytes CSF

46
Q

ependymoma

A

slow growing tumor of children and young adults

hydrocephalus

intraventricular or on spinal cord

47
Q

bilateral schwannoma

A

NF2

benign

40-60yo

48
Q

schwannoma

A

more often in peripheral nerves

but in CNS is vestibular branch of CN VIII

Neuro II Exam 1 (14 decks)

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