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D&T2 Exam 1 > CNS tumors- Norton > Flashcards

CNS tumors- Norton Flashcards

1
Q

where do most brain tumors occur in children

A

posterior fossa

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2
Q

where do most brain tumors occur in adults

A

supratentorial

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3
Q

what can be found on the PE for a primary brain tumor

A 
fundoscopic exam: papilledema 
CN3 and 6 nerve palsy 
increase ICP 
headache
hemiparesis 
aphasia 
seizures
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4
Q

tumors in the ventricles present with what clinical features

A

hydrocephalus

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5
Q

what tool is used to diagnose brain tumor

A

MRI with contrast

BBB does not allow contrast but the new vessels in tumor do

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6
Q

what is the only risk factor for brain tumors

A

ionizing radiation

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7
Q

what are the glioma tumors impact what cells and create their own tumors

A

astrocytes
oligodendrocytes
Ependymal cells

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8
Q

what are the two types of Astocytoma

A

infiltrating

noninfiltrating

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9
Q

what is the most common genetic mutation for astrocytoma infiltrating

A

p53

over expression of platelet derived growth factor

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10
Q

what is the histologic grading for astrocytomas I -IV

A

I: well-differentiated- pilocytic astrocytoma

II: diffuse growth of well-differentiated astrocytes-diffuse or fibrillary astrocytoma

III: anaplastic features (pleomorphism, increased mitosis) - anaplastic astrocytoma

IV: undifferentiated w/necrosis - gliobastoma

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11
Q

name a type of astrocytoma infiltrating that occurs in younger adults

A

diffuse astrocytoma

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12
Q

what is the histology for diffuse astrocytoma

A
  • increased number of glial cells
  • variable nuclear pleomorphism
  • GFAP-positive astrocytic processes give a fibrillary background
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13
Q

how long do patients survive with diffuse astrocytoma

A

5 years

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14
Q

Name a astrocytoma infiltrating tumor that has regions of more densely cellular with greater nuclear pleomorphism, mitotic figures

A

anaplastic astrocytoma

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15
Q

what tool is used to diagnose diffuse and anaplastic astrocytoma infiltrating

A

MRI

brain biopsy

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16
Q

treatment options for diffuse and anaplastic astrocytoma infiltrating

A

surgical resection

radiation

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17
Q

survival rate for diffuse and anaplastic astrocytoma infiltrating

A

2 years

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18
Q

name the astrocytoma infiltrating tumor that is high grade end of spectrum of astrocytomas, most atypical and mitotically active

A

gliobastoma

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19
Q

what is the treatment for gliobastoma

A

surgery
radiation
chemotherapy

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20
Q

glioblastoma usually occurs in who and what is the prongosis

A

5th - 7th decade (40s-60s)

always fatal

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21
Q

what does the histology for glioblastoma look like

A

densely cellular, vascular proliferation, necrosis and pseudopalisading (ring shape)

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22
Q

Name a non-infiltrating astrocytoma

A

pilocytic

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23
Q

who usually gets pilocytic astrocytomas and what is the prognosis

A

children and young adults

lived for 40 years

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24
Q

where does pilocytic astrocytoma usually occur in the brain? what grows

A

cerebellum
third ventricle
cystic with mural nodule in wall of cyst

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25
what does pilocytic astrocytoma look like under the microscope
cells with hair-like processes | Rosenthal eosinophilic fibers
26
Name a type of tumore that occurs in the 30s - 40s that is slow growing, may be diagnostic after years of neurologic complaints, and often seen in cerebral hemisphere
Oligodendroglioma
27
what does oligodendroglioma look like under the microscope
sheets of regular cells with spherical nuclei | surrounded by clear halo of cytoplasm
28
what is the genetics of oligodendroglioma
deletions of chromosome 1p and 19q
29
what is the treatment and survival of oligodendroglioma
surgery radiation and chemotherapy | 5-10 years
30
Ependymoma usually occurs in who and where in the brain for adults and young people
children and young adults ependymal-lined ventricles children/young adults: 4th ventricle adults: spinal cour
31
ependymoma presents with what?
hydrocephalus
32
what is seen under the microscope for ependymoma cells
small dark cells with perivascular pseudorosettes | benign appearing
33
what is the molecular genetics for ependymoma tumors with spinal cord lesions and supratentoral ependymomas
spinal cord: mutation in NF2 gene on chromosome 22 | supratentorial: alterations in chromosome 9
34
prognosis for ependymoma
5 years after surgery | better for supratentorial and spinal then posterior fossa
35
what is myxopapillary pendymoma
in filum terminale may extend into subarachnoid space surround roots fo cauda equina
36
Choroid plexus papillomas is most common in who and location of tumur in adults and childres
common children: lateral ventricle | adults: 4th ventricle
37
what does choroid plexus papillomas look like under microscope
normal choroid plexus
38
how do people with choroid plexus papillomas present
hydrocephalus
39
who usually gets colloid cyst of 3rd ventricle? location? what can this obstruct? what can it cause? prognosis ? clinical complaint
``` children roof of ventricle foramina of monro hydrocephalus fatal complain of positional headache ```
40
What is the histology of colloid cyst of 3rd ventricle
spherical mass filled with mucinous material | -simple epithelial lining may contain ciliated or goblet cells
41
Name two embryonal tumors
medulloblastoma | CNS PNET
42
where does medulloblastoma occur in the brain and who usually gets it
cerebellum only, midline | children
43
what does medulloblastoma look like under the microscope
small round blue cell tumor | rosettes or perivascular pseudorosettes
44
what is the molecular genetics for medulloblastoma
loss from 17p
45
medulloblastoma is sensitive to what and prognosis
radiosenstive | 5 yr
46
what brain tumor occurs in children in the cerebral hemisphere. resembles medulloblastoma in histology and genetically distinct from medulloblastoma
CNS supratentroial primitive neuroectodermal tumors CNS PNET
47
What is the most common CNS neoplasm in immunosuppressed patients
primary brain lymphoma
48
do primary brain lymphomas spread
not to lymph nodes or outside of brain
49
most common sites for metastic tumors
``` Lung breast skin kidney GI lots of bad stuff kills gila ```
50
this is actually not a true brain tumor, arises from meningothelial cells from external membranes covering the brain
meningioma
51
how can the patient present in the clinical with Meningioma
headache or neurological symptoms | not usually found until autopsy
52
multiple meningiomas are found in patients with what
neurofibromatosis type 2
53
what is seen on an MRI for meningiomas
"dural tail"
54
what does meningioma look like under the microscope
whorls of bland cells | psammoma bodies
55
where does Craniopharyngioma occur
suprasellar asrising in pituitary stalk arise from remnants of Rathke's pouch sold or mixed solid and cystic
56
what is the age distribution for carniopharyngioma
5-14 yrs | 50-75 yrs
57
what is the histologic feature of craniopharyngioma in children
adamantinomatous - stratified squamous epithelium in nests or chords spongy reticulum calcifications lamellar keratin formation cysts with thick brownish-yellow fluid content
58
what is the histologic feature of craniopharyngioma in adults
squamous epithelium lined solid sheets and papillae | no keratin, calcifications or cysts
59
what are clinical symptoms for craniopharyngioma
visual from pressure on optic chiasm endocrine symptoms from compressed pituitary headache
60
what is the treatment for craniopharyngioma
surgery | radiation therapy
61
what is commonly seen at cerebellopontine angle where attached vestibular branch of 8th nerve - also called acoustic neuroma
schwannoma
62
how do patients with schwannoma present in the clinic
tinnitus and hearing loss
63
Schwannoma is associated with what
neurofibromastosis type 2
64
Schwannoma shows a mixture of what 2 growth patterns
Antoni A: moderate to high cellularity with nuclear palisading ; " nuclear-free zones" called Verocay bodies Antoni B: less cellular area, more myxoid
65
Neurofibromas are benign spindle cell lesions which occur in what 2 forms
cutaneous or solitary | plexiform
66
cutaneous or solitary neurofibroma occurs where
skin or peripheral nerve | never turns malignant
67
plexiform neurofibromas occurs in what type of patients
with NF | potential malignant transformation
68
what are clinical features of neurofibromastosis 1
gliomas of optic nerve pigmented nodules of iris ( Lisch nodules) Cafe au lait spots: brown spots on skin
69
neurofibromastosis 1 is associated with what gene
NF1 gene tumor suppressor gene | chromosome 17
70
which neurofibromastosis develop a range of tumors
neurofibromastosis 2
71
neurofibromastosis 2 what chromosome association
chromosome 22
72
what tumor has CNS hamartomas- occur as haphazardly arranged neurons which lack normal neural oragnziation "cortical tubers"
Tuberous sclerosis
73
where do extracranial lesions occur for tuberous sclerosis
renal angiomyolipomas pulmonary and cardiac myomas skin rash
74
Von-Hippel-Lindau develop what
capillary hemangioblastomas in cerebellum, retina, and spinal cord - highly vascular tumor
75
von-Hippel_lindau can also have cysts where else
pancreas liver and kidney

D&T2 Exam 1 (22 decks)

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