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CM Clinical Symposia > CNS tumours (9) > Flashcards

CNS tumours (9) Flashcards

1
Q

What percentage are CNS tumours of all neoplasms?

A

2%

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2
Q

What’s the most common cancer in children?

A

Leukaemia, then CNS tumours

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3
Q

Which CNS tumours are most common in women?

A

Meningioma

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4
Q

Which CNS tumours are most common in men?

A

Glioma

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5
Q

What CNS tumours are most common in children?

A

Cerebellum, PNET (medulloblastoma)

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6
Q

Which CNS tumours are most common in adults?

A

Cerebrum, glioma and meningioma

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7
Q

Function of arachnoid membrane and pia mater

A

Protein and support

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8
Q

Tumour of arachnoid membrane and pia mater

A

Meningioma

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9
Q

Function of neurons

A

Sit in cortex, cause epilepsy, not in contact with blood supply need quiet environment, don’t give origin to many tumours, metabolic needs supplied by glia cells

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10
Q

Tumour of neuronal

A

Neurocytoma

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11
Q

Tumour of nerve sheath

A

Schwannoma

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12
Q

Glia cells

A

Astrocytes, Oligodendrocytes, Ependymal cells and choroid plexus cells, microglia

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13
Q

Tumour of glia

A

Glioma

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14
Q

Function of astrocytes

A

Support and protect (connect neurons with blood supply)

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15
Q

Tumour of astrocytes

A

Astrocytoma

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16
Q

Function of oligodendrocytes

A

Myelination

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17
Q

Tumours of oligodendrocytes

A

Oligodendroglioma

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18
Q

Function of ependymal cells

A

Controls, produces and moves CSF

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19
Q

Tumour of ependymal cells

A

Ependyoma

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20
Q

Function of choroid plexus cells

A

Specialised ependymal cell

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21
Q

Function of microglia

A

Defence (activated if ischaemia, allows inflammatory cells cross BBB)

22
Q

Benign behaviour

A

Slow growing, respect surrounding tissue, no/slow progression, no recurrence, surgery

23
Q

Malignant behaviour

A

Rapid growing, invade and destroy surrounding tissue, progress, recurrent, surgery and adjuvant therapy

24
Q

Grade 1

A

Benign, no recurrence, no/very slow progression

25
Q

Grade 2

A

Low grade, progression (astrocytoma 6-7 y)

26
Q

Grade 3

A

High grade, rapid progression (astrocytoma 2-3 y)

27
Q

Grade 4

A

Aggressive (necrosis and vascular proliferation)

28
Q

Histological criteria for malignancy

A
  1. Cellular density and atypia
  2. Mitotic activity
  3. Necrosis
  4. Vascular proflieration
29
Q

Atypia

A

Structural abnormality in cell

30
Q

Hardest part about treating Gliomas?

A

Cells migrate through brain, can’t see borders/take it out completely, no barriers in communication

31
Q

Space occupying lesion

A

Only 50ml allowed to accumulated, malignancy, abscess, haematoma

32
Q

Astrocytic tumours

A

Fine fibrillary and microcytic background, increased cellular density, pleomorphism (size/shape/chromasia)

33
Q

Diffuse astrocytoma II

A

Infiltrative, microcytic, fibrillary, low cellular density, mild atypia, no mitotic activity

34
Q

Anaplastic astrocytoma III

A

Moderate cellular density, moderate pleomorphism, mitoses

35
Q

Glioblastoma IV

A

High cellular density and mitoses, necrosis, vascular proliferation

36
Q

Pilocytic astrocytoma I

A

Benign, non-infiltrative, children, cerebellum, well-defined, cystic, pilocytes (thin hair-like), Rosenthal fibres (think elongated worm-like), vascular proliferation

37
Q

Oligodendroglioma II/III

A

Round uniform nuclei with clear cytoplasm (fried-egg appearance), arborising capillaries (chicken wire), calcifications

38
Q

Ependymoma II/III

A

Well-defined tumour, ventricles, pseudo rosettes, round small uniform cells

39
Q

Meningioma I

A

(Can be grade 2/3 aggressive), females, dura, adults, well-defined extra-axial tumour, whorls/swirls, psammonma bodies (lamellate calcified structures)

40
Q

PNET (medulloblastoma) IV

A

Children, cerebellum, very high cellular density, anaplastic hyper chromatic cells, frequent mitoses and apoptosis, rosette formation

41
Q

Nerve sheath tumours - Spindle-cell tumours

A

Benign

42
Q

Nerve sheath tumours - Schwannoma I

A

8th cranial nerve, biphasic pattern (loose and dense areas), Reticulin

43
Q

Nerve sheath tumours - Neurofibroma I

A

Spinal nerves, rich in collagen

44
Q

Aetiology

A

Radiotherapy - meningioma
Immunosuppression - lymphoma
Familial syndromes - NF1, NF2

45
Q

Stem cell pathways - Wnt signalling

A

Haematopoietic, epidermal, gut self-renewal > colon carcinoma/epidermal tumours

46
Q

Stem cell pathways - Shh

A

Haematopoietic, neural, germ line self-renewal > medulloblastoma, basal cell carcinoma

47
Q

Stem cell pathways - Notch

A

Haematopoietic, neural, germ line > Leukaemia, mammary tumours

48
Q

4 markers of molecular diagnostics of gliomas

A
  1. MGMT promotor methylation
  2. 1p/19q deletion
  3. IDH1/IDH2 mutation
  4. BRAF duplication/fusion
49
Q

Prognosis

A

Glioblastoma IV -

50
Q

Factors affecting prognosis

A

Age, site, surgical resection, adjuvant therapy, genetic

CM Clinical Symposia (24 decks)

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