Histopathology 11 - Neuro-oncology Flashcards
Primary or secondary brain tumours more common?
Secondary brain tumours 10x more common
Second most common cancer in children?
Brain tumours (after leukaemia)
radiological classification of brain tumours
Extra-axial (brain coverings) and intra-axial (brain parenchyma)
cancer of embryonal cells in brain –> ?
Medulloblastoma (in children)
What brain cell of origin do most brain tumours arise from?
GLIAL CELLS
Neurofibromatosis 1 –> which brain tumours?
Neurofibroma, pilocytic astrocytoma
Nf2 –> Which brain tumours?
schwannomas, meningioma
Tuberous sclerosis –> which tumours?
Hamartomas
vHL –> which tumours?
Haemangioblastomas
Most common genetic syndrome associated with brain tumours
Neurofibromatosis (AD)
Symptoms of supretentorial (cerebrum) lesions
Focal neurological deficits, seizures, personality changes
Symptoms of subtentorial (Cerebellar) lesions
Cerebellar ataxia, cranial nerve dysfunction
Which tumours require radiotherapy?
Low and high grade gliomas, mets
Which tumours require chemotherapy?
high grade gliomas
Most common primary CNS tumours
GLIAL TUMORUS
Tumour differentiation/grading process
Determined by histology, predicts prognosis Grade I = benign, long term sruvival Grade II = cause death in >5 years Grade III = cause death in <5 years Grade IV = cause death in <1 year
DOES NOT CONSIDER RESPONSE TO TREATMENT, IT GUIDES TREATMENT
Is there a staging system for CNS tumours?
No (except for medulloblastoma)
How can glial tumours be divided?
Circumscribed gliomas (children, grade I-II) Diffuse gliomas (adults, grade 2+)
Glial cells (6x)
Astrocytes, ependymal cells, oligodendrocytes, Schwann cells, microglia and satellite cells
Common mutation in circumscribed glial tumorus
BRAF (MAPK pathway)
Common mutation in diffuse glial tumorus
IDH1/2 (POSITIVE PROGNOSTIC FACTOR)
Example of a common circumscribed glioma
Pilocytic astrocytoma
Most common child brain tumour
Pilocytic astrocytoma
Where in the brain are pilcoytic astrocytomas commonly found?
CEREBELLAR
