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Path Y > Histopathology - Neuro-oncology > Flashcards

Histopathology - Neuro-oncology Flashcards

1
Q

Which 3 types of cancer are most likely to metastasise to the brain?

A

Lung
Breast most commonly
Malignant melanoma

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2
Q

What is the most common form of primary brain tumour?

A

Glial tumours

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3
Q

Which genetic syndrome is associated with meningioma?

A

Neurofibromatosis type 2

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4
Q

What type of tumour is being described by “a ventricular tumour that presents with hydrocephalus”?

A

Ependymoma

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5
Q

Which brain tumour is an indolent CNS tumour of childhood?

A

Pilocystic astrocytoma

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6
Q

Which type of brain tumour is soft, gelatinous and can become calcified?

A

Oligodendroglioma

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7
Q

Which CNS tumour does Von Hippel-Lindau predispose to?

A

Hemangioblastoma

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8
Q

Which CNS tumour does tuberous sclerosis predispose to?

A

Giant cell astrocytoma

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9
Q

Recall the order in which imaging should be performed in CNS tumour investigation

A
  1. CT
  2. MRI (T1 and without contrast)
  3. MR spectroscopy for gliomas (useful prognostically)
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10
Q

Recall the 4 factors that guide grading of brain tumours

A

Morphology
Proliferative activity
Cell differentiation
Necrosis

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11
Q

Recall the survival prediction for each grade of CNS tuour

A

Grade 1 = longterm
Grade 2 = >5 years
Grade 3 = <5 years
Grade 4 = <1 year

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12
Q

What are the 2 broad subtypes of glial tumours, and in which age groups are they typically seen?

A

Diffuse (adults) or circumscribed (children)

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13
Q

What grade are circumscribed glial tumours?

A

1 or 2

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14
Q

What is the most common type of circumscribed glial tumour?

A

Pilocystic adenoma

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15
Q

Mutation of which gene is associated with circumscribed glial tumours?

A

BRAF gene mutation

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16
Q

Which gene mutation is associated with diffuse glial cell tumour prediliction?

A

IDH gene

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17
Q

How can glioblastoma and diffuse astrocytoma be differentiated on CT?

A

Glioblastoma = enhancing
Diffuse astrocytoma = non-enhancing

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18
Q

Which gene mutation is always seen in oligodendroglioma?

A

IDH gene

19
Q

What is the WHO grade of oligodendroglioma?

A

Stage 2 - 3

20
Q

What is the pathognemonic histological finding in oligodendroglioma?

A

Fried egg cells

21
Q

How is oligodendroglioma most often managed?

A

Usually appropriate for surgical excision as often well-circumscribed

22
Q

What must be investigated in the case of multiple meningiomas?

A

Neurofibromatosis type 2

23
Q

What is the most important factor to assess when grading meningiomas?

A

Mitotic activity

24
Q

What is the most common type of embryonal CNS tumour?

A

Medulloblastoma

25
Q

Where do medulloblastomas always form?

A

In cerebellum near 4th ventricle

26
Q

What is the pathognemonic histological finding in medulloblastoma?

A

Very poorly differentiated ‘small round blue cells’

27
Q

Which subtype of medulloblastoma has the best prognosis?

A

WNT-activated subtype

28
Q

What is the basis of epigenetic profiling in CNS tumours?

A

DNA methylation of CpG islands

29
Q

are primary or secondary CNS tumours more common?

A

secondary (metasases) are 10 x more common than primary

30
Q

are brain tumours more common in adults or children

A

Children by far

31
Q

2 CNS tumours associated w NF1

A

optic glioma
neurofibroma astrocytoma

32
Q

2 CNS tumours associated w NF2

A

meningioma
vestibular schwannoma

33
Q

CNS tumour associated w MEN1

A

pituitary adenoma

34
Q

what type of cancer is pilocytic astocytoma

A

its a GLIOMA grade 1 (WHO classification)

35
Q

2 histological findings of pilocytic astrocytoma

A 
piloid cell (hairy cell)
Rosenthal fibres
36
Q

name a mutation commonly seen in pilocytc astrocytoma

A

BRAF mutation in 70%

37
Q

what are the 6 glial cells

A

astrocytes
oligodendrocytes
ependymal
Schwann
microglia
satellite

38
Q

most common child brain tumour?

A

pilocytic astrocytoma

39
Q

most common primary brain cancer

A

glioblastoma multiforme (grade IV)

40
Q

is IDH mutation a positive or negative prognostic factor

A

positive

41
Q

state 4 glial tumours

A

circumscribed
pilocytic astrocytoma

diffuse
glioblastoma multiforme
oligodendroglioma
diffuses astrocytoma

42
Q

2nd most common brain tumour in children

A

medulloblastoma

43
Q

3 features of medulloblastoma

A

small blue round cell
neuronal marker - ssynaptophysin
homer wright rosettes

44
Q

where do mets in brain tend to be

A

grey-white junction

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