intracranial tumors Flashcards
exam 2
most common glioma
glioblastoma
most common in pediatric population
medulloblastoma
extra-axial
outside of the brain
intra-axial
in the brain substance
neuro-epithelial tumors (3)
- glioma
- ependymoma
- neuronal tumor
ependyome tend to occur
between the ventricles
Grade 1
example
low grade; circumscribed
- pilocytic astrocytoma: occurs in children
Grade 2
diffusely infiltrating
Grade 3
anaplastic; mitotic figures
Glioblastoma 4
endothelial proliferation and/or necrosis
Gliomas (2)
- Astrocytoma
2. oligodendroglioma
Case 1:
- lost while driving home
- not shaving left side of face
- not dressing on left
left homonophesis hemipolgia
- non-dominant parietal syndrome; hemi-neglect
pilocytic
wavy cells
pilocytic astrocytoma
- benign, slow growing tumor pediatric
- in cerebellum
- cerebellar signs; headaches
- might block CSF; secondary hydrocephalus leading to an icnrease in pressure and induce vomiting
tx. : surgical excision
- horse hair
- biphasic pattern
- rosenthal fibers: intracytoplasmic pink stuff
Pilocytic astrocytoma
Low grade astrocytoma; diffuse
- malignant tumor
- diffuse infiltrating mass–> they do not look different from normal brain
- on MRI in T1 they look hypodense and look white in T2
- hypercellular
- irregular nuclei, hyperchromatic, atypia;
- mitosis absent or rare
low grade astrocytoma
Anaplastic astrocytoma
- malignnt tumor
- looks swollen on MRI
prognosis is poor; more about quality
Glioblastoma multiforme
- high grade
- necrotic
- worst kind is that that affects the corpus collosum
- looks like a butterfly on MRI
- a lot of cells
nuclei look different
red patches
anaplastic astrocytoma
- areas of death: densely cellular with nuclear atypia
- palisading necrosis
hemorrhagic change
Glioblastoma
oligodendroglioma
- seizures
- curable if they can be resected completely
- perinuclear clearing “fried eggs”
- calcification (dark purple areaa)
vascular satellitosis
oligodendroglioma
- hoarsness and trouble swallowing
- headaches
- progressed projectile vomiting
- several month history of spontnaeous worse in the morning
tumor in the brainstem
- ependymoma
ependymoma
- low grade
- occur in ventricular system and spinal cord
-
Myxopapillary subtype
occurs in the conus medullaris-filum region
associated with ependymoma
- moderately cellular, ovioid monomorphic nuclei
- ependymal rosettes
- perivascular pseudorosette
ependymoma
Neuronal tumor
- rare
-low grade - occur in temporal lobe
- ## associated with those with chronic seizure disorder
extra-axial tumors
- meningioma (in the dura)
case 3:
- food taste bland
- headache
- papilledema
front lobe
- clinoidal meningioma
meningioma
- slow growing benign dural based tumor
- arise from arachinoidal cap cells
- more common in female
- tx. surgery and then radiation
- Dural tail
- whorls
- somoma bodies
meningioma
Hemangioblastoma
- highly vascular
- benign
- occurs sporadically or past of the VHL
- most common primary cerebellar tumor in the adult
- chromosome 3
VHL
HGB of cerebellum, retina, brainstem, spinal cord
sellar tumors
- pituitary adenoma
- 2 subtypes:
functionl and non-functional - slow growing
- endocrinological dysfunction
- visual loss
Most common functional sellar tumors
- prolactin
- growth hormone- acromegaly
- Cortisol- cushing’s disease
Moon face
adrenal gland functional sellar tumor
cranial nerve tumors
- benign tumor of schawnn cells
- most common CN8
- slow growing
- balance issues, tinnitus
- might affect CN 7 but it has to be a big tumor
- Bilateral? NF-2
- chromosome 22
- verocay bodies
- antoni A: dense : school of fish”
- antoni B: loose and fatty looking
Swanomma
