Intracranial tumours

Question 1

What is the age distribution of intracranial tumours?

Answer 1

bimodal

Question 2

Are males or females more likely to have gliomas?

Answer 2

males

Question 3

Are males or females more likely to get meningioma?

Answer 3

females

Question 4

What are the 4 types of glial cells?

Answer 4

• astrocytes
• oligodendrocytes
• ependymal cells and choroid plexus cells
• microglia

Question 5

What is the function of astrocytes?

Answer 5

support and protection

Question 6

What is the function of oligodendrocytes?

Answer 6

produce myelin

Question 7

What is the function of choroid plexus cells and ependymal cells?

Answer 7

CSF production

Question 8

What is the function of microglia?

Answer 8

defence from pathogens

Question 9

What is a meningeal tumour called?

Answer 9

meningioma

Question 10

What is the name of a tumour in the nerve sheath?

Answer 10

schwannoma

Question 11

What are the two component of a histological diagnosis?

Answer 11

name of tumour and grade

Question 12

Describe the behaviour of a benign tumour

Answer 12

• slow growing
• respect surrounding tissue
• no/slow progression
• no recurrence

Question 13

Describe the behaviour of a malignant tumour

Answer 13

• rapid growing
• invade and destroy surrounding tissue
• progress
• recurrent

Question 14

Describe a grade I tumour

Answer 14

benign, no recurrence, no/very slow progression

Question 15

Describe a grade II tumour

Answer 15

low grade, progression

Question 16

Describe a grade II tumour

Answer 16

high grade, rapid progression

Question 17

Describe a grade IV tumour

Answer 17

aggressive

Question 18

What are the histological criteria fro malignancy in brain tumour?

Answer 18

• cellular density and atypia
• mitotic activity
• necrosis
• vascular proliferation

Question 19

What is pleomorphism?

Answer 19

variation in size, shape and chromasia

Question 20

What are the characteristics of a diffuse astrocytoma II?

Answer 20

• infiltrative, microcystic, fibrillary
• low cellular density
• mild atypia
• NO MITOTIC ACTIVITY (why it’s only grade II)

Question 21

What are the characteristics of an anaplastic astrocytoma III?

Answer 21

• moderate cellular density
• moderate pleomorphism
• mitoses

Question 22

What are the characteristics of a meningioma I?

Answer 22

• females, dura, adults
• well-defined extra-axial tumour
• whorls, psammoma bodies

Question 23

What does PNET stand for?

Answer 23

primitive neuroectodermal tumour

Question 24

Describe a schwannoma I

Answer 24

• 8th cranial nerve
• biphasic pattern (loose and dense areas)
• reticulin

Question 25

Which intracranial tumour does radiotherapy raise risk of?

Answer 25

menignioma

Question 26

What are the 4 markers that are presently the most relevant for molecular diagnostics of gliomas?

Answer 26

- MGMT promotor methylation - 1p/19q deletion - IDH1/IDH2 mutation - BRAF duplication/fusion

Question 27

what are the symptoms of raised intracranial pressure?

Answer 27

- headaches (early morning) - vomiting - blurred vision

Question 28

what can cause raised ICP?

Answer 28

- tumour mass - surrounding edema - obstructive hydrocephalus

Question 29

Which types of imaging may you use for diagnosis?

Answer 29

- computerised tomographic scan - magnetic resonance imaging - cerebral angiography

Question 30

If there is language loss, where would you expect the tumour to be?

Answer 30

left hemisphere (or whichever is dominant)

Question 31

Right handed women seems to be understanding but cannot make others understand her, where is the lesion?

Answer 31

left temporo-frontal region

Question 32

Someone becomes withdrawn, apathetic and bad-tempered then develops headaches and vomiting, where is the lesion?

Answer 32

frontal region

Question 33

Sensory loss, dyspraxia, inattention, where is the lesion?

Answer 33

parietal lobe

Question 34

What is radiotherapy?

Answer 34

the use of X-rays to treat tumours - carefully controlled high energy X-ray beams are focused on the tumour

Question 35

What are the acute side effects of cranial radiotherapy?

Answer 35

- cerebral oedema causing raised ICP and exacerbation of pre-RT neurological symptoms - hair loss - scalp/ear erythema

Question 36

What are the late side effects of radiotherapy?

Answer 36

damage to sensitive structures (eg lens, pituitary, cerebral hemispheres)

Question 37

Why are steroids used as part of treatment?

Answer 37

reduce swelling around the brain