Neoplasms Flashcards
Pilocytic Astrocytoma
Ages and Grade
CHILDHOOD (and sometimes young adults)
Grade 1
Pilocytic Astrocytoma
Locations
Cerebellum, optic pathway, hypothalamus & thalamus, spinal cord, temporal lobe
Pilocytic Astrocytoma
Genetics/Histol/etc.
BRAF:KIAA fusion
Bipolar cells with hairlike processes, Rosenthal fibers
Diffuse Astrocytoma
Ages and Grade
Mean: 30s-40s
Grade 2
Diffuse Astrocytoma
Locations
Cerebral hemispheres (also poss. brainstem) but NOT areas of pilocytic
Diffuse Astrocytoma
Genetics/Histol/etc.
irregular distribution of tumor cells, no mitoses
Gross: diffuse expansion of pons in brainstem
Anaplastic Astrocytoma
Ages and Grade
Mean: 45 yrs
Grade 3
Anaplastic Astrocytoma
Location
Cerebral hemispheres but MORE MITOSES
Anaplastic Astrocytoma
Genetics/Histol/etc.
deep/blue purple (more chromatin), aneuploidy
IDH1 mutation + LOH 1p/19q + p53/ATRX
1p/19q responds well to chemo
Oligodendroglioma
Ages and Grade
Mean: 42 yrs (onset)
Grade 2
Oligodendroglioma
Location
Cerebral WHITE matter but can invade grey (if so - seizures)
Oligodendroglioma
Genetics/Histol/etc.
Defined as: 1p/19q deletion to make combined protein (with IDH1 grandparent mutation)
Fried egg w/ v little cytplasm
Anaplastic Oligodendroglioma
Ages and Grade
Mean: 46 yrs onset
Grade 3
Anaplastic Oligodendroglioma
Location
As Oligodendroglioma
Anaplastic Oligodendroglioma
Genetics/Histol/etc.
1p/19q codeletion with 9p loss and 10q loss (found by FISH)
Histol: increased cellularity, nuclear atypia, MITOSES
Glioblastoma (GBM)
Ages and Grade
Primary mean: 62 yrs (de novo 90%)
Secondary mean: 45 years (progression from lesser glioma)
GRADE 4
Glioblastoma (GBM)
Location
Usually Cerebral hemispheres
Glioblastoma (GBM)
Genetics/Histol/etc.
Proliferative blood vessels Can be multifocal Very adverse prognosis If MGMT (methylation) positive then will respond well to alkylating agent Poss EGFR amp (bad ) on 7p12
Ependymoma
USUALLY pediatric (first 2 decades) Grade 2 (3 if anaplastic) Ependymal cells that line ventricles (usually 4th) - so presents with obstructive hydroencephalus If in ADULTS - SPINAL CORD
Choroid plexus papilloma
NOT an ependymoma but DOES occur in ventricles
Grade 1
Medulloblastoma
Most common malignant brain tumor in CHILDREN
ALL grade 4
Slight M>f, ~50% survival
Origin: GCPs (cerebellar granular) from EGL
Histol: Homer Wright rosettes
Chromosome 17 deletions
Meningioma
Women in 50s
“Push/shove” rather than invade, usually solitary
Grade 1 (atypical grade 2 prone to recurrence, anaplastic grade 3)
Hemangioperictyoma: much worse
NF2 mutation on 22q
Schwannoma
Slow growing, on nerves, malignancy rare
CRANIAL NERVE 8 most common (so “acoustic neuroma”)
Familial Tumor Syndromes
NF-1, NF-2 Tuberous Sclerosis VHL Cowden Turcot's
