Neoplasms Flashcards
Brain edema type in lead encephalopathy
Vasogenic
Brain edema type in malignant hypertensiln
Vasogenic
Brain edema type in hypoxic ischemic encephalopathy
Cytotoxic
Brain edema type in SIADH encephalopathy
Cytotoxic
Brain edema type in osmotic dysequilibrium syndrom of hemodialysis
Cytotoxic
True or False. High levels of MGMT means poor response to Temozolamide
True.
But if MGMT is methylated, then there is a better response
EGFR inhibitors
Erlotinib
Gefitinib
VEGF inhibitors
Bevacizumab
Describe the characteristic histologic findings of glioblastoma
AMEN Atypia Mitosis Endothelial proliferation Necrosis
Hypercellularity with pleomorphism of cells and NUCLEAR ATYPIA; identifiable astrocytes with fibrils in combination with primitive forms in many cases; tumor giant cells and cells in MITOSIS; HYPERPLASIA OF ENDOTHELIAL CELLS of small vessels; and NECROSIS, hemorrhage, and thrombosis of vessels.
In GBM, what is the significance of
- EFGR gene amplification
- p53 gene mutation
in relation to affected age group and development of GBM
Amplification of the EGFR gene is characteristic in older patients with tumors that begin entirely as glioblastomas
Acquired mutations of the p53 gene tend to occur in younger indi viduals whose tumors progress from an astrocytoma to a glioblastoma
Explain the Stupp protocol
Temozolamide is administered daily (75 mg/m2) concurrently with radiotherapy (fractionated focal irradiation in daily fractions of 2Gy given 5 days per week for a total of 60Gy) for 6 weeks and, after a hiatus of 4 weeks, given at 150 to 200mg/m2 for 5 days every 28 days for 6 cycles.
In GBM, what is median survival rate when Stupp protocol is followed?
14.6 months
In GBM, what is the median survival rate with surgical removal and radiotherapy (no chemotherapy with temozolamide) alone?
12 months
In GBM, what is the median survival rate without treatment?
7-9 months
Instead of alpha ketoglutarate, what substrate is produced by a mutated IDH (isocitrate dehydrogenase) produce?
2- hydroxyglutarate (2HG)
True or false.
Radiofrequency energy exposure for portable cellular devices has been classified by the International Agency for Research on Cancer as “possibly carcinogenic.”
True.
Radiofrequency energy exposure from portable cellular devices has failed to be linked to elevated incidence of meningiomas (or gliomas), however due to some inconclusive data, and mainly social pressure, the International Agency for Research on Cancer has classified radiofrequency electromagnetic fields as “possibly carcinogenic.”
Explain why meningiomas are more common in women than in men
Some meningiomas contain estrogen and pro gesterone receptors. The implications of these findings are not yet clear, but may relate to the increased incidence of the tumor in women, its tendency to enlarge during pregnancy, and an association with breast cancer.
These are laminated calcific bodies seen in Meningiomas
Psammoma Bodies
What is the most common form of Meningioma?
Meningothelial Form
According to the WHO 2016, meningioma with brain invasion is what grade?
Grade II
What are the malignant cells in lymphoma
B lymphocytes
rarely, T lymphocytes
This is a purely meningeal form of B cell lymphoma that involves the peripheral nerves presenting with painful, predominantly motor polyradiculopathies
Neurolymphomatosis
Lymphoma: Reticulin stain
Positive or negative?
Positive
What viral genome is implicated in PCNSL?
EBV genome
What are the top 3 most common sources of brain metastasis?
1st: lung
2nd: breast
3rd: melanoma
Metastatic tumors most likely to be solitary
kidney,
breast,
thyroid,
adenocarcinoma of the lung
Metastatic tumors most likely to be multiple
small cell carcinomas and melanomas
metastatic tumors most likely to cause intratumoral haemorrhage
melanoma choriocarcinoma lung Ca thyroid Ca renal Ca
Dose of whole brain irradiation for brain metastasis
10 doses of 300 cGy fragmented over a 2 week period
Serious complication of combination of radiation and intrathecal and intravenous methotrexate
Necrotizing Leukoencephalopathy
It is a solid, green coloured mass of myelogenous leukaemic cells that may infiltrate the dura
Chloroma
True or false: systemic lymphoma rarely metastasize to the brain
True.
Mode of action of METHOTREXATE
Inhibition of folic acid reductase, leading to inhibition of DNA synthesis and inhibition of cellular replication
Lymphomatoid granulomatosis is also known as?
Castleman Disease
What is the associated antibody in paraneoplastic syndrome of cerebellar degeneration?
Anti-Yo (anti-Purkinje cell)
What is the associated antibody in paraneoplastic syndrome of Encephalomyelitis?
Anti-Hu (ANNA 1)
Anti-Ma
Anti-NMDA
What is the associated antibody in paraneoplastic syndrome of Opsoclonus–myoclonus–ataxia?
Anti-Ri (ANNA 2)
What is the associated antibody in paraneoplastic syndrome of Retinal degeneration?
Antirecoverin (Anti-CAR)
What is the associated antibody in paraneoplastic syndrome of Subacute sensory neuropathy and neuronopathy?
Anti-Hu (ANNA-1)
What is the associated antibody in paraneoplastic syndrome of Lambert-Eaton myasthenic syndrome?
Anti-voltage-gated (VGCG) calcium channel
What is the associated antibody in paraneoplastic syndrome of Stiff man syndrome?
Antiamphiphysin
What is the associated antibody in paraneoplastic syndrome of Chorea?
Anti-Hu
Anti-CRMP-5
What is the associated antibody in paraneoplastic syndrome of Optic neuropathy?
Anti-CRMP-5
What are the associated tumors in paraneoplastic syndrome of cerebellar degeneration?
Ovary, fallopian tube, lung, Hodgkin disease (anti-Tr)
What are the associated tumors in paraneoplastic syndrome of Encephalomyelitis
Small cell lung, neuroblastoma, prostate, breast, Hodgkin, testicular (Ma), Ovarian (and other site), teratoma
What are the associated tumors in paraneoplastic syndrome of Opsoclonus–myoclonus–ataxia?
Breast, fallopian tube, small cell lung
What are the associated tumors in paraneoplastic syndrome of Retinal degeneration?
Small cell lung, thymoma, renal cell, melanoma
What are the associated tumors in paraneoplastic syndrome of Subacute sensory neuropathy and neuronopathy?
Small cell lung, Hodgkin, other lymphomas
What are the associated tumors in paraneoplastic syndrome of Lambert-Eaton myasthenic syndrome?
Small cell lung, Hodgkin, other lymphomas
What are the associated tumors in paraneoplastic syndrome of Stiff man syndrome?
Breast
What are the associated tumors in paraneoplastic syndrome of Chorea?
Lung, Hodgkin, others
What are the associated tumors in paraneoplastic syndrome of Optic neuropathy?
Lung
What is the molecular signature of an ASTROCYTOMA?
Tp53/IDH/ATRX
intact 1p/19q