Neuro: 17.8: CNS Tumors Flashcards
1
Q
What is a craniopharyngioma?
A
a tumor that arises from epithelial remnants of Rathke’s pouch
2
Q
What is the prognosis for medulloblastoma? Why?
A
- poor
- it grows rapidly and spreads thru the CSF
3
Q
This is a malignant tumor of oligodendrocytes seen in adults.
A
oligodendroglioma
4
Q
What receptor does a meningioma express?
A
estrogen receptor
5
Q
What key findings will be seen microscopically in pilocytic astrocytoma?
A
Rosenthal fibers (astrocytes with thick eosinophilic processes, corkscrew shaped)
6
Q
What is the most common CNS tumor in children?
A
pilocytic astrocytoma
7
Q
What imaging findings will be seen in pilocytic astrocytoma?
A
- a well-circumscribed, cystic lesion with a mural nodule
- *** “pyloCYSTIC astrocytoma”
8
Q
What is the tumor that classically arises from astrocytes in a child?
A
pylocytic astrocytoma
9
Q
How do pts with schwannomas present?
A
- tinnitus (ringing in the ears)
- hearing loss
10
Q
Dx?
- large amounts of necrosis surrounded by pseudopalasading normal tissue
- endothelial cell proliferation
A
glioblastoma multiforme
11
Q
Dx?
- a tumor that arises from epithelial remnants of Rathke’s pouch
A
craniopharyngioma
12
Q
What is the most abundant glial cell?
A
astrocytes
13
Q
What is a glioblastoma multiforme?
A
- a malignant, high-grade tumor of astrocytes (a glial cell)
- the most common CNS tumor in adults
14
Q
This is a malignant CNS tumor in children arising from ependymal cells.
A
ependymoma
15
Q
How does a meningioma present?
A
with seizures
16
Q
Dx?
- a well-circumscribed, cystic lesion with a mural nodule in the cerebellum
A
pilocytic astrocytoma
17
Q
What is an ependymoma?
A
a malignant CNS tumor of ependymal cells seen in children
18
Q
What is the most common benign CNS tumor in adults?
A
meningioma
19
Q
Where does an ependymoma most commonly arise?
A
in the 4th ventricle
20
Q
What is a schwannoma?
A
a benign tumor of schwann cells
21
Q
How will medulloblastomas appear on microscopy?
A
- small, round blue cells
- Homer-Wright rosettes
22
Q
What is the function of the microglia?
A
phagocytic scavenging in the CNS
23
Q
Dx?
- whorled spindle cells
- abundant psammoma bodies (laminated calcifications)
A
meningioma
24
Q
What is the most common supratentorial tumor?
A
craniopharyngioma
25
Dx?
* S100 positive
schwannoma
26
How does a craniopharyngioma present??
a supratentorial mass in a child or young adult
27
Who gets medulloblastoma?
children
28
This is when medulloblastoma spreads into the spinal cord via the CSF.
drop metastases
29
What are the microscopic findings in craniopharyngioma?
* Cholesterol crystals found in “motor oil”–like fluid within tumor
30
What microscopic findings are seen in ependymomas?
* perivascular pseudo-rosettes
* Rod-shaped blepharoplasts (basal ciliary bodies) found near the nucleus
31
This is a malignant CNS tumor of children arising from the neuroectoderm.
medulloblastoma
32
This is a benign CNS tumor from the arachnoid (meningothelial) cells classically seen in adult females
meningioma
33
This is:
* the intermediate filament present within glial cells
* marker for glioblastoma multiforme and pilocytic astrocytomas.
GFAP
34
What are the astrocytes derived from?
neuroectoderm
35
Dx?
* small, round blue cells
* Homer-Wright rosettes
medulloblastoma
36
How does an oligodendroglioma present?
seizures
37
What is the embryonic origin of a craniopharyngioma?
surface ectoderm
38
What is the tx for glioblastoma multiforme?
Nitrosoureas (Carmustine, lomustine, semustine, streptozocin)
39
Where does a glioblastoma multiforme most frequently arise?
in the cerebral hemispheres WITH CROSSING OVER the corpus callosum
40
This is a benign tumor of astrocytes in children.
pilocytic astrocytoma
41
Where in the brain are oligodendrogliomas usually found?
the frontal lobe
42
Dx?
* a calcified tumor in the white matter
* "fried egg" appearance
* "chicken wire" capillary pattern
Oligodendroglioma
43
Dx?
* Rosenthal fibers (astrocytes with thick eosinophilic processes, corkscrew shaped)
pilocytic astrocytoma
44
What is the tissue that supports the neurons?
glial tissue
45
What cell forms the BBB?
astrocytes
46
Dx?
* Cholesterol crystals found in “motor oil”–like fluid within tumor
craniopharyngioma
47
What is a pylocytic astrocytoma?
a benign tumor of the astrocytes in a child
48
Dx?
* tumor in the cerebral hemispheres WITH CROSSING OVER the corpus callosum
glioblastoma multiforme
49
What do pilocytic astrocytomas stain positively for?
GFAP
50
What is another name for a glioblastoma multiforme?
a butterfly glioma
51
What kind of cells do meningiomas arise from?
arachnoid
52
What is a pilocytic astrocytoma?
a benign tumor of astrocytes
53
Relative to the tentorium, where do CNS tumors in children occur?
children = beneath
54
On imaging, this will look like a round mass attached to the dura.
meningioma
55
From what are oligodendrocytes derived from?
neuroectoderm
56
What is a noncommunicating hydrocephalus?
structural blockage of CSF circulation
57
Dx?
* a supratentorial mass in a child or young adult
craniopharyngioma
58
What does an oligodendroglioma look like microscopically?
* a calcified tumor in the white matter
* "fried egg" appearance
* "chicken wire" capillary pattern
59
What is the most common CNS tumor in adults?
glioblastoma multiforme
60
What is glial tissue?
the tissue that supports the neurons
61
How does a craniopharyngioma appear on imaging?
calcified
62
What is the prognosis for an ependymoma?
poor
63
What is an oligodendroglioma?
a malignant tumor of oligodendrocytes seen in adults
64
What is the function of an oligodendrocyte?
myelinate CNS axons
65
Nitrosoureas (Carmustine, lomustine, semustine, streptozocin) are used to treat \_\_\_\_\_\_\_.
brain tumors, including glioblastoma multiforme
66
How does an ependymoma present?
hydrocephalus
67
What is the function of the ependymal cells? Where are they found?
* produce CSF
* lining the ventricular spaces
68
What is GFAP?
* the intermediate filament present within glial cells
* marker for glioblastoma multiforme and pilocytic astrocytomas
69
What does a meningioma look like on histology?
* whorled spindle cells
* abundant psammoma bodies (laminated calcifications)
70
What are Homer-Wright rosettes? What are they assoc. with?
* Circular grouping of dark tumor cells surrounding pale neurofibrils
* seen in medulloblastoma or neuroblastoma
71
Who gets craniopharyngiomas?
children or young adults
72
What do schwannomas involve?
* cranial or spinal nerves
* esp. CN8 at the cerebello-pontine angle (CPA)
73
What is a medulloblastoma?
a malignant CNS tumor of children arising from the neuroectoderm
74
Medulloblastoma can compress the \_\_\_\_, causing \_\_\_\_\_.
4th ventricle --\> noncommunicating hydrocephalus
75
What do ependymal cells derive from?
neuroectoderm
76
Circular grouping of dark tumor cells surrounding pale neurofibrils seen in medulloblastoma or neuroblastoma are called \_\_\_\_\_.
Homer-Wright rosettes
77
Where are schwannomas most likely to occur?
* CN8 at the cerebello-pontine angle (CPA)
* "vestibular schwannoma"
78
Where do pilocytic astrocytoma most often arise?
in the cerebellum (posterior fossa)
79
Name 2 histological features of glioblastoma multiforme.
1. large amounts of necrosis surrounded by pseudopalasading normal tissue
2. endothelial cell proliferation
80
Who most often gets pilocytic astrocytoma?
children
81
Bilateral schwanommas are seen in \_\_\_\_\_.
neurofibromatosis type 2 (NF2)
82
What is the prognosis for glioblastoma multiforme?
death in about 1 year
83
What is the tumor that classically arises from astrocytes in an adult?
glioblastoma multiforme
84
The 3 most common mets to the brain come from the \_\_\_\_, \_\_\_\_\_, and \_\_\_\_\_.
1. lung
2. breast
3. kidney
85
What is a meningioma? Who gets them?
* a benign CNS tumor from the arachnoid (meningothelial) cells
* classically seen in adult females
86
Why do pts with craniopharyngiomas get bitemporal hemianopsia?
compression of the optic chiasm
87
What are drop metastases? What are they associated with?
when medulloblastoma spreads into the spinal cord via the CSF
88
If you see bitemporal hemianopsia, think _____ or \_\_\_\_\_.
* pituitary tumors
* craniopharyngioma
89
What marker are schwannomas positive for?
S100
90
Where do meningiomas most commonly occur within the brain?
* near the surfaces
* parasaggital region
91
Where and how do metastatic lesions to the CNS most often occur?
* at the gray-white junction
* as multiple, well-circumscribed lesions
92
What is the function of the astrocytes?
* form the BBB
* K+ metabolism
* repair
* NT reuptake
93
What are the imaging findings in a meningioma?
a round mass attached to the dura
94
What is the prognosis for craniopharyngioma?
it's benign but can recur
95
What are the microglia derived from?
mesoderm (mononuclear origin)
96
What are meningothelial cells?
cells making up the meninges
97
Relative to the tentorium, where do CNS tumors in adults occur?
above = adults
98
Dx?
* perivascular pseudo-rosettes
* Rod-shaped blepharoplasts (basal ciliary bodies) found near the nucleus
ependymoma
99
What is the marker for the astrocytes?
GFAP
