Neuro-onc Flashcards
type of tumor with fried egg appearance on path AND microcalcifications sometimes evident on CT
oligodendroglioma
type of primary CNS tumor most likely to have evidence of dissemination in CSF
Grade III ependymoma
mutation in grade II/III astrocytomas (2 possible)
p53 mutation and IDH1 mutations
most common site of ependymomas
often off lining of ventricles in posterior fossa
mutation that predicts favorable response to DNA damaging chemos in oligodendrogliomas
1p19q loss of heterozygosity
chemo for GBM
temozolamide
rosettes with microlumina and pseudorosettes
think ependymoma
small round blue cells sometimes in rosettes
medulloblastoma
type of tumor for medulloblastoma
PNET: primitive neuroectodermal tumors
Types of PNET / small round blue cell tumors
All grade IV
- medulloblastoma
- supratentorial PNET
- pineoblastoma
poor prognosis for medulloblastoma
young children < 3 yrs
vermian tumor in cerebellum in kid is likely what
medulloblastoma
treatment for CNS lymphoma
methotrexate based regimen
MRI features of lymphoma CNS
diffusely enhancing and crosses corpus callosum
Bcell vs Tcell markers on path
Bcell: CD20
TCell: CD3
Restricted diffusion in non-stroke
lymphoma or abscess
pituitary tumor with cystic components containing motor-oil like fluid
adamantinous craniopharyngioma
2 types of craniopharyngioma
- squamous papillary - solid
- **Adamantinous cystic: with motor oil
(From Rathke’s cyst remnants)
where do meningiomas arise from
extraaxial, from arachnoid cells
dural tail
meningioma
loss of chromosome 22 found in what kind of tumor
meningioma
whorls on pathology
meningioma
two types of pineal parenchymal tumors and major other types?
parenchymal:
1. pineoblastoma grade IV (like medulloblastoma, bad behavior, spreads w/ CSF and can occur w/ b/l retinoblastoma)
2. pineocytoma grade I very slow growing
3. germ cell tumors: germinomas and everything else
what tumor might you see in conjunction with b/l retinoblastoma
pineoblastoma
Typical treatment of germinoma / pineal tumor treatment
germinoma type is VERY sensitive to RT and chemo, so no surgery.
areas of closely and loosely packed tumor (2)
- JPA
2. schwannoma
nerve most commonly involved in malignant peripheral nerve sheath tumor and what does it most likely arise from
sciatic plexiform neurofibromas
tx for SEGA in TS?
everolimus (mtor inhibitor)
cauliflower looking lesion in posterior fossa
choroid plexus papilloma
well circumscribed posterior fossa mass
ependymoma
single histology most common pedi brain tumor and group of brain tumors
medulloblastoma or glioma/all comers
voltage gated K channel Abs can cause what
neuromyotomia, seizures, limbic encephalitis
ab in stiff person syndrome
anti GAD from breast cancer or SCLC
most common brain met
NSCLC
axonal peripheral neuropathy - two main chemos
vincristine, taxanes
chemo causing cerebral edema
cisplatin (give with mannitol and steroids)
drug used for GBM and s/e
temozolamide
marrow suppression, n/v, constipation
drug used for recurrent GBM and s/e
bevacizumab
-bleeding, clotting, incr BP, urine protein
drug for oligodendroglioma that causes neuropathy, constipation, myelosuppression
vincristine
drug that can cause a leukoencephalopathy similar to NPH
methotrexate
cancers assoc w/ anti voltage gated K channels
SCLC thymoma
brain mets likely to bleed
melanoma, renal cell, chorioca, thyroid ca
most common histological primary brain tumor
meningioma
what is the course of a pilocytic astrocytoma / JPA
what path and MRI features
grade I, can be surgically resected
Path: Rosenthal fibers
MRI: enhancing, well circumscribed
Grade II/III astrocytomas often with what mutation
enhancing?
p53
Grade II rarely enhance, grade III may
what grade is a SEGA
grade 1
three types of glial cells / gliomas
- astrocytoma
- oligodendroglioma
- ependymoma
path features of juvenile pilocytic astrocytoma (2) MRI features (1)
1 Rosenthal fibers
2. GFAP +
- MRI: cyst with mural nodule
cyst with mural nodule in kid vs adult
kid: JPA
adult: hemangioblastoma and von hippel lindau
special cyst with mural nodule in temporal lobe and with seizure that aren’t quite JPA
pleomorphic xanthoastrocytoma (Grade II)
two tumors that butterfly across the corpus callosum
GBM or lymphoma
calcifications, perinuclear halos on path, delicate vessels
oligodendroglioma: fried egg/ chicken wire vessels
most common primary brain tumor to bleed
oligodendroglioma: think of fragile vessels / chicken wire
most common spinal cord glioma
ependymoma
spinal cord tumor arising from filum terminale?
myxopapillary ependymoma
perivascular pseudorosettes
ependymoma
whorls, psammoma bodies,
desmosomes on EM
meningioma
chromosome associated with meningiomas
merlin chr 22 loss: monosomy 22 (think NF2, chr 22, many meningiomas)
what are the high grade meningiomas? (5)
atypical, clear cell, choroid, rhabdoid, anaplastic
most common supratentorial tumor in childhood
craniopharyngioma
atypical teratoid / rhabdoid tumor (AT/RT) are assoc w/ what genetics?
partial loss of ch22 or LOH of chr 22
rosette with central lumen (name and tumor)
true: flexner-wintersteiner in retinoblastoma
rosette with cytoplasmic process in center - name and tumor
homer wright
-medulloblastoma neuroblastoma
perivascular rosette
pseudorosette, ependymoma
type of brain tumor in this syndrome
Cowden’s syndrome: multiple hamartomas:
Lhermitte Duclos: dysplastic gangliocytoma of cerebellum
type of brain tumor in this syndrome
Gorlin’s syndrome
Nevoid basal cell cardinoma syndrome: medulloblastoma
MED GORY
Li-Fraumeni syndrome
type of brain tumor in this syndrome
p53 tumor disease: diffuse astrocytomas
type of brain tumor in this syndrome
Turcot’s syndrome
GBM or medulloblastoma
The disease most assoc w/ paraneoplastic syndromes
SCLC
amphiphisin antibody causes what and is assoc w/ what cancers
stiff person syndrome / encephalomyelitis
SCLC, breast
Anti-Hu assoc w/ what dz
SCLC smokers get SCLC and Hugh Hefner smokes
Hodgkins assoc w/ what antibody/paraneoplastic syndrome
Tr: cerebellar degeneration (Trip due to cerebellar)
cerebellar degeneration caused by anti-Yo Abs in what cancer?
breast, ovary (Yo mamma)
anti-Ta from what cancer, what syndrome
limbic encephalitis / brainstem dysfunction in testicular cancer
ataxia, opsoclonus/myoclonus, brainstem encephalitis with what Ab and what cancer
anti-Ri in breast, gyne, SCLC
chemo causing stroke/central venous thrombosis
aspariginase
chemo making you have SIADH/psych sx
cyclophosphamide
chemo causing arachnoiditis and cerebellar dysfunction
ARA-C (ARAchnoiditis, Cerebellar), and also seizures (ARA_Czur)
PRES / reversible posterior leukoencephalopathy caused by what chemo
MTX
most common tumor of pineal gland
germinoma
most common neural crest derived tumor of sacrum
chordoma