Neuro-oncology Flashcards
Cancer associations with opsoclonus myoclonus syndrome in children?
Adults?
What antibody is sometimes associated with this in adults only?
Treatment in kids?
Children: neuroblastoma
Adults: breast, ovarian, SCLC
Anti-RI, especially in breast cancer
ACTH in kids (alternatives include steroids which is usually used in adults, and other immunosuppression like IVIG)
(Also treat malignancy)
Tumor associated with perinecrotic pseudopalisaging?
Glioblastoma
(Also seen: nuclear atypia, mitoses, endothelial hyperplasia, necrosis)
Tumor associated with “fried egg” appearance
Oligodendrogliomas
(“Fried egg” is cells with uniformally rounded nuclei with clear pericellular haloes)
Tumor associated with perivascular pseudorosettes
Ependymomas
Tumor assoiated with Homer-Wright rosettes
Medulloblastoma
Paraneoplastic cerebellar disease antibodies, and tumors to which they are associated with (3)
Anti-YO: breast and ovarian (also others including Hodgkin’s and SCLC)
Anti-HU: SCLC (and others)
Anti-Tr: lymphomas
Antibody treatment for recurrent glioblastomas
Bevacizumab (antibody against VEGF, anti-angiogenesis)
Paraneoplastic syndrome associated with paraneoplastic optic neuropathy
Anti-CRMP5, a/w lng cancer
(Also can lead to encephalitis, cerebellar degeneration, chorea and others)
Antibody with paraneoplastic retinal degeneration
Anti-recoverin aka anti-CAR
(A/w SCLC, thymoma, RCC, melanoma)
Two antibodies associated with paraneoplastic chorea?
HU and CRMP5
Mutation associated with half of anaplastic astrocytomas
P53 mutation
(also seen is loss of p16 and other retinoblastoma pathway genes)
Tumor associated with 1p19q deletion
Oligodendrogliomas
Most common glioma in children
Pilocytic astrocytomas
(Grade I tumor typically well circumscribed, often in the cerebellum where it is typically cystic with an enhancing mural nodule, but they are solid if in hypoathalamus or optic nerves)
Grade I gliomas that can be a well-circumscribed cystic tumor with an enhancing mural nodule
Pilocytic astrocytoma
Well-demarcated tumor usually in superficial cortex, most commonly temporal, that is a cyst with an enhancing mural nodule.
Pleomorphic xanthroastrocytoma
Tumor associated with pleomorphic astrocytes arranges in fascicles with intercellular reticulin deposition, mesenchymal-like cells, and multinucleated giant cells
Pleomorphic xanthroastrocytoma
Benign hamartomatous intraventricular tumor associated with tuberuous sclerosis
SEGA - subependymal giant cell astrocytoma
“Candle gutterings” are histologically seen in…?
SEGA - subependymal giant cell astrocytoma
Glial neoplasm associated with biphasic pattern of compact regions along with microcystic components, with hair-like astrocytic processes
Pilocytic astrocytoma
(The hair-like astrocytic processes are the pilocytic namesake)
Genetic tumor syndrome associated with spinal ependymomas
NF2
Tumor associated with synaptophysin staining
Neurocytoma (synaptophysin is a marker of neuronal differentiation and seen with neuronal tumors but not glial tumors, which would potentially be GFAP positive)
CNS tumor associated with psammoma bodies
Meningioma (also prolactinomas)
(Psammoma body is a round collection of calcium that is also seen in other tumors outside the CNS, like papillary thyroid ca and papillary RCC,.
Tumor with prominent capillary vasculature and stromal cells with a vacuolated cytoplasm
Hemangioblastoma
What tumor syndrome is associated with hemangioblastoma?
VHL (but only about 25% of cases)
Tumor with hypercellular, sheet-like proliferation of small blue cells wit high nuclear-to-cytoplasm ratio
Medulloblastoma
Pineal tumor with homogenous, small uniform cells that resemble pineocytes
Pineocytoma
(As opposed to pineoblastoma, which show proliferation of small rounds cells, which are undifferentiated and resemble primitive neuroectodermal tumors rather than pineocytes)
Pineal tumor with proliferation of small rounds cells, which are undifferentiated and resemble primitive neuroectodermal tumors rather than pineocytes
Pineoblastoma
(As opposed to pineocytoma, which is a pineal tumor with homogenous, small uniform cells that resemble pineocytes)
T1 hyperintense cyst near the foramen of monro.
How can it present?
Colloid cyst
Can lead to forman of monro obstruction and therefore HA, AMS, drop attacks, acute hydro, and sudden death.
Cyst with slight FLAIR hyperintensity and diffusion restrction
Epidermoid cyst (as opposed to arachnoid cysts, which contain CSF and so isointense to CSF on T2 and black on FLAIR)
Pediatric tumor with prominent clear spaces with interspersed cells including glial cells?
DNET - dysembryoplastic neuroepithelial tumor
Tumor associated with EBV in immunocompromised patients
Primary CNS lymphoma (typically a B cell lymphoma)
Sellar tumor with multicystic components, with cord of epiethilial-appearing cells
Craniopharyngioma (from Rathke’s pouch remnants)
Tumor with proliferation of epithelial cells in a papillary pattern lining fibrovascular cores
Choroid plexus papilloma (childhood gradeI tumor)
Invasic osseodestructive dumor
Chordoma (most commonly clivus here they can lead to HA, neck pain, and cranial neuropathies, can also be sacrococcygeal and lead to sphincter dysfunction and pain)
Encephalitis associated with testicular tumors in young males?
Anti-MA (also seen w SCLC in older adults)
(Can lead to limbic, brainstem, or diencephalon encephalitis)
