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Year 2 > Neuro Path - Eye and tumors > Flashcards

Neuro Path - Eye and tumors Flashcards

1
Q

New-onset adult seizure?

A

think brain tumor

- glioblastoma is mc in adults

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2
Q

How do you astrocytomas progress with age?

A

Worsen as you get older grade wise

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3
Q

Grade I/IV
Most commonly in post fossa enter or cerebral hemispheres or cerebellum
First two decades of life
associated with an NF1 functional loss of neurofibromin
cystic with a mural nodule
low cellularity

Contain a biphasic pattern with a loose glial with cystic changes and dense pilots tissue

Hair like cells with a long bipolar processes, Rosenthal fibers, eosinophilic granular bodies

A

Pilocytic astrocytoma

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4
Q

mc primary brain neoplasm

contrast ring-enhancing, hypodense central necrosis

A

glioblastoma, IV/IV

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5
Q

types of glioblastoma

A

primary - later in life, no precursor lesions
EGFR and PTEN

secondary - have low grade lesion - TP53
IDH1 (R132H mut has better prognosis)
IDH2 (younger)

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6
Q

histo hallmarks of glioblastoma

A

necrosis - serpentine pattern
pseudo-palisading cells around necrosis
vascular/endothelial proliferation - VEGF thickens malig astrocytes

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7
Q

adults, II/IV
IDH1 and IDH2 - favorable prognosis, 1p19Q, favorable, anaplastic (III/IV)
cerebral hemispheres
calcification restricted to cortex, curvy or gyriform distribution
perinuc halows and anastomosing capillaries

A

“fried eggs and chicken wire appearance”

oligodendroglioma

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8
Q 
first 2 decades of life
4th ventricle - discrete, exophytic, enhancing, mc site, spinal cord for adults
suprattentorial
grade III
true rosettes are diagnostic
A

ependymoma

ependymal rosettes are true with an opening

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9
Q

mc in children in lateral ventricles

hydrocephalus and increased CSF

A

choroid plexus papilloma

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10
Q

ya
obstruction of foramen monro bc of its attachment to roof of 3rd ventricle -> noncommunication hydrocephalus
fatal and positional

A

colloid cyst of 3rd ventricle

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11
Q

IV/IV children, malignant embryonal tumor
cerebellum, midline and occludes csf flow
sheets of anaplastic cells, abundant mitoses, homer-wright rosettes
drop mets (cauda equine)
radiosensitive
supratentorial PNET

A

medulloblastoma

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12
Q

medulloblastoma molecular grps

A

WNT - older kid, chr 6, B catenin, good prog
SHH - infants-ya, MYCN, intermediate prog
group 3 - MYC and I17Q, infant and childern, WORST prognosis
gropu 4 - I17Q, maybel MYCN, poor prog

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13
Q 
<2yo, large cell w paranuc filamentous inclusions, prob w large cell medulloblastoma
posterior fossa or supratentorial 
EMA and VImentin
Rhabdoid cells - eosinophilic cytoplasm
ch22, HSNF5/INI1
aggressive, <1yr survival
A

atypical teratoid, rhabdoid tumor

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14
Q

immunosuppressed, increased in AIDS

multifocal, periventricular
Bcell, CD20, aggressive, assoc w EBV
accum around vessels - Hooping (cells sep by reticulin)

A

primary cns lymphoma

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15
Q

primary brain germ cell tumors that are midline
see in Japanese, in first two decards
mets of gonadal germ cell to cns is common
mc males? supraselluar

A

germ cell tumors
pineal

germinoma - responds to XRT and chemo, track w AFP and b-hCG

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16
Q

mc pineal tumor

A

germinoma

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17
Q

mc pineal tumor in adults

A

LG, pinecytoma

18
Q

mc in kids

A

pineblastoma, high grade, necrosis, mitosis, RB gene

19
Q

after 3rd decade
slow, compresses brain but doesn’t hardly infiltrate, penetrates bone
radiation induced
calcified psammoma bodies,=- en plaque (sheet like spread along dura)
wholred clusters of monotonous cells
secretory - PAS+ droplets, TRAF7, KLF4
atypical II/IV - more aggressive, clear and chordoid
anaplastic II/IV is malig (pap and rhaboid subtypes)

A

meningioma, who I

20
Q

molecular types of meningioma

A

NF2 on 22Q, higher grade and multiple/sporadic
TRAF7, mc next, lower histo grade

dura based- meningothelial cell origin of arachnoid EMA+

21
Q

meningiomas are mc in

A

women, spinal, express PR, after preg and during

22
Q

mc metastatic brain tumors

meninges mc site of metc, gray and white jxn, spc compression

A

lung, breast, melanoma, kidney, gi

choriocarcinoma mc spreads to

23
Q

mc hemorrhage of metastatic brain tumors

A

melanoma, choriocarcinoma, RCC, lung

24
Q

carcinomatosis mc in

A

lung and breast, tumor spread along surface of brain and s

25
Q

PCA-1 antibody
destroys purkinje cells, gliosis and mild chronic inflammatory infiltrate
women w ovarian, uterine and breast carcinoma

A

subaute cerebullar degeneration

26
Q

limbic encephalitis types

A

anna-1 antibody, scc of lung
NMDA receptor - overain teratomas
VGKC complex antibody, peripheral neuropathy,

27
Q

AD, mc of types, 17q, neg regulates RAS signaling
pheochromocytoma
Neurofibromatosis, cafe au lait spots, optic n glioma, lisch nodules-pigment nod of iris

A

NF1

neurofibromatosis type1

28
Q

RCC, hemangioblastoma, panc endocrine neoplasm
pheochromocytoma, paraganglioma
AD, downreg HIF-1, which reg VEGF causes polycythemia and increases erythropoietin

A

von hippel lindau

VHL

29
Q

AD
ch 1pq23
lipid phosphatase, benign follicular appendage tumors (trichilemmomas), internal adenoca (breast, endometrial)

A

PTEN -> IK3/AKT signal pathway

cowden syndrome

30
Q 
AD
22q
merlin
integrates cytoskeletal sig and neurofibromas and acoustic neuromas
bilateral schwannomas - cn VIII
increased meningiomas and ependymomas
A

NF2

neurofibromatosis II

31
Q

AD
9q, 16p
TSC1 hamartin, TSC2 tuberin
work together in a complex that neg regulates mTOR/angiofibromas/MR
hamartomas, cortical tubers, subependymal nodules, SEGA, renal angiomyolipomas, cardiac rhabomyomas, cut lesion slike shagreen and ash leak patches

A

tuberous sclerosis

32
Q

medulloblastomas, mut in TP53

A

li-fraumeni syndrome

33
Q

mut in apc, medullo or glioblastoma, mismatch repair genes

A

turcot syndrome

34
Q

mut in PTCH gene, meduloblastoma, upreg of SHH

A

gorlin syndrome

35
Q

s100
cerebellar pontine angle
acoustic neuroma - cn viiii, tinnitus and hearing loss
NF2, loss of merlin, antoni A (verocay bodies palisading nuclei around nuc free zoens), antoni B

A

schwannoma

36
Q

bag of worms, sporadic
nf-1 related
superficial cutaneous, diffuse, and plexiform

A

neurofibroma

37
Q

HG tumors, arrise in NF1 pt

A

mpnst

38
Q

risk factor - DM
lenticular opacities - acquired or congenital
can result from opacification of the lens nucleus (nuclear sclerosis)

A

cataracts

39
Q

assoc w increased intraocular pressure
from resitance to aqueous outlfow or peripheral zone of iris adheres to trabecular meshwork and physically impedes outflow
RF - aa/hispanic, DM

A

glaucoma

40
Q

corneal transplant lacks what two things

A

blood vessels and lymphatics

this contributes to its opacity and lack of rejection

41
Q

mc intraocular malignancy of childhood
ch 13 long arm, RB

leukocoria (white pupillary reflex), pseudohypopyon, can cause metz to distant places via optic nerve (poor prog)

histo - round shape hyperchromatic nuclei w scant cytoplasm, flexner wintersteiner (eosinophilic columnar cells w peripherally oriented nuclei around a lumen), homer wright, fleurette

A

retinoblastoma

Year 2 (10 decks)

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