Neuro - Pathology (Brain Tumors & Herniation Syndromes) Flashcards
Pg. 488-489 in First Aid 2014 Pg. 447-448 in First Aid 2013 Sections include: -Adult primary brain tumors -Childhood primary brain tumors -Herniation syndromes
What are 6 examples of adult primary brain tumors?
(1) Glioblastoma multiforme (grade IV astrocytoma) (2) Meningioma (3) Hemangioblastoma (4) Schwannoma (5) Oligodendroglia (6) Pituitary adenoma
What is another name for glioblastoma multiforme? Describe the tumor: Is it common or rare? Is it benign or malignant? What is the median survival of patients with it?
Grade IV astrocytoma; Common, highly malignant primary brain tumor with ~ 1 year median survival
Where in the brain is glioblastoma multiforme (grade IV astrocytoma) found? To where can it expand, what is that called?
Found in cerebral hemispheres. Can cross corpus callosum (“butterfly glioma”)
What stain is used in glioblastoma multiforme, and for what cells?
Stain astrocytes for GFAP.
Describe the tumor cells seen in glioblastoma multiforme (grade IV astrocytoma).
“Pseudopalisading” pleomorphic tumor cells - border central area of necrosis and hemorrhage.
Describe a meningioma: Is it common or rare? Is it benign or malignant?
Common, typically benign primary brain tumor
Where in the brain do meningiomas most often occur?
Most often occurs in convexities of hemispheres (near surfaces of brain) and parasagittal region
From what kind of cells does a meningioma typically arise? What is the involvement of brain parenchyma and dura?
Arises from arachnoid cells, is extra-axial (external to brain parenchyma), and may have a dural attachment (“tail”)
How does meningioma often present? What are other ways in which it might present?
Often asymptomatic; may present with seizures or focal neurological signs
What are 2 defining characteristics of meningioma on histology?
Spindle cells concentrically arranged in a whorled pattern; psammoma bodies (laminated calcifications).
What is the treatment/management in meningioma?
Resection and/or radiosurgery.
Where in the brain is hemangioblastoma most often found?
Most often cerebellar;
With what condition is hemangioblastoma associated, and in what clinical context?
Associated with von Hippel-Lindau syndrome when found with retinal angiomas
What substance can be produced by hemangioblastoma, and what result does this have?
Can produce erythropoietin –> secondary polycythemia
What characterizes hemangioblastoma on histology?
Closely arranged, thin-walled capillaries with minimal interleaving parenchyma.
Where in the brain is Schwannoma usually found?
Usually found at cerebellopontine angle
From what cell does a Schwannoma originate? What can be used to test this? What is a common example of Schwannoma localization and its result?
Schwann cell origin, S-100 (+). Often localized to CN VIII –> acoustic schwannoma (aka acoustic neuroma)
What is the treatment/management for schwannoma?
Resectable or treated with stereotactic radiosurgery.
In what condition are bilateral acoustic schwannomas found?
Bilateral acoustic schwannomas found in NF-2.
Is oligodendroglioma common or rare? Is it fast or slow growing?
Relatively rare, slow growing
Where is oligodendroglioma most often found?
Most often in frontal lobes
What describes the capillary pattern in oligodendroglia? How do its oliogodendrocytes appear on histology?
Chicken-wire capillary pattern. Oligodendrocytes = “fried egg” cells - round nuclei with clear cytoplasm.
What (imaging) finding is often present in oligodendroglioma?
Often calcified in oligodendroglia.
What is the most common pituitary adenoma?
Most commonly prolactinoma
