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3 Pathology and Radiology > Oncology > Flashcards

Oncology Flashcards

1
Q

Epidermoid cyst/tumor: what % of primary tumor

A

1%

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2
Q

Epidermoid cyst/tumor: Peak age

A

30-50 years

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3
Q

Epidermoid cyst/tumor: Sex predominance

A

None

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4
Q

Epidermoid cyst/tumor: Intracranial locations

A

CPA (50%), suprasellar, intraventricular, thalamic

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5
Q

Epidermoid cyst/tumor: what % is extradural-intradiploic?

A

10%

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6
Q

3 most common CPA lesion

A

Vestibular schwannoma Meningioma Epidermoid cyst

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7
Q

Epidermoid cyst/tumor: MRI intensity

A

T1 and T2 similar to CSF, with NO enhancement FLAIR and DWI HYPERintense to CSF

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8
Q

Epidermoid cyst/tumor: what does it look like and what is inside?

A

Smooth, encapsulated, pearly sheen Dry, flaky keratin and stratified cuboidal squamous epithelium

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9
Q

What causes growth in epidermoid cyst/tumor?

A

Progressive desquamation of the cyst wall causes a linear growth rate

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10
Q

Epidermoid cyst/tumor: % with calcifications

A

15%

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11
Q

Epidermoid cyst/tumor: Does it rupture or recurs after surgery?

A

Rare ruptures Frequently recurs

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12
Q

How can you differentiate an arachnoid cyst v.s. an epidermoid cyst on MRI?

A

DWI shows epidermoid to be HYPERintense to CSF

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13
Q

Epidermoid cyst/tumor: formation

A

Ectoderm elements trapped intracranially E.g. epidermoid form in lumbosacral spine after LP with introduction of skin elements deposited into deep layers

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14
Q

Mollaret meningitis: what is it? What tumor is it associated with?

A

Recurrent aseptic meningitis with large cells in the CSF Occurs in some with epidermoid tumors.

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15
Q

What is this tumor?

A

Epidermoid cyst
Lamellated keratin with cyst lined by squamous epithelium

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16
Q

What is this tumor?

A

Epidermoid cyst
Stratified squamous epithelium around thin “dry” keratin

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17
Q

Dermoid cyst: what % of primary tumor

A

0.1%

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18
Q

Dermoid cyst: Sex predominance

A

None

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19
Q

Dermoid cyst: Mean age

A 
20 years (head)
10 years (spine)
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20
Q

Dermoid cyst: Most common locations

A

Located in midline: parasellar, 4th ventricular, or interhemispheric

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21
Q

Dermoid cyst: MRI findings

A

Like Fat, with frequent calcifications

T1: Hyperintense (Cholesterol)
T1+G: No enhancement
T2: Variable

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22
Q

Dermoid cyst: What does it contain?

A

Cholesterol, calcium
Cheesy material, pilosebaceous units with hair shafts and sebaceous glands, sweat glands, teeth

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23
Q

Dermoid cyst: Growth

A

Desquamation and gland secretion

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24
Q

Dermoid cyst: Does it rupture?

A

Frequently

25
Q

Dermoid cyst: How do they develop?

A

Congenital or acquired through trauma/LP

26
Q

Do dermoid and epidermoid undergo malignancy?

A

Rarely to squamous cell carcinoma
May be a fistula to skin with recurrent bouts of bacterial meningitis

27
Q

Describe this MRI

A 
T2 Hyperintense
Flair heterogeneous
(T1 Hypointense - not shown)

Epidermoid Cyst

28
Q

What is this tumor?

A

Dermoid cyst

Epidermis wth sebaceous cysts and hair follicles

29
Q

Colloid cyst: Mean age

A

20-40 years

30
Q

Colloid cyst: Sex predominance

A

None

31
Q

Colloid cyst: where are is normally located?

A

Anterior roof of third ventricle between columns of fornices
Frequently attached to the stroma of the choroid.

32
Q

Colloid cyst: origin

A

Endodermal origin from vestigial third ventricular structure

Abnormal folding of primitive neuro-epithelium (paraphysis elements)
Rarely associated with craniopharyngioma

33
Q

Colloid cyst: What is inside?

A

Mucus (mucopolysaccharides)
Hemosiderin (old blood), cholesterol

34
Q

Colloid cyst: CT and MRI findings

A

CT: 2/3 hyperdense and 1/3 hypodense
MR T1: Hyperintense
MR T2: Isointense to brain

35
Q

Colloid cyst: Pathology

A

Fibrous capsule lined by a single pseudostratified layer of columnar cells with cilia and PAS+ globlet cells.

No calcifications.

36
Q

Colloid cyst: At what size should you start considering surgery?

A

> 7 mm

37
Q

What is the diagnosis?

A

Colloid cyst

38
Q

What is this diagnosis?

A

Single layer of columnar cells lining the cyst with occasional cilia

39
Q

Arachnoid cyst: Sex predominance

A

Male

40
Q

Arachnoid cyst: % in children

A

75%

41
Q

Arachnoid cyst: Most common locations

A

Middle fossa (60%)
Suprasellar (10%)
Quadrigeminal cistern (10%)
Posterior fossa (10% CPA/cisterna magna)
Convexity (5%)

42
Q

What hemorrhage is arachnoid cyst associated with?

A

SDH
Tearing of bridging veins that traverse the cyst

43
Q

Arachnoid cyst: MRI and CT

A

CT: hypodense
T1: Hypointense
T2: Hyperintense
Flair: Suppressed

Like CSF (v.s. epidermoid cysts)

44
Q

Arachnoid cyst: Potential treatment

A

Craniotomy for fenestration/excision or placement of cystoperitoneal shunt

45
Q

Differential diagnoses for arachnoid cyst

A

Enlarged CSF space (mega cisterna magna)
Epidermoid cyst
Subdural hygroma
Cystic tumors (pilocytic astrocytoma, hemangioblastoma)
Non-neoplastic cysts (neurenteric cyst)
Neurocysticercosis

46
Q

Neuroepithelial cyst: origin

A

Infolding of developing neuroectoderm

47
Q

Neurepithelial cyst: where are they located intracranially?

A

Ependyma, choroid plexus, choroidal fissure

48
Q

Neurenteric (Enterogenous) cyst: Sex predominance

A

Male

49
Q

Neurenteric cyst: Origin

A

Foregut duplication
Notochord-gut fusion

50
Q

Neurenteric cyst: What is inside?

A

Endoderm of GI or respiratory mucosa

51
Q

Neurenteric cyst: Pathology

A

Single layer of cuboidal/columnar cells with interspersed goblet cells

52
Q

Neurenteric cyst: Location

A

80% spine
15% intracranial
CPA, craniocervical junction

53
Q

Neurenteric cyst: CT, MRI findings

A

CT: hypoattenuating lesion, may show soft tissue attenuation
MRI: variable depending on protein contents

54
Q

Cavum septum pellucidum

A

Normal variant CSF space between leaflets of septum pellucidum

CSF between sheets of septum pellucidum in lateral ventricles at level of caudate head

55
Q

Cavum septum pellucidum: what % of adult population

A

Normal in fetus and over 85% fuse by 3-6 months of age
15% in adult population

56
Q

Cavum vergae: what is it?

A

Posterior continuation of cavum septum pellucidum

Embryological fluid-filled space between leaflets of septum; common anatomic variant

57
Q

Cavum velum interpositum: what is it?

A

Failure of fusion of the tela choroidea in the third ventricle

58
Q
A

3 Pathology and Radiology (3 decks)

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