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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
Dermoid cyst: How do they develop?
Congenital or acquired through trauma/LP
26
Do dermoid and epidermoid undergo malignancy?
Rarely to squamous cell carcinoma May be a fistula to skin with recurrent bouts of bacterial meningitis
27
Describe this MRI
``` T2 Hyperintense Flair heterogeneous (T1 Hypointense - not shown) ``` Epidermoid Cyst
28
What is this tumor?
Dermoid cyst Epidermis wth sebaceous cysts and hair follicles
29
Colloid cyst: Mean age
20-40 years
30
Colloid cyst: Sex predominance
None
31
Colloid cyst: where are is normally located?
Anterior roof of third ventricle between columns of fornices Frequently attached to the stroma of the choroid.
32
Colloid cyst: origin
Endodermal origin from vestigial third ventricular structure Abnormal folding of primitive neuro-epithelium (paraphysis elements) Rarely associated with craniopharyngioma
33
Colloid cyst: What is inside?
Mucus (mucopolysaccharides) Hemosiderin (old blood), cholesterol
34
Colloid cyst: CT and MRI findings
CT: 2/3 hyperdense and 1/3 hypodense MR T1: Hyperintense MR T2: Isointense to brain
35
Colloid cyst: Pathology
Fibrous capsule lined by a single pseudostratified layer of columnar cells with cilia and PAS+ globlet cells. No calcifications.
36
Colloid cyst: At what size should you start considering surgery?
\> 7 mm
37
What is the diagnosis?
Colloid cyst
38
What is this diagnosis?
Single layer of columnar cells lining the cyst with occasional cilia
39
Arachnoid cyst: Sex predominance
Male
40
Arachnoid cyst: % in children
75%
41
Arachnoid cyst: Most common locations
Middle fossa (60%) Suprasellar (10%) Quadrigeminal cistern (10%) Posterior fossa (10% CPA/cisterna magna) Convexity (5%)
42
What hemorrhage is arachnoid cyst associated with?
SDH Tearing of bridging veins that traverse the cyst
43
Arachnoid cyst: MRI and CT
CT: hypodense T1: Hypointense T2: Hyperintense Flair: Suppressed Like CSF (v.s. epidermoid cysts)
44
Arachnoid cyst: Potential treatment
Craniotomy for fenestration/excision or placement of cystoperitoneal shunt
45
Differential diagnoses for arachnoid cyst
Enlarged CSF space (mega cisterna magna) Epidermoid cyst Subdural hygroma Cystic tumors (pilocytic astrocytoma, hemangioblastoma) Non-neoplastic cysts (neurenteric cyst) Neurocysticercosis
46
Neuroepithelial cyst: origin
Infolding of developing neuroectoderm
47
Neurepithelial cyst: where are they located intracranially?
Ependyma, choroid plexus, choroidal fissure
48
Neurenteric (Enterogenous) cyst: Sex predominance
Male
49
Neurenteric cyst: Origin
Foregut duplication Notochord-gut fusion
50
Neurenteric cyst: What is inside?
Endoderm of GI or respiratory mucosa
51
Neurenteric cyst: Pathology
Single layer of cuboidal/columnar cells with interspersed goblet cells
52
Neurenteric cyst: Location
80% spine 15% intracranial CPA, craniocervical junction
53
Neurenteric cyst: CT, MRI findings
CT: hypoattenuating lesion, may show soft tissue attenuation MRI: variable depending on protein contents
54
Cavum septum pellucidum
Normal variant CSF space between leaflets of septum pellucidum CSF between sheets of septum pellucidum in lateral ventricles at level of caudate head
55
Cavum septum pellucidum: what % of adult population
Normal in fetus and over 85% fuse by 3-6 months of age 15% in adult population
56
Cavum vergae: what is it?
Posterior continuation of cavum septum pellucidum Embryological fluid-filled space between leaflets of septum; common anatomic variant
57
Cavum velum interpositum: what is it?
Failure of fusion of the tela choroidea in the third ventricle
58

3 Pathology and Radiology (3 decks)

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