Path: Tumors Flashcards
What are the most common tumors of the cerebrum in adults?
extra axial, intradural - meningioma
intra axial - diffusely infiltrating astrocytoma, oligodendroglioma, metastatic carcinoma, metastatic melanoma, malignant lymphoma
What cytologic and architectural features are evaluated when grading a diffusely infiltrating astrocytoma?
nuclear pleomorphism
mitotic figures
tumor necrosis - indicates grade 4 glioblastoma
microvascular proliferation - indicates grade 4 glioblastoma
Compare and contrast pilocytic astrocytoma (WHO grade 1) and diffusely infiltrating astrocytoma (WHO grade 2).
younger ages vs. older ages usually cerebellum vs. cerebrum well circumscribed vs. poorly circumscribed minimal vs. diffuse infiltration better prognosis vs. worse
What are the grades of the Schwann cell neoplasms of the peripheral nervous system?
scwannoma - WHO grade1
neurofibroma - WHO grade 1
malignant peripheral nerve sheath tumor, WHO grades 2,3,4
What is the hallmark tumor of tuberous sclerosis?
subependymal giant cell astrocytoma
What is the hallmark tumor of von Hippel-Lindau syndrome?
hemangioblastoma
What are the environmental factors with or without relationships to nervous system tumors?
no toxin with proven association no association with smoking no association with any viruses no association with trauma no association yet with cell phone use IS an association with HIGH dose X-irradiation (not low dose)
What are familial tumor syndromes with nervous system tumors?
NF1, NF2, tuberous sclerosis, von Hippel-Lindau
What kind of cells do the type and grade of a neoplasm refer to?
UNRESECTED
What are the different cranial compartments that can have tumors?
parenchymal (intra-axial) outside parenchyma (extra-axial) but intra-dural epidural (skull and scalp)
What are the different spinal compartments that can have tumors?
parenchymal (intramedullary) outside parenchyma (extramedullary) but intradural epidural (fat and vertebrae)
What are the different classifications of astrocytomas?
not diffusely infiltrating (grade 1) = pilocytic astrocytoma
grade 2 = diffuse astrocytoma
grade 3 = anaplastic astrocytoma
grade4 = glioblastoma
What are the genetics of diffusely infiltrating astrocytomas?
mutations of isocitrate dehydrogenase (IDH) in grades 2 or 3 - produces 2-hydroxyglutarate instead of alpha-ketoglutarate
mutations of TP53 - grade 4, worse prognosis
What are primary vs secondary glioblastomas?
secondary - younger pts by progression from lower grade
primary - after short hx without evidence of lower grade, majority in adults
Who has better prognosis - low grade oligodendroglioma or low grade astrocytoma?
low grade oligodendroglioma
