Path XVI Flashcards
most frequent glial tumor in children
pilocytic astroctyoma
pilocytic astrocytomas develop where
cerebellum
thalamus
hypothalamus
optic nerve
well circumscribed, not diffuse
solid and cystic in cerebellum in child
hydrocephalus
pilocytic astrocytoma
Prognosis pilocytic astrocytoma
overall good prognosis
histo of pilocytic astrocytoma
cytoplasm very thin
gelatinous cyst material
GFAP + b/c astrocytic
diffuse astrocytoma
any site in CNS: supratentorial
seizures, headaches, focal signs
tendency to progress higher grade
prognosis diffuse astrocytoma
5-7 years
what is a diffuse pontine glioma
astrocytoma
most frequent glial tumor in adults
glioblastoma WHO IV
glioblastoma signs
seizures, HA, focal deficits
supratentorial
survival around a year
primary glioblastoma
loss of heterogenicity!!
secondary glioblastoma
starts low grade astrocytoma, anaplastic
IDH1 and 2 point mutations
TP53
loss of heterogenicity
isocitrate dehydrogenase mutation
secondary glioblastoma
IDH mutations have better or worse prognosis
better
why do glioblastomas light up with contrast
neovascularization
what are the sheets of pink in the sea of blue cells in glioblastoma
necrosis
where do oligodendrogliomas grow
supratentorial
cortical
white matter
frontal lobe!!
presentation oligodendrogliomas
long Hx headaches and seizures
mutations in olidodendrogliomas
IDH1/2
deletion 1p and 19q
what mutation determines long lasting response to chemo and radiation
1p 19q
fried egg appearance on brain tissue histo with calcifications
oligodendroglioma
medulloblastomas form where
posterior fossa in vermis
signs of medulloblastoma
ataxia and signs of increased pressure
where do medulloblastomas disseminate
subarachnoid space
prognosis medulloblastomas
50-70% 5 yr
medulloblastomas arise from
stem cells in subependymal matrix in extra granular layer of cerebellum
are medulloblastomas cystic
no
solid
homer wright rosettes
medulloblastoma
CSF in medulloblastoma
high protein
low glucose
tumor cells +
Tx medulloblastoma
resection, shunting, radiation, intrathecal chemo
“caked” surface on brain of tumor
medulloblastoma
CNS lymphoma thought to arise from
microglia
patients affected by PCNSL
immunocompromised
PCNSL is usually what type
diffuse large B cell lymphoma
Dx PCNSL
Biopsy or IHC studies
test needed to be done on immunocompromised patient with PCNSL
EBV positive
spread of PCNSL
meningeal
Tx PCNSL
corticosteroids induce apoptosis
majority mets tumors are what kind
brain tumors
primary tumor in men causing brain tumors
lung
primary tumor in women causing brain tumors
breast cancer
tumor with highest rate of mets
melanoma
signs of meningeal carcinomatosis
headache, drowsiness,CN deficits, spinal root pain, paresthesias
CSF in meningeal carcinomatosis
high protein
low glucose
few lymphocytes
ependymoma
slow growing tumor, well circumscribed but can disseminate
hydrocephalus
in ventricular sytem and spinal cord
where are schwannomas in CNS
vestibular branch of 8th CN
syndrome with b/l schwanomas (benign)
NF2
histo ependymoma
rossette with empty lumen
