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Year 2 Neurology > Pathology of brain tumors > Flashcards

Pathology of brain tumors Flashcards

1
Q

what % of brain tumors are primary? which are metastatic?

A

50%, 50%

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2
Q

what is the most common primary brain tumor?

A

glioblastoma multiforme 40%

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3
Q

what is the order of prevalence of metastatic brain tumors?

A

LuBGOM

  • lung
  • breast
  • GU (renal cell carcinoma)
  • osteosarcoma
  • melanoma
  • (GI)
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4
Q

where do metastatic brain tumors usually arise? what is the appearance?

A
  • gray / white junction

- well circumscribed

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5
Q

what are symptoms that suggest a rise in ICP?

A
  • headache
  • vomiting WITHOUT nausea
  • papilledema

OTHERS:

  • ocular palsies
  • altered level of consciousness
  • back pain
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6
Q

what is given to lower ICP?

A

mannitol asap

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7
Q

how do brain tumors differ between children and adults based on location?

A
  • children: infratentorial

- adult: supratentorial

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8
Q

how do brain tumors differ between children and adults based on histology?

A

ADULT:

  • glioblastoma multiforme
  • meningioma
  • hemangioblastoma
  • schwannoma
  • oligodendroglioma
  • pituitary adenoma

CHILDREN:

  • pilocytic (low grade) astrocytoma
  • medulloblastoma
  • ependymoma
  • craniopharyngioma
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9
Q

what is the histology for glioblastoma?

A
  • marked cellularity
  • marked hyperchromatism and pleomorphism
  • prominent vascularity
  • area of necrosis with palisading cells around it
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10
Q

can / does glioblastoma multiforme cross the corpus callosum?

A

yes

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11
Q

glioblastoma multiforme stains for what marker?

A

GFAP - glial fibrillary acidic protein

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12
Q

what is GFAP? what is its role?

A
  • glial fibrillary acidic protein

- intermediate filament protein that is expressed by numerous cell types in CNS including astrocytes and ependymal cells

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13
Q

what is the histology of (benign) meningiomas?

A
  • tight WHORLING by spindle tumor cells

-

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14
Q

histology:

  • marked cellularity
  • marked hyperchromatism and pleomorphism
  • prominent vascularity
  • area of necrosis with palisading cells around it
A

glioblastoma multiforme

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15
Q

histology:

  • tight whorling of spindle cells
  • psammoma bodies
A

meningoma (benign)

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16
Q

which tumors / cancers display psammoma bodies?

A
  • papillary thyroid carcinoma
  • papillary serous cystadenocarcinoma of ovary
  • meningioma
  • papillary renal cell carcinoma
17
Q

histology: hemangioblastoma

A
  • closely arranged, thin walled capillaries with MINIMAL interweaving parenchyma
  • hemangioma-based parenchyma
  • stromal cells contain bubbly cytoplasm that stains positive for fat
  • pleomorphism of nuclei
  • generally benign
18
Q

hemangioblastomas are associated with what syndrome?

A

VHL

19
Q

hemangioblastomas can cause secondary polycythemia by production of what compound?

A

EPO

20
Q
  • closely arranged, thin walled capillaries with MINIMAL interweaving parenchyma
  • stromal cells contain bubbly cytoplasm that stains positive for fat
A

hemangioblastoma

21
Q

gross morphology for schwannoma

A

fish flesh appearance, soft tan in color

22
Q

schwannomas stain positive for what marker?

A

S-100

23
Q

bilateral schwannomas are found in what disease?

A

NF-2

24
Q

histology: oligodendroglioma

A
  • small round nuclei with perinuclear halo (FRIED EGG appearance)
  • increase in small vessels forming trabeculae
  • CHICKEN WIRE appearance (describing the vascular structures, not parenchyma)
  • often calcified
25
Q

in what lobes do oligodendrogliomas usually present?

A

frontal

26
Q
  • small round nuclei with perinuclear halo (FRIED EGG appearance)
  • increase in small vessels forming trabeculae
  • CHICKEN WIRE appearance
  • often calcified
A

oligodendroglioma

27
Q

histology: juvenile pilocystic astrocytoma

A
  • microcystic change
  • small, well differentiated nuclei
  • rosenthal fibers
28
Q

what are rosenthal fibers? in which tumors are they typically seen?

A
  • thick, elongated, worm-like or “corkscrew” eosinophilic bundles on H&E
  • clumped intermediate filament proteins
  • seen in pilocytic (low grade) astrocytoma (and some metabolic disorders)
29
Q

where are pilocytic astrocytomas usually found?

A

cerebellum

30
Q

histology: medulloblastoma

A
  • homer wright rosettes

- small round blue cells

31
Q

what is the germ layer or origin for medulloblastomas?

A

primitive neuroectoderm

32
Q

how can medulloblastomas cause hydrocephalus?

A

compression of 4th ventricle

33
Q

which brain tumor exhibits homer wright rosettes?

A

medulloblastoma

34
Q

histology: ependymoma

A
  • perivascular pseudorosette
  • small vessel in center
  • rod shaped blepharoplasts (basal ciliary bodies) near nucleus
35
Q

what is a blepharoplast? in which tumor is it seen?

A
  • modified centriole

- ependymoma

36
Q

what is the most common childhood supratentorial tumor?

A

craniopharyngioma

37
Q

craniopharyngiomas are derived from what developmental area?

A

rathke’s pouch

Year 2 Neurology (23 decks)

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