Pathology of brain tumors Flashcards
what % of brain tumors are primary? which are metastatic?
50%, 50%
what is the most common primary brain tumor?
glioblastoma multiforme 40%
what is the order of prevalence of metastatic brain tumors?
LuBGOM
- lung
- breast
- GU (renal cell carcinoma)
- osteosarcoma
- melanoma
- (GI)
where do metastatic brain tumors usually arise? what is the appearance?
- gray / white junction
- well circumscribed
what are symptoms that suggest a rise in ICP?
- headache
- vomiting WITHOUT nausea
- papilledema
OTHERS:
- ocular palsies
- altered level of consciousness
- back pain
what is given to lower ICP?
mannitol asap
how do brain tumors differ between children and adults based on location?
- children: infratentorial
- adult: supratentorial
how do brain tumors differ between children and adults based on histology?
ADULT:
- glioblastoma multiforme
- meningioma
- hemangioblastoma
- schwannoma
- oligodendroglioma
- pituitary adenoma
CHILDREN:
- pilocytic (low grade) astrocytoma
- medulloblastoma
- ependymoma
- craniopharyngioma
what is the histology for glioblastoma?
- marked cellularity
- marked hyperchromatism and pleomorphism
- prominent vascularity
- area of necrosis with palisading cells around it
can / does glioblastoma multiforme cross the corpus callosum?
yes
glioblastoma multiforme stains for what marker?
GFAP - glial fibrillary acidic protein
what is GFAP? what is its role?
- glial fibrillary acidic protein
- intermediate filament protein that is expressed by numerous cell types in CNS including astrocytes and ependymal cells
what is the histology of (benign) meningiomas?
- tight WHORLING by spindle tumor cells
-
histology:
- marked cellularity
- marked hyperchromatism and pleomorphism
- prominent vascularity
- area of necrosis with palisading cells around it
glioblastoma multiforme
histology:
- tight whorling of spindle cells
- psammoma bodies
meningoma (benign)
which tumors / cancers display psammoma bodies?
- papillary thyroid carcinoma
- papillary serous cystadenocarcinoma of ovary
- meningioma
- papillary renal cell carcinoma
histology: hemangioblastoma
- 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
hemangioblastomas are associated with what syndrome?
VHL
hemangioblastomas can cause secondary polycythemia by production of what compound?
EPO
- closely arranged, thin walled capillaries with MINIMAL interweaving parenchyma
- stromal cells contain bubbly cytoplasm that stains positive for fat
hemangioblastoma
gross morphology for schwannoma
fish flesh appearance, soft tan in color
schwannomas stain positive for what marker?
S-100
bilateral schwannomas are found in what disease?
NF-2
histology: oligodendroglioma
- 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
