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neurology > pathology of brain tumours > Flashcards

pathology of brain tumours Flashcards

1
Q

where are the 4 most common sites that a primary tumour can metastasize to the brain from?

A

lung- 35%
breast- 20%
kidney - 10%
GI tract - 5%

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2
Q

how are brain tumours classified?

A

tissue of origin
location
primary or secondary
grading

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3
Q

what is a GX grading for a CNS tumour?

A

grade cannot be assessed

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4
Q

what is a G1 grading for a CNS tumour

A

well differentiated (low grade)

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5
Q

what is a G2 grading for a CNS tumour?

A

moderately differentiated (intermediate grade)

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6
Q

what is a G3 grading for a CNS tumour?

A

poorly differentiated (high grade)

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7
Q

what is a G4 grading for a CNS tumour?

A

undifferentiated (high grade)

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8
Q

what are some common ways that a brain tumour can present?

A 
neurological deficit 68%
motor weakness 45%
mental status changes
seizures 26%
headache 54%
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9
Q

what are some general signs and symptoms of brain tumours?

A 
cerebral oedema
increased ICP
focal neuro deficits
obstruction of CSF flow
pituitary dysfunction
papilloedema
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10
Q

what are some signs and symptoms that are specific to cerebral tumours?

A

headache
vomiting NOT related to food intake
changes in visual fields and acuity

hemiparesis or hemiplegia
hypokinesia
decreased tactile discrimination
seizures
changes in personality or behaviour
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11
Q

what are som signs and symptoms more specific to brainstem tumours?

A 
hearing loss
facial pain and weakness
dysphagia, decreased gag reflex
nystagmus
hoarseness
ataxia
dysarthria
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12
Q

what are some signs and symptoms more specific to cerebellar tumours?

A

disturbances in coordination and equilibrium

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13
Q

what are some signs and symptoms more specific to pituitary tumours?

A

endocrine dysfunction
visual deficits
headache

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14
Q

what are some signs and symptoms more specific to frontal lobe tumours?

A 
inappropriate behaviour
personality changes
inability to concentrate 
impaired judgement
memory loss
headache
expressive aphasia
motor dysfunctions
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15
Q

what are some signs and symptoms more specific to parietal lobe tumours?

A

paraethesia
loss of 2 part discrimination
visual field deficits

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16
Q

what are some signs and symptoms more specific to temporal lobe tumours?

A

psychomotor seizures
hallucinations
loss of consciousness without convulsions

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17
Q

what are some signs and symptoms more specific to occipital lobe tumours?

A

visual disturbances

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18
Q

what are some classifications of intra axial tumours?

A 
gliomas
oligodendroglioa
ependymomas
medulloblastoma
CNS lymphoma
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19
Q

what are 3 types of glioma?

A

astrocytoma
anaplastic astrocytoma
glioblastoma multiforme

20
Q

where do ependymomas originate from?

A

lining of the ventricle

21
Q

what types of patients are CNS lymphomas common in?

A

immunocompromised patients

22
Q

what are some classifications of extra axial tumours?

A 
meningioma
metastatic
acoustic neuromas
pituitary adenoma
neurofibroma
23
Q

what do meningiomas arise from?

A

arachnoid cap cell types from the arachnoid membrane

24
Q

are meningiomas usually non invasive?

A

yes

25
Q

where are some common locations for meningiomas?

A

parasagittal region
sphenoid wing
parasellar region

26
Q

how do meningiomas present?

A

asymptomatic
focal or generalized seizure
gradually worsening neurological deficit

27
Q

what is a defining characteristic of meningiomas when contrast is increased on MRI and CT?

A

they become enhanced with contrast

28
Q

do diffuse low grade astrocytomas infiltrate surrounding tissue?

A

yes, widely

29
Q

where in the brain do diffuse low grade astrocytomas present?

A

frontal region in the subcortical white matter

30
Q

how do diffuse low grade astrocytomas present?

A

seizures
headaches
slowly progressive neurological deficits

31
Q

do diffuse low grade astrocytomas enhance with contrast when imaged?

A

not usually

32
Q

what is more sensitive when attempting to stage a diffuse low grade astrocytoma - CT or MRI?

A

MRI

33
Q

how does a glioblastoma infiltrate?

A

along white matter (can cross the corpus callosum)

34
Q

where do glioblastomas present?

A

frontal and temporal lobes

basal ganglia

35
Q

how do glioblastomas present?

A

seizures
headache
slowly progressive neurologic deficits

36
Q

what are some features of a glioblastoma when viewed on a CT?

A

hypodense/isodense
central hypodense area of necrosis surrounded by thick enhancing rim
surrounding oedema

37
Q

how are oligodendrogliomas distinguished from astrocytomas?

A

“fried egg” appearance

38
Q

what do oligodendrogliomas arise from?

A

myelin

39
Q

where are oligodendrogliomas located?

A

superficially in frontal lobes

40
Q

how do oligodendrogliomas present?

A

seizures most common
headache
slowly progressive neurologic deficits

41
Q

how do oligodendrogliomas look on a CT?

A

well circumscribed, hypodense lesions with heavy calcification
cystic degeneration of common but haemorrhage and oedema are uncommon

42
Q

what are some features of a CNS lymphoma?

A

B lymphocytes
increased ICP
brain destruction

43
Q

what can cause haemorrhagic brain mets?

A

melanoma
renal cell
choriocarcinoma

44
Q

what are some imaging modalities that can be used to diagnose brain tumours?

A 
CT scan with/without contrast
MRI with/without contrast
plain films
myelography
PET scan
45
Q

what kind of tumours might a CT scan miss?

A

small tumours
brain stem tumours
low grade astrocytomas
tumours adjacent to bone

46
Q

what are some post op complications that may arise from removal of a brain tumour?

A 
raised ICP
hypovolemic shock
hydrocephalus
atelectasis
pulmonary oedema
meningitis
CSF leak
seizures

neurology (29 decks)

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