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%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

how are brain tumours classified?

A

tissue of origin
location
primary or secondary
grading

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what is a GX grading for a CNS tumour?

A

grade cannot be assessed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what is a G1 grading for a CNS tumour

A

well differentiated (low grade)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what is a G2 grading for a CNS tumour?

A

moderately differentiated (intermediate grade)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what is a G3 grading for a CNS tumour?

A

poorly differentiated (high grade)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what is a G4 grading for a CNS tumour?

A

undifferentiated (high grade)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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%
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

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

A

disturbances in coordination and equilibrium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

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

A

endocrine dysfunction
visual deficits
headache

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

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

A

paraethesia
loss of 2 part discrimination
visual field deficits

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

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

A

psychomotor seizures
hallucinations
loss of consciousness without convulsions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

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

A

visual disturbances

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what are some classifications of intra axial tumours?

A
gliomas
oligodendroglioa
ependymomas
medulloblastoma
CNS lymphoma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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