Pathology of CNS Neoplasia Flashcards

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1
Q

T/F: Primary brain tumors are relatively common in adults.

A

False. Common in children (20% of all cancer in children)

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2
Q

Most adult brain tumors occur in ____

A

Cerebral hemisphere, above the tentorium

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3
Q

Most children brain tumors occur in _____

A

Cerebellum and brainstem, below the tentorium

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4
Q

Most common glial tumor

A

glioblastoma

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5
Q
Which of the following is NOT a common type of metastases that causes CNS tumors?
A. Lung
B. Breast
C. Melanoma
D. Pituitary
A

D

Also commonly renal, colorectal

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6
Q
Which of the following is NOT common CNS tumor in adults?
A. Astrocytomas (glioblastoma)
B. Meningioma
C. Pilocytic astrocytoma
D. Metastasis
A

C. Common in children

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7
Q
Which of the following is NOT common CNS tumor in children?
A. Medulloblastoma
B. Pilocytic astrocytoma
C. Meningioma
D. Craniopharyngioma
A

C. Common in adult

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8
Q

T/F: Ependymoma is mostly exclusively seen in children.

A

False. Has wide age distribution. 5-10% of pediatric tumors.

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9
Q
Which of the following is NOT a glioma?
A. Astrocytoma
B. Pilocytic astrocytoma
C. Oligodendroglioma
D. Ependymoma 
E. Medulloblastoma
A

E

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10
Q

Genetic mutations (2) associated with primary glioblastoma.

A

EGFR amplification

PTEN mutation

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11
Q

Genetic mutation associated with secondary glioblastoma.

A

TP53 mutation

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12
Q

Which of the following about Astrocytoma WHO II is TRUE?
A. Mass lesion with enhancement on imaging
B. Hemorrhage and necrosis is present
C. Mitosis is present.
D. Hypercellular atypical astrocytes w/ angular, hyperchromatic nuclei

A

D. Mildly hypercellular

A. W/o enhancement
B. NO hemorrhage or necrosis
C. NO mitosis activity

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13
Q

Anaplastic astrocytoma WHO III must have ___

A

mitosis

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14
Q

Which of the following about Glioblastoma WHO IV is FALSE?
A. Mass lesion w/o enhancement on imaging
B. Necrosis and vascular proliferation present
C. Pseudopalisading necrosis present
D. Mass effect

A

A

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15
Q

Most common location of pilocytic astrocytoma

A

cerebellum

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16
Q

Name the glioma:

Cystic w/ enhancing mural nodule

A

Pilocytic astrocytoma

17
Q

Which of the following is FALSE about Pilocytic Astrocytoma?
A. Pathology shows rosenthal fibers (thick, elongated, brightly eosinophilic inclusions in astrocytic processes)
B. Presents with papilledema, hypdrocephalus, cerebellar signs, headache.
C. Aggressive prognosis
D. Most common low grade tumor in children.

A

C. Rarely aggressive

18
Q

T/F: Oligodendroglioma is common in adults.

A

True

19
Q
Which of the following is TRUE about Oligodendroglioma?
A. No ring enhancement on imaging
B. Seizures are common 
C. Infratentorial
D. Atypical pleomorphic cells
A

B. Cortical invasion causes seizures commonly

A. Variable enhancement
C. Supratentorial, especially frontal lobe
D. Uniform cells with perinuclear clearing (halo)

20
Q

T/F: Oligodendroglioma grade IV presents with necrosis and vascular proliferation

A

False.

There is NO grade IV. Oligodendroglioma Grade III presents this way.

21
Q

Perivascular pseudorosette formation seen in ____

A

Ependynoma WHO II-III

22
Q

Most common location of ependynoma in children

A

Infratentorial: 4th ventricle/posterior fossa

Supratentorial common in adults

23
Q

Which of the following about ependynoma is TRUE?
A. Found in spinal cord in children more than adults.
B. Diffusely infiltrates brain
C. Presents with hydrocephalus
D. Stain for glial fibrillary acidic protein negative

A

C

A. More common in adults
B. Does NOT diffusely infiltrate brain. Grossly discrete.
D. Positive stain

24
Q

T/F: Medulloblastoma common in children/young adults

A

True

25
Q

Which of the following about Medulloblastoma is TRUE?
A. Rarely aggressive
B. Location = Midline cerebellum/posterior fossa
C. Non-enhancing imaging
D. Involves the 4th ventricle
E. Low mitotic activity

A

B

A. Aggressive: 5 year survival: 75%
C. Enhancing midline cerebellar mass
D. NO 4th ventricle involvement
E. High mitotic activity, necrosis

26
Q

Which to the following is TRUE about Cranioharyngioma?
A. More common in adults
B. Located in suprasellar region (pituitary gland)
C. Presents with headache and seizures
D. Surgery to resect is common done to treat
E. No enhancement on imaging

A

B.

A. Common in children
C. Visual changes and endocrine (Diabetes)
D. Sx difficult depending on involvement of hypothalamus and optic chiasm
E. Enhancing suprasellar mass MRI

27
Q

Name the CNS tumor:
Pathology composed of nests and whorls of meningothelial cells
Calcification

A

Meningioma

28
Q

Which of the following about Primary CNS Lymphoma is TRUE?
A. Seen commonly in children
B. Does not respond to steroids
C. Most are diffuse B cell lymphomas
D. Slow mitotic rate with little necrosis

A

C

A. Common in elderly or immunosuppressed
B. Responds to steroids initially
D. Fast mitotic activity, ooften w/ necrosis