Pathology of Intracranial Tumours Flashcards
What are some causes of raised ICP?
Haemorrhage
Tumour
Abscess
Oedema - post trauma
What is subfalcine herniation?
Herniation of the falx cerebri
What is cerebella tonsillar herniation?
Tonsils of the cerebellum are moved inwards and downwards and crush the brainstem
How can tumours cause localised ischaemia?
Tumours can squeeze nearby tissue and cause local ischaemia
What is a sign and a symptoms of a tumour pressing on the cortex and brainstem?
Morning headaches and sickness
What is a sign and symptoms of a tumour pressing on the optic nerve?
Papilloedema
What are the consequences of increased ICP?
Pupillary dilation
Falling GSC
Brain stem death
Where does the cerebellum move in raised ICP?
Squeezes the cerebellum downwards and into the foramen magnum crushing the brainstem
In relation to the tentorium where are the majority of adult tumours?
Above the tentorium
In relation to the tentorium where are the majority of chil tumours?
Below the tenotrium
What is a glioma?
Cancer of the glial cells
Do gliomas metastasise out of the CNS?
No
What is an astrocytoma?
Glioma of astrocytes
What is an oligodendroglioma?
Glioma of oligodendrocytes
What is an ependymoma?
Glioma of ependymal cells
What shape is an astrocyte?
Star
What are the 2 extremes of astrocytoma?
Low grade astrocytoma
Glioblastoma
Describe low grade astrocytoma pathology?
Bland cells on microscopy
Grows very slowly
What is the most malignant type of astrocytoma?
Glioblastoma
Describe the pathology of glioblastoma
Large tumour with necrosis
Cellular, atypical tumour with necrosis
Grow quickly
What is a medulloblastoma?
Paediatric tumour of primitive neuroectoderm (primitive neural cells)
What is the neuroectoderm?
Primitive neural cells
Where do medulloblastoma originate?
Posterior fossa
Particularly in the brainstem
What is a meningioma?
Tumour of the cells that make up the meninges
From arachnocytes
Are meningioma usually malignant?
No usually benign
Are meningioma fast or slow growing?
Slow
Are meningiomas usually resectable?
Yes
What are nerve sheath tumours?
Tumours around peripheral nerves
What is a schwannoma?
Tumur of scwann cells
What do schwann cells in the PNS?
Myelin sheath
What is an Acoustic neuroma?
8th vestibulochoclear nerve schwannoma at angle between pons and medulla
Where does CN VIII originate from?
Pontomedullar junction
What is the main symptoms of a acoustic neuroma?
Unilateral deafness
What is a pituitary adenoma?
Benign tumour in the pituitary fossa
What do pituitary adenomas usually secrete?
A pituitary hormone
Where can pituitary adenomas grown and impinge?
On optic chiasma
If someone has visual signs where could the tumour have originated and be pressing on?
Pituitary adenoma pressing on the optic chiasma
What is a CNS lymphoma?
high grade neoplasm
Usually diffuse large B cell lymphoma
Why are CNS lymphoma difficult to biopsy?
Because they are often deep and of central site in the brain
Do CNS lymphoma usually spread outside the CNS?
No
What are haemangioblastomas?
Tumours of blood vessels
Where are haemangioblastomas usually located?
In the cerebellum
What is the most common secondary tumour?
Carcinoma
What is the histology of secondary brain tumours?
Similar to that of the primary tumour
