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Pediatrics > Pediatric Malignancies > Flashcards

Pediatric Malignancies Flashcards

1
Q

What type of cancers are more common in younger vs older children?

A
  • younger: embryonal (neuro, retino, hepato, medulllo, nephroblastoma)
  • older: epithelial (osteosarcoma)
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2
Q

Death in pediartic cancers usually occur in:

A
  • Infants <1 year

- Adolescents

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3
Q

What is the most common cancer in pediatrics?

A

Acute lymphoblastic leukemia

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4
Q

Which has a better prognosis

Acute myeloid or acute lymphoid??

A

Lympohoid with b-cell lineage

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5
Q

What is the peak age for acute lymphoblastic leukemia

A

2-5 yeats

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6
Q

First most common cancer in pediatrics:

A

Acute leukemia

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7
Q

2- Second most common group of cancers in children:

A

CNS malignancies

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8
Q

Usually short duration of symptoms, Constitutional symptoms, Related to the blasts infiltrating organs:

A

Acute leukemia

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9
Q

Acute leukemia emergencies:

A
  • Tumor Lysis Syndrome
  • Hyperleukocytosis / Leukostasis > More common in AML
  • Disseminated intravascular Coagulation (DIC) > Classic in a type of AML
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10
Q

Indicates increase risk of DIC:

A

Auer rods (mostly located in Acute promyelocytic leukemia M3)

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11
Q

Seen in Mature type of leukemia (Burkitt) & Indicates increase risk of tumor lysis syndrome:

A

Cytoplasmic vacuoles

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12
Q

Blasts should be ……. to be diagnosed as leukemia:

A

> 20%

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13
Q

Guide for prognosis and therapy of acute leukemia:

A

Cytogenetics / molecular

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14
Q

What is the standard risk for ALL?

A

WBC count < 50,000 AND Age between 1 and 10 in ALL:

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15
Q

What is the high risk for ALL?

A

WBC count > 50,000 OR Age < 1 or >10 in ALL:

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16
Q

What is a favorable prognosis of all?

A

Hyperdiploidy > 50 chromosomes:

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17
Q

Other factors that make patient high risk in ALL:

A

CNS disease / Testicular disease

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18
Q

Risk factors for AML (Certain syndromes):

A

Down syndrome / Fanconi anemia

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19
Q

Risk factors for AML (Acquired conditions):

A

Aplastic anemia / Myelodysplastic syndromes

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20
Q

Risk factors for AML (Environmental exposures):

A

Previous chemotherapy / Radiation / Benzene exposure

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21
Q

Translocation of acute promylocytic anemia

A

15:17

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22
Q

A type of vitamin A can induce differentiation and maturation of cells:

A

All trans-retionic acid (ATRA)

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23
Q

ALL is more common in general except in the first ….. of life - AML more common:

A

3 year

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24
Q

What is Transient Myeloproliferative Disorder

A
  • 10% of Down syndrome,
  • high WBC, anemia, thrombocytopenia
  • blasts in peripheral smear
  • hepatosplenomegaly
  • spontaneous resolution
  • 20 to 30% will develop AML later
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25
Q

Most common cancer in adolescents:

A

Hodgkin Lymphoma

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26
Q

What is Hodgkin Lymphoma characterised of

A
  • progressive enlargement of lymph nodes

‘slow, painless, non tender, firm lymph nodes’

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27
Q

B-symptoms are of prognostic value in which type of cancer

A

Hodgkin lymphoma:

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28
Q

Patients with immunodeficiencies are at increased risk of:

A

Non Hodgkin lymphoma

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29
Q

Microscopy of hodgkin lymohoma will show

A

Reed sternburg

30
Q

More likely to have extra-nodal presentation, usually high grade and aggressive, has a unpredictable pattern of spread:

A

:

Non Hodgkin lymphoma

31
Q

Most common type of Non Hodgkin lymphoma in 0-14 years age group:

A

Burkitt Lymphoma

32
Q

Most common type of Non Hodgkin lymphoma in 15-19 years age group:e

A

Diffuse Large B-cell Lymphoma

33
Q

Type of lymphoma

from mature cells (B-cell origin):
from immature cells (T-cell more common than B-cell):
from mature cells (T-cell origin):

A
  • Burkitt Lymphoma & Diffuse Large B-cell
  • Lymphoblastic Lymphoma
  • Anaplastic Large Cell Lymphoma
34
Q

Emergency of non-hodgkin lymphoma

A

Tumor Lysis syndrome, Superior mediastinal syndrome, Superior Vena Cava syndrome, Spinal Cord Compression

35
Q

Define Superior mediastinal syndrome (Non Hodgkin lymphoma)

A

Enlarged lymph nodes in the anterior mediastinum & Respiratory symptoms:

36
Q

Define Superior Vena Cava syndrome (Non Hodgkin lymphoma)

A

Compression of the superior vena cava, Swelling, plethora and cyanosis of the face, neck and upper extremities, Altered mental status:

37
Q

Define Spinal Cord Compression (Non Hodgkin lymphoma)

A

Localized back pain, Bowel / bladder incontinence, Loss of strength and sensation:

38
Q

Burkitt lymphoma translocation

A

t(8:14) c-myc:

39
Q

Jaw mass vs abdominal mass in lymphoma

A
  • endemic

- sporadic

40
Q

Optic pathway glioma is associated with

A

Neurofibromatosis Type 1

41
Q

Vestibular Schwannoma is associated with

A

Neurofibromatosis Type 2

42
Q

Subependymal giant cell astrocytoma (SEGA) is associated with

A

Tuberous Sclerosis

43
Q

Astrocytoma is associated with

A

Li-Fraumeni Syndrome

44
Q

What are supra tentorial tumors

A
  • Cerbral hemisphere: Low grade glioma (Pilocytic astrocytoma) &High grade glioma (glioblastoma multiform)
  • Sella - germ cell tumors
  • Chaism - optic pathway glioma
45
Q

What are the Infratentorial Tumors:

A
  • Posterior fossa
  • Medulloblastoma
  • Brain stem tumors
  • Low and high grade glioma (DIPG)
46
Q

The most common CNS tumors in children:

A

Infratentorial tumors

47
Q

Increased intracranial pressure symptoms

A

Headache, irritability, lethargy, vomiting, Papilledema, Bulging fontanelle are …… in CNS malignancies:

48
Q

Supratentorial masses symptoms

A

Lateralized deficits, Focal motor weakness, Language disorders, Focal seizures, Asymmetrical reflexes, In infants may present with premature hand preference, increasing size of head circumference

49
Q

Infratentorial symptoms

A

Disorders of equilibrium, gait and coordination:

50
Q

Brainstem malignancy symptoms

A

Multiple cranial nerve palsies:

51
Q

Most common CNS malignancy in children:

A

Pilocytic astocytoma

52
Q

How to treat pilocytic astrocytoma

A

Surgery only

53
Q

What is the growth rate of pilocytic astrocytoma

A

Slow growing

54
Q

What is the common site for pilocytic astrocytoma

A

cerebellum

55
Q

Name, the radio sensitive tumors in the lecture

A

Diffuse Intrinsic Pontine Glioma (DIPG

And high-grade astrocytoma

56
Q

Can you obtain biopsy from DIPG?

A

No, very critical site

57
Q

Where is the location of the medulloblastoma

A

Cerbellum vermis

58
Q

What is the risk that comes with medulloblastoma?

A

Leptomeningeal metastasis

59
Q

What is Most common extra cranial solid tumor in children:

A

Neuroblastoma

60
Q

What is the clinical presentation of neuroblastoma?

A

Abdomen mass (most common), Neck mass, Neurologic abnormalities (from sympathetic ganglia)

61
Q

Neuroblastoma

High or low risk of metastasis?

A

High

62
Q

Racoon eye is commonly seen in

A

Neuroblastoma

63
Q

What will you see in the basic investigations of neuroblastoma?

A

Anemia + thrombocytopenia + increased serum catechloamine metabolites (Homovanillic acid (HVA), Vanillymandelic acid (VMA))

64
Q

In neuroblastoma; Presence of …….. indicates more aggressive disease and less favorable prognosis:

A

n-myc amplification

65
Q

Most common renal tumor in children:

A

Wilm’s tumor

66
Q

Wilms tumor is characterized by

A

Asymptomatic abdominal mass felt by parents while bathing or clothing patient, Hypertension, Hematuria:

67
Q

Where is calcification more common

“Neuroblastoma or wilms tumor”

A

Neuroblastoma

68
Q

What is the tumor of

  • metaphysis
  • diaphesis
A
  • osteosarcoma

- Ewing sarcoma

69
Q

What is the pattern of osteosarcoma in x-ray

A

Sunburst appearance

70
Q

Ewing sarcoma occur in which type of bone

A

Flat

71
Q

Which one is more common to have fever

  • ewing
  • osteosarcoma
A

Ewing

72
Q

What is the x-ray finding of ewing sarcoma?

A

Moth eaten and onion peel

Pediatrics (41 decks)

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