Sketchy Path: Neuro - "Adult CNS Tumors"

Question 1

The three most common metastatic brain cancers are _________________.

Answer 1

lung cancer, breast cancer, and melanoma (woman with crabs on her shirt and jacket and an ink stain on her pants)

Question 2

Metastases typically have what patter on MRI?

Answer 2

Nodular, clustered, ring-enhancing pattern (like the clusters of crabs with the ringed planet behind them)

Question 3

The only established risk factor for primary CNS tumors is ________________.

Answer 3

radiation (particularly CTs during childhood)

Question 4

What are the symptoms of CNS tumors?

Answer 4

• Seizures (guy shaking outside ship)
• Focal neurologic deficit (magnifying glass outside his helmet)
• Intracranial hypertension (guy with air leak from his helmet that resembles steam)

Question 5

The most common primary CNS tumor is ______________.

Answer 5

meningioma

Question 6

On imaging, _____________ can be seen in meningiomas.

Answer 6

well-circumscribed peripheral lesions with a dural tail

Think of the well-circumscribed head antennae with tails on the meningioma girl.

Question 7

While they do not grow into brain parenchyma, meningiomas can penetrate ________________.

Answer 7

the interhemispheric fissure (on the falx cerebri)

Question 8

The classic pathologic sign of meningiomas is ________________.

Answer 8

the psammoma body (like the whirled galaxy design on her shirt)

Question 9

The most common glial cell tumor in adults is _________________.

Answer 9

astrocytoma (which includes gliomas and glioblastomas)

Question 10

Unfortunately, the most common malignant tumor in adults is _______________.

Answer 10

glioblastoma

Question 11

Glioblastomas are most commonly found in which lobes?

Answer 11

Frontal and temporal (like the Klingon’s stains on the front and sides of his head)

Question 12

Glioblastomas (like all gliomas) stain positive for __________________.

Answer 12

glial fibrillary acidic protein (GFAP)

Think of the Galaxy Federation of Allied Planets banner.

Question 13

_____________ are slow-growing tumors that often present in the temporal and frontal white matter.

Answer 13

Oligodendrogliomas

Question 14

90% of oligodendrogliomas show some degree of _______________.

Answer 14

calcification (like the glass of milk near the oligodendroglioma monitor)

Question 15

List two descriptive features of oligodendrogliomas.

Answer 15

• Fried-egg look (fried eggs)

* Chicken-wire capillary beds (like the chicken-wire design on his visor)

Question 16

______________ (a genetic condition) predisposes people to hemangioblastomas of the CNS.

Answer 16

von Hippel Lindau (like the Nascar-driving pilot with bright red hair)

(Double mnemonic: there is a BLAST behind her red hair to help you remember hemangioblastoma.)

Question 17

Hemangioblastomas stain positive for ________________.

Answer 17

PAS –periodic acid-Schiff (like the UFO PASsing by)

Question 18

In addition to hemangioblastomas in the CNS, those with vHL are at increased risk of _________________.

Answer 18

bilateral RCC (crabs on Nascar jersey), retinal hemangioblastomas, pheochromocytomas (rainbow frappe on table), and cavernous hemangiomas (red yarn in little cave)

Question 19

Which are more likely to rupture, hemangiomas or hemangioblastomas?

Answer 19

Hemangiomas (like the puddle of blood leaking out of the cave)

Hemangioblastomas have a relatively normal architecture (represented by the smooth muscle headband), and thus are less likely to break.

Question 20

Immunocompromised individuals are at increased risk of which type of CNS cancer?

Answer 20

Primary lymphoma (like the guy with crutches next to the chess board with archers and knights)

Question 21

Almost all primary CNS lymphomas are associated with _______________.

Answer 21

Epstein-Bar virus (like the beer from Epstein’s bar)

Question 22

Primary CNS lymphomas tend to arise near ________________.

Answer 22

the ventricles in the white matter