Thursday 2 - bemis - CNS tumors Flashcards
__% of brain tumors are metastatic from another site
70%
the rest are primary brain tumors
meningiomas
low grade brain tumors, not as bad as glioblastomas
primary brain tumors general
circumscribed?
how common in children
two general names for them (very general)
poorly circumscribed
27% of all cancer in children
- meduloblastoma
- astrocytoma
metastatic brain tumors general
more circumscribed
very pleomorphic cells i.e. the nucleii all look different
WHO grading of the CNS tumor
names for each
histological malignancy scale
1 - pylocytic astrocytoma
2 - diffuse astrocytoma
3 - anaplastic astrocytoma
4 - Glioblastoma
read about them in other cards
adjuvant treatment
just Tx that follows the primary Tx
i.e. trying to get rid of residual cancer
children and adults: where are the majority of brain tumors
children: 70% are posterior fossa
adult: 70% are supratentorial
gliomas general
come from
common Sx
AKA astrocytomas
come from
- astrocytes
- oligodendrocytes
- ependymal cells
- headache
- seizure
- memory loss
- changes in behavior
grade 1 primary brain tumor
name
general characteristics
pylocytic astrocytoma
most often in children - low proliferative potential (e.x. meningiomas). histo: very pink rosenthal fibers with GFAP (glial fibrillary acid proteins.) relatively favorable outcome
how do you see fused DNA in a nucleus, like how they found BRAF fused to KIAA1549?
FISH
fluorescent in situ hybridization
grade 2 primary brain tumors
name
general characteristics
avg lifespans
2 - diffuse astrocytoma
generally infiltrative but low proliferative activity. usually recurr.
Lifespan >5 years
can progress to grade 3
usually get in your mid 30s-40s
hard to resect because they are diffuse ya dingus
what is never good to seen in resections of brain tissue
fibrils
Grade 3 primary brain tumor
name
general characteristics
avg lifespans
Anaplastic astrocytoma
shows more cellular regions
more pleomorphism, more mitoses.
2-3 years
GFAP
glial fibrillary acidic protein
you should see it in normal astrocytes, but you have way more astrocytes in astrocytomas (go figure) so you see a lot of it.
Grade 4 primary brain tumor
name
general characteristics - what type of necrosis is seen
avg lifespans
4 - Glioblastoma, primary or secondary (secondary meaning derived from grades 1,2,or3.)
cytologically malignant, mitotically active. PSEUDOPALISADING NECROSIS means the tumor cells are trying to get away from the necrosis. often pathologists will describe how many mitotically active cells they see on a slide. usually fatal.
survival depends. GBM ~1year. state of the art Tx may be 5+ years.
(primary glioblastoma is the most common primary brain tumor in adults. sometimes can see a “butterfly” glioma, where it crosses the midline of the brain.)
