Tumors Flashcards

0
Q

Diffuse Astrocytoma

A
  • Grade II
  • No mitosis
  • Pleomorphic, angulated and hyperchromatic nucleus
  • Pathology: diffusely invades cerebrum producing midline shift
  • Gemistocytic variant: plump cells with pink cytoplasm
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1
Q

List the diffuse, infiltrating astrocytomas

A
  1. Diffuse Astrocytoma (Grade II)
  2. Anaplastic Astrocytoma (Grade III)
  3. Glioblastoma (Grade IV)
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2
Q

Anaplastic Astrocytoma

A

-Grade III (mitosis)

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3
Q

Glioblastoma

A
  • Grade IV

- Necrosis, microvascular proliferation, glomeruloid tufts

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4
Q

Glioblastoma genotypes

A
  • Primary: older people, EGFR

- Secondary: younger people, P53, IDH1/IDH2 (better prognosis)

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5
Q

What is the relatively circumscribed, non-infiltrating tumor we learned about?

A

Pilocytic Astrocytoma

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6
Q

Pilocytic Astrocytoma

A
  • Grade I (non-infiltrative, rarely progress, well circumscribed/easy to resect)
  • 7q34 BRAF+ KIAA1549 novel fusion oncogene
  • Children and young adults
  • Cystic cerebellar lesion
  • Rosenthal fibers
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7
Q

Oligodendrogliomas

A
  • Grade II
  • Well differentiated, infiltrating tumor
  • Expands into gyri and deep white matter
  • Fried egg/chicken wire appearance (vessels branching capillaries)
  • Loss of heterozygosity
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8
Q

Embryonal Tumors

A

Medulloblastoma

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9
Q

Medulloblastoma

A
  • Grade IV embryonal tumor made from granule neurons
  • Most commonly vermis–>4th ventricle
  • Well circumscribed, gray/pink with small foci areas of necrosis and gelatinous opacification with CSF dissemination
  • 40% have Homer-Wright Rosettes (rosette around neuropil)
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10
Q

Ependymomas

A
  • Grade II

- Pseudorosettes (neoplastic cells cluster around blood vessels)

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11
Q

List the cranial/spinal nerve tumors

A

Schwannomas and Neurofibromas

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12
Q

Schwannoma

A
  • Slowly growing neoplasm
  • CN VIII most commonly effected
  • NF2 patients present with bilateral CN VIII involvement
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13
Q

Neurofibromas

A
  • Grade I
    1. Dermal producing nodular lesion of skin or 2. Intraneural, solitary or plexiform
  • If multiple=NF1
  • incorporates axons, are harder to remove whereas schwannoma displaces normal elements of nerve to one side
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14
Q

Meningioma

A
  • Meningothelial cells of the leptomeninges
  • F>M
  • Occurs in 50% of pts with NF2
  • Transitional meningioma=whorls and cords of neopastic cells
  • Psammomatous meningioma=numerous compact whorls
  • Fibrous=fibrous
  • 15% of intracranial neoplasma are meningiomas
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15
Q

Metastatic tumors

A
  • Secondary CNS neoplasms account for 15%

- Most commonly from: Lungs, breast, skin, kidney and colon