Tumors Flashcards
Diffuse Astrocytoma
- Grade II
- No mitosis
- Pleomorphic, angulated and hyperchromatic nucleus
- Pathology: diffusely invades cerebrum producing midline shift
- Gemistocytic variant: plump cells with pink cytoplasm
List the diffuse, infiltrating astrocytomas
- Diffuse Astrocytoma (Grade II)
- Anaplastic Astrocytoma (Grade III)
- Glioblastoma (Grade IV)
Anaplastic Astrocytoma
-Grade III (mitosis)
Glioblastoma
- Grade IV
- Necrosis, microvascular proliferation, glomeruloid tufts
Glioblastoma genotypes
- Primary: older people, EGFR
- Secondary: younger people, P53, IDH1/IDH2 (better prognosis)
What is the relatively circumscribed, non-infiltrating tumor we learned about?
Pilocytic Astrocytoma
Pilocytic Astrocytoma
- 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
Oligodendrogliomas
- Grade II
- Well differentiated, infiltrating tumor
- Expands into gyri and deep white matter
- Fried egg/chicken wire appearance (vessels branching capillaries)
- Loss of heterozygosity
Embryonal Tumors
Medulloblastoma
Medulloblastoma
- 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)
Ependymomas
- Grade II
- Pseudorosettes (neoplastic cells cluster around blood vessels)
List the cranial/spinal nerve tumors
Schwannomas and Neurofibromas
Schwannoma
- Slowly growing neoplasm
- CN VIII most commonly effected
- NF2 patients present with bilateral CN VIII involvement
Neurofibromas
- Grade I
- 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
Meningioma
- 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
Metastatic tumors
- Secondary CNS neoplasms account for 15%
- Most commonly from: Lungs, breast, skin, kidney and colon