Tumors (Martin) Flashcards
What are the second most common malignancy among children?
Brain tumors
Supratentorial tumors are common in?
Infratentorial tumors are common in?
1) Adults
2) Kids
With new onset of seizure in an adult what should come to mind?
Glioblastoma (brain tumor)
What is the grading range for tumors?
I-IV
What does a grade II tumor entail?
Grade III?
Grade IV?
1) Diffuse astrocytoma
2) Anaplastic astrocytoma
3) Glioblastoma
Grade II astrocytoma is usually in what decade of life?
Grade III?
Grade IV?
1) 3rd-4th
2) 5th
3) 6th and beyond
What tumor occurs in the first two decades of life and are composed of bipolar cells with long, thin, processes that are GFAP positive?
Pilocytic astrocytoma
Pilocytic astrocytoma are located in?
Cerebellum
What predisposes a child to pilocytic astrocytoma, especially optic nerve tumors?
NF1
How are pilocytic astrocytoma’s often described?
Cystic with a mural nodule
What are characteristic findings of pilocytic astrocytoma?
Rosenthal fibers and eosinophilic granular bodies
What is the most common primary brain neoplasm?
Glioblastoma
Primary glioblastomas have mutations in?
Secondary glioblastoma have mutations in?
Which has a better prognosis?
1) PTEN
2) IDH1
3) IDH1 mutation
What is seen on imaging for glioblastomas?
Contrast ring enhancing lesion with central necrosis
What are the 3 histologic hallmarks of glioblastoma?
1) Serpentine pattern of necrosis
2) Pseudo-Palisading (Tumor cells collect along the edges of the necrotic regions)
3) Vascular/endothelial proliferation
What infiltration gliomas are mostly found in the cerebral hemispheres with a predilection for white matter?
Oligodendroglioma
Oligodendroglioma are well circumscribed tumors that often have cysts, focal hemorrhage, and?
Calcification
What are distinct characteristic words used for oligodendroglioma?
1) Fried eggs (Perinuclear halos)
2) Chicken wire (Delicate anastomosing capillaries)
What are the most common mutations in Oligodendroglioma?
What prognosis does this give?
1) IDH1 and IDH2
2) Favorable
Ependymomas commonly arise in what location?
What does this cause?
What is diagnostic of it?
1) Fourth ventricle
2) Obstructs CSF flow
3) Ependymal rosettes (true rosettes)
Choroid plexus papilloma is most common in what population?
Most commonly occurring where?
What does it cause due to obstruction of the ventricular system?
1) Children
2) Lateral ventricles
3) Hydrocephalus
Because Colloid cyst of the 3rd ventricle obstructs the Foramen of Monro it causes?
What is the most important clinical sign?
1) Noncommunicating hydrocephalus
2) Headache (sometime positional)
What brain tumor accounts for 20% of all brain tumors in kids and is very malignant and will often kill quickly, but it is very radiosensitive?
Medulloblastoma
Medulloblastoma exclusively appears in what area?
How does it relate to “drop metastasis”?
1) Cerebellum
2) It disseminates through CSF to cauda equina
What genetic subtype of medulloblastoma has the best prognosis?
Which has the worst?
1) WNT
2) Group 3 -> MYC amplification and isochrome 17
What is medulloblastoma characterized by?
1) Sheets of anaplastic cells
2) Abundant mitoses
3) Homer-Wright Rosettes
In regards to rhabdoid tumors, what do the cytoplasm of the rhabdoid cell contain?
It is immunoreactive for?
1) Intermediate filaments
2) Epithelial membrane antigen (EMA) and vimentin
What are the most common CNS tumor in AIDS patients and those who are immune suppressed?
Primary CNS lymphoma
In immune suppressed patients, the cells in nearly all primary brain lymphomas are latently infected by?
What CD is it positive for?
1) Epstein-Barr virus
2) CD20 (B-cell origin)
What is characteristic of primary CNS lymphoma?
Hooping = cells separated by reticulin and silver stain
Where do germ cell tumors occur along?
Germ cell tumors in what location predominantly affect males?
It more commonly affects what population?
1) Midline
2) Pineal region
3) Japanese
Pineoblastomas occurs with increased frequency in individuals with the germline mutation in?
RB gene
What are mostly benign tumors that are attached to the dura in adults?
Meningioma
Meningiomas are associated with what occurrence decades earlier?
Prior radiation therapy
Meningiomas are associated with loss of what gene on chromosome 22q that encodes for merlin?
NF2 gene
What is morphologically characteristic of meningioma?
Calcified psammoma bodies
Meningiomas generally present with vague non-localizing signs and symptoms or with focal findings due to?
Brain compression
Why do meningiomas grow more rapidly during pregnancy?
They express progesterone receptors
What are the most common tumors that metastasize to the brain?
What are the most common locations?
1) Carcinomas
2) lung, breast, melanoma
What rare tumor frequently metastases to the brain?
Choriocarcinoma
What antibody is associated with Subacute cerebellar degeneration?
PCA-1
What antibody is associated with limbic encephalitis from small cell carcinoma of the lung?
ANNA-1 antibody (anti-Hu)
Tuberous sclerosis complex is characterized by development of?
Hamartomas and benign tumors in the brain
What does Von Hippel-Lindau Disease develop?
Where may cysts be found?
1) Hemangioblastomas of the CNS
2) Liver
Because Von Hippel-Lindau Disease is involved in regulating expression of erythropoietin what is it associated with?
Polycythemia
Von Hippel-Lindau Disease patients are more likely to develop?
Renal cell carcinoma and pheochromocytoma
What is characteristic of Neurofibromatosis type 1?
1) Optic nerve gliomas
2) Lisch Nodules (pigmented nodules of the iris)
3) Café au lait spots
What is characteristic of Neurofibromatosis type 2?
1) Bilateral schwannomas of CN VIII (vestibulocochlear)
2) Multiple meningiomas
Which has a better prognosis, mutated IDH or wild type IDH?
Mutant IDH
