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NMSP > Tumors of the Nervous System part 1 > Flashcards

Tumors of the Nervous System part 1 Flashcards

1
Q

What anatomic location is the most common for KID CNS tumors?

A

Posterior Fossa – infratentorial

– cerebellum/brainstem

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2
Q

What anatomic location is the most common for ADULT CNS tumors?

A

Cerebral Hemispheres – supratentorial

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3
Q

What is the most common CNS tumor type for children?

A

Medulloblastoma (embyronal)

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4
Q

What is the most common CNS tumor type for adults?

A

Glioblastoma

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5
Q

Define the CNS tumor Grade system

A

Grade 1
Grade 2 - Infiltrative with Atypia
Grade 3 - Anaplastic and mitoses
Grade 4 - Microvascular proliferation and Necrosis

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6
Q

What are 3 types of Astrocytomas?

A
  1. Infiltrating Astrocytomas
  2. Pilocytic Astrocytoma
  3. Glioblastoma
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7
Q

With Astrocytomas, the grade of the tumor usually increases as?

A

As age increases

– ex. Grade 4 = Older adults

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8
Q

What grade is a Pilocytic Astrocytoma and what age group/location does it usually affect?

A

Grade 1

  • Affects those in first 2 decades of life
  • Affects Cerebellum
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9
Q

Besides the IAA1549 - BRAF gene, what other gene predisposes an individual to a Pilocytic Astrocytoma?

A

NF1

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10
Q

How does a Pilocytic Astrocytoma look in the brain?

A

Well circumscribed

= Cystic with a mural nodule

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11
Q

Cystic tumor with a mural nodule in the cerebellum in likely a?

A

Pilocytic Astroctyoma

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12
Q

What are the histo attributes of a Pilocytic Astrocytoma? (4)

A
  • Rosenthal fibers
  • EGBs (eosinophilic granular bodies)
  • Biphasic pattern (loose + dense tissue)
  • Hair-like cells with bipolar processes
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13
Q

What are the histo attributes of a Pilocytic Astrocytoma? (4)

A
  • Rosenthal fibers
  • EGBs (eosinophilic granular bodies)
  • Biphasic pattern (loose and dense tissue)
  • Hair-like cells with bipolar processes
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14
Q

Infiltrating Astrocytomas are Grades 2-4. What is a common symptom with them?

A

SEIZURES, headaches, focal neuro deficits

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15
Q

What gene mutation is more favorable due to a better prognosis with Infiltrating Astrocytomas?

A

IDH1 R132H mutant&raquo_space; IDH wild type

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16
Q

Infiltrating Astrocytomas have ______ _____ nuclei and a _____ background

A

Hypercellular Hyperchromatic nuclei

Fibrillar background

17
Q

What grade is a Glioblastoma and what is it the most common of?

A

Grade 4 – most common brain neoplasm

18
Q

Primary Glioblastoma

A

Older patient with NO precursor lesion

19
Q

What mutations (3) are likely present in a Primary Glioblastoma?

A

IDH wild type, EGFR, TERT

20
Q

Secondary Glioblastoma

A

Younger patient preceded by a lower grade lesion

21
Q

What mutation is likely present with a Secondary Glioblastoma?

A

IDH1 R132H mutant == better prognosis

22
Q

On imaging, how does a Glioblastoma appear?

A

Contrast ring enhancing with central necrosis

23
Q

What are the 3 histo attributes of a Glioblastoma?

A
  1. Serpentine (snake) pattern
  2. Pseudo-palisading
  3. Vascular/endothelial proliferation
24
Q

What are the 3 histo attributes of a Glioblastoma?

A
  1. Serpentine (snake) pattern
  2. Pseudo-palisading
  3. Vascular/endothelial proliferation
25
Q

How does an Oligodendroglioma usually present?

A

Seizures and neuro complaints for several YEARS

26
Q

What will be seen on the cortex of the brain with an Oligodendroglioma?

A

Calcification on the cortex in a curvilinear pattern

27
Q

What are the 2 histo attributes of an Oligodendroglioma?

A
  1. Perinuclear halos = fried eggs

2. Anastomosing capillaries = chicken wire

28
Q

What 3 mutations offer a favorable prognosis for an Oligodendroglioma?

A
  • IDH1 and IDH2 mutations

- 1p19Q loss

29
Q

When and where do Ependymomas usually present?

A

First 2 decades of life

– 4th ventricle floor/spinal

30
Q

Ependymomas are usually Grade 2 neoplasms. If they are Grade 3, what histo attribute is more diagnostic?

A

Ependymal (true) Rosettes with a central canal&raquo_space; Perivascular (pseudo) Rosettes

31
Q

How do Ependymomas look in the 4th ventricle?

A

Discrete and exophytic

32
Q

A Mxyopapillary Ependymoma is a Grade 1 subtype. Where does it present?

A

Filum Terminale

33
Q

A Subependymoma is a Grade 1 subtype. Where does it present?

A

Lateral or 4th ventricle under the ependymal layer

34
Q

What symptom can a Subependymoma Grade 1 subtype tumor cause?

A

Obstructive Hydrocephalus

35
Q

What are 3 types of Gliomas?

A

Astroctyomas
Oligodendroglioma
Ependymoma

36
Q

What will a Choroid Plexus Papilloma present as?

A

Hydrocephalus due to obstruction

37
Q

A Colloid Cyst of the 3rd ventricle is a type of choroid plexus tumor. What does it obstruct?

A

Foramen of Monro

38
Q

A Colloid Cyst of the 3rd ventricle can also be positional because what does it cause?

A

NON-communicating hydrocephalus

NMSP (28 decks)

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