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Clinical symposium > Tumours of the CNS > Flashcards

Tumours of the CNS Flashcards

1
Q

what are the most common CNS tumours

A

gliomas, meningiomas

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2
Q

what is the occurrence distribution of tumours of the nervous system

A

age distribution is bimodal

Adults: cerebrum, glioma and menigioma.

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3
Q

where are tumours commonly found in children in the cerebrum or cerebellum

A

cerbellum (PNET and medullablastoma)

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4
Q

where are tumours commonly found in adults in the cerebrum or cerebellum

A

Glioma and Meningioma

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5
Q

do males have a increased risk of glioma or meningioma

A

glioma

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6
Q

do females have an increased risk of glioma and meningioma

A

meningioma

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7
Q

are neuronal tumours common or rare

A

rare

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8
Q

Do neurones communicate with the blood supply

A

no

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9
Q

how many astrocytes are there per neurone

A

10 astrocytes

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10
Q

define astrocyte

A

support and protect

connect neurones with blood supply so that they can access the metabolites they need to function.

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11
Q

define oligodendrocyte

A

myelin- insulate neurones

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12
Q

define ependymal cells and choroid plexus cells (CSF)

A

produce CSF
protect brain from trauma
control external environment

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13
Q

define micoglia defense

A

comes from bone arrow

sends astrocytes signal so that inflammatory cells can enter the blood brain barrier.

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14
Q

what are the 4 types of glial cells (support cells)

A

astrocytes
oligodendrocytes
ependymal cells and choroid plexus
micoglial cells (defense)

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15
Q

what is tumour of the neurone known as

A

ganglioma

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16
Q

what is tumour of the glial cells known as

A

glioma

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17
Q

what is tumour of the meninges known as

A

meningioma

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18
Q

how many layers is the cerebrum

A

6 layers

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19
Q

how many layers is the cerebellum

A

3 layers

20
Q

how are CNS tumours diagnosed

A

Histology- name of tumour

biological behaviour- grade of the tumour.

21
Q

do you have micoglial tumours

A

No

22
Q

what are the characteristic features of a benign tumour

A 
slow growing
respect surrounding tissue
no/ slow progression
no recurrence
surgery -depends on postion
23
Q

what are the characteristic features of a malignant tumour

A 
rapid growing
invade and destroy surrounding tissue
progress
recurrent
surgery and adjuvant therapy (radiotherapy and chemotherapy)
24
Q

what grade are benign tumours

A

grade 1

25
Q

are all graded tumours malignant

A

No

grade one can be benign.

26
Q

what histological changes are present in a malignant tumour

A

cell size and shape
mitotic activity
Necrosis-TNF to kill other cells
vascular proliferation- increase endothelial cells to supply tumour.

27
Q

what are the 3 types of gliomas

A

Astrocytic tumours
Oligodendroglioma
Ependymoma

28
Q

what are the 2 types of nerve sheath tumours

A

Schwannoma and neurofibroma

29
Q

Microscopical features of astrocytic tumours

A

Fine fibrillary and microcystic background
Increased cellular density
Pleomorphism ( variation in size, shape and chromasia)

30
Q

what are the features of diffuse astrocytoma II

A

infiltrative, micro cystic fibrillary,
low cellular density
mild atypia
no mitotic activity- grade 2

31
Q

what are the features of Anaplastic astrocytoma III

A

Moderate cellular density
Moderate Pleomorphism
Mitoses - grade 3

32
Q

what are the features of glioblastoma

A

High cellular density and mitoses
Vascular proliferation
Necrosis
Histology- necrosis occurring in the centre and tumour cells are trying to escape

33
Q

is the men age for developing glioblastma younger or older than anapaestic astrocytoma

A

older

34
Q

what are the features of pilocytic astrocytoma

A 
Children, cerebellum
Well-defined, cystic
Pilocytes 
Rosenthal fibres 
Vascular proliferation
35
Q

what are the features of oligodendroglioma II/III

A

Round uniform nuclei with clear cytoplasm (fried-egg appearance)
Arborising capillaries (chicken wire)
Calcifications

36
Q

what are the main features of Ependymoma II / III

A

Well-defined tumour, ventricles
Pseudorosettes
Round small uniform cells

37
Q

what are the main features on meningioma

A

Females, dura, adults
Well-defined extra-axial tumour
Whorls, psammoma bodies
Histology- tumour cells whirl around each other.

38
Q

what are the main features of PNET

A 
Children, cerebellum
Very high cellular density- no cytoplasm seen in histology.
Anaplastic hyperchromatic cells
Frequent mitoses and apoptosis 
Rosette formation
39
Q

what are the main features of

A 
Spindle-cell tumours  
Schwannoma I
–	8th cranial nerve
–	Biphasic pattern: loose and dense areas
–	Reticulin rich
Neurofibroma I
–	Spinal nerves
–	Rich in collagen
40
Q

what causes meningioma

A

radiotherapy

41
Q

what causes lymphoma

A

immunosupression

42
Q

what causes familial syndromes

A

NF1, NF2

43
Q

Mutations in any of Wnt 7, SHH and notch leads to what

A

tumours.

44
Q

MGMT promoter methylation is a predictive marker of which type of CNS tumour to akylating chemotherapy

A

glioblastomas

45
Q

1p/19q deletion is a predicative marker of n prognosis of what CNS tumour is patients receiving adjuvant radio and/ or chemotherapy.

A

(oligodendro)glial tumor

46
Q

What CNS tumours are IDH1/IDH2 mutations a diagnostic marker for

A

II and III gliomas as well as secondary glioblastomas

47
Q

What CNS tumours use BRAF duplication/fusion to determine the diagnosis of tumours.

A

Diagnostic marker for pilocytic astrocytomas, helpful to distinguish these from diffuse astrocytomas

Clinical symposium (20 decks)

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