CNS tumors

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Author:
bigfootedbertha
ID:
85528
Filename:
CNS tumors
Updated:
2011-05-12 19:38:16
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neurology
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Description:
for upcoming pathology exam
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  1. What are the most common types of tumor for each sex?
    • Gliomas: males
    • Meningiomas: females
  2. Most primary CNS tumors are caused by what cells?
    Glial cells (astrocytes, ependymal cells, oligodendrocytes)
  3. Astrocytoma that does not infiltrate or progress to a higher grade with a better prognosis
    Grade 1
  4. Well circumscribed mural nodule associated with a cyst
    Pilocytic astrocytoma
  5. Rosenthal fibers and thickened blood vessels
    Pilocytic astrocytoma
  6. Astrocytoma with increased pleomorphism and diffusely
    infiltrative growth pattern
  7. Grade 1
  8. worst, marked vascular proliferation with production of VEGF, hemorrhage, necrosis, pseudopalisading pattern of cells in the tumor, large fungating, multicentric lesion with ring density
    Grade IV astrocytoma
  9. Grade II astrocytoma
    mitoses and pleomorphism
  10. Diffusely expand white matter, poorly demarcated
    astrocytomas 2-4
  11. dense meshwork of cytoplasmic processes
    Astrocytomas 2-4
  12. Which astrocytoma grades usually progress to GBM?
    2 and 3
  13. associated with epilepsy, seizures, calcification, hemorrhage (can lead to infarction, stroke)
    Oligodendroglioma
  14. Chromosome 1p and 19q deletions
    Oligodendroglioma
  15. Diffusely infiltrate of cortex
    oligodnedroglioma
  16. Uniform cells with perinuclear halos and round nuclei. Fried egg look, with branching capillaries
    Oligodendroglioma
  17. Third most common brain tumor in children
    Ependymoma
  18. Often grow near ependyma lined ventricles or spinal cord central canal (can excise if on SC)
    Ependymoma
  19. Ependymal canals and rosettes
    Perivascular pseudorosettes –cells lining vessel
    Ependyoma
  20. In filum terminale of spinal cord
    Myxopapillary ependyoma
  21. Cuboidal cells around papillary cores in myxoid background
    myxopapillary ependyoma
  22. Prognosis of myxopapillary ependyoma
    Biologically benign, prognosis depends on extent of excision
  23. Grade 1 tumor arising in the 4th or lateral ventricles
    Subependyoma
  24. Small, may be calcified, Highly fibrillar background, Low cellularity
    Subependyoma
  25. Highly malignant and poorly differentiated tumor causing 20% of childhood brain tumors
    medulloblastoma
  26. Difference in location of medulloblastomas in children and adults
    Seen in cerebellum in the midline in children and in the lateral aspects in adults
  27. May be associated with hydrocephalus and CSF spread is common
    medulloblastoma
  28. tumor cells surround proteinaceous material, tongue like protrusions to surround SC
    Homer Wright and Flexner-Wintersteiner Rosettes, associated with medulloblastomas
  29. highlights of cells in medulloblastomas
    Radiosensitive, high N/C ratio, highly cellular with increased mitoses and karyorhexis
  30. How do medulloblastomas spread?
    CSF
  31. Most common extra axial tumor
    meningioma
  32. Most common non-glial brain tumor in adults
    Meningiomas
  33. Most common populations in meningiomas
    Middle aged females
  34. Slow growing dural based mass arising from arachnoid cap cells
    menigioma
  35. associated with hyperostosis of overlying skull – excessive bone formation
    meningioma
  36. concentric laminations
    Psammoma bodies, associated with meningiomas
  37. May arise post irradiation
    Meningioma
  38. Associated with neurofibromatosis type 2 and deletion of chromosome 22q
    Meningioma
  39. En plaque variant has a carpet like growth and can induce hyperostosis
    Meningioma
  40. CNS manifestations of von Hippel-Lindau disease
    Hemangioblastoma
  41. Autosomal dominant (chromosome 3p)
    Hemangioblastoma
  42. Can develop tumors of the cerebellum, retina, brainstem and spinal cord, pancreas, liver, renal cell CA
    Hemangioblastoma
  43. Mixture of delicate capillary vessels and stroma cells with multiloculated cytoplasm
    hemangioblastoma
  44. Presents as a cerebellar cyst with mural nodule, vascular lesion
    Hemangioblastoma
  45. papillary neoplasm
    Chorid plexus neoplasm
  46. What age period do choroid plexus neoplasms pop up the most?
    First decade; carciomas occur before 3 years
  47. What is the difference in ventricle location of choroid plexus neoplasms in child and adults?
    • Lateral and 3rd: children
    • Fourth: adults
  48. Benign encapsulated tumor arising from Schwann cells
    Schwannoma
  49. What age range is associated with schwannomas?
    30-60 yos
  50. Spindle cell tumor with alternating dense regions (Antoni A) and loose regions (Antoni B) – cigar shaped cells
    Schwannoma
  51. alignment or palisading of nuclei
    Verocay body, associated with schwannomas
  52. Hyalinized pink blood vessels
    Schwannomas
  53. What kind of nerves do Schwannomas tend to affect?
    sensory
  54. Chromosome 17
    Neurofibromatosis type 1
  55. Associated with multiple neurofibromas and pilocytic astrocytomas
    Neurofibromatosis type 1
  56. Chromosome 22
    Neurofibromatosis 2
  57. Assoc w/ Bilateral acoustic schwannomas, multiple ependymomas and meningiomas
    Neurofibromatosis 2
  58. Assoc w/ Bilateral acoustic schwannomas, multiple ependymomas and meningiomas
    Neurofibromatosis 2
  59. Neurofibromatosis with risk of malignant transformation
    Type 2
  60. Arise from transformation of primordial tissue derived from ectoderm, mesoderm or endoderm
    Germ cell tumor
  61. Most common site for germ cell tumors
    pineal gland, second is suprasellar region
  62. Features resemble to seminoma in testis and dysgerminoma in ovary
    Germ cell tumor
  63. cells that are large with distinct cell borders, large vesicular nuclei and prominent nucleoli
    Germ cell tumor
  64. What types of cells make up germ cell tumors?
    Lymphocytes, mainly T cells
  65. Soft gray pink with areas of necrosis and hemorrhage, often angiocentric
    Primary CNS lymphoma
  66. NHL usually arises from what cells?
    B cells
  67. NHL has an increased frequency in what population?
    AIDs pts
  68. Most comon route of spread for metastatic brain tumors
    Hematogenous route
  69. What type of cancers may infiltrate the CSF?
    leukemias and lymphomas
  70. In a pt over 60 yo, with new onset seizures, where do you consider metastasis?
    Lung, breast, and colon
  71. Localized to gray white junction
    CNS metastasis
  72. Necrosis with islands of tumor cells, Most have well defined borders
    CNS metastasis
  73. CNS metastasis is more common in what part of the brain?
    The cerebral cortex, primarily where the MCA distributes its blood supply
  74. What cancers can metastasize to the brain?
    Melanomas, chroriocarcinomas, lung carcinomas (adeono and small cell), RCC

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