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133 Cards in this Set
- Front
- Back
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Extradural Neoplasm Categories (5)
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"Meningeal, Neurogenic, Metastatic, Choroid, Non-neoplastic"
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Meningeal Extradural Tumors (4)
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"Meningioma and Variants, Mesenchymal Tumors, Hemangiopericytoma, Melanocytic lesions"
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Meningioma Variants (3)
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"Atypical, malignant, Radiation-induced"
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Imaging features of classic meningioma (4)
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"dural tail, CSF cleft, strong homogeneous enhancement, hyperostosis"
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MR Spectroscopy feature of Meningioma (1)
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high alanine
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Neurogenic Extradural Tumors (3)
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"Schwannoma, Neurofibroma, Neuroma"
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Extradural Metastatic Disease (3)
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"Dural mets, Subarachnoid seeding, chloroma"
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Most Common Primary Malignancies to cause Dural mets (6)
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"Lung, Breast, Prostate, Melanoma, Lymphoma, Plasmacytoma"
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Primaries which cause Subarachnoid Seeding (3)
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"Lymphoma, Leukemia, Primary CNS"
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CNS Chloroma location and association
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"Epidural Space, harbinger of leukemia"
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CNS primaries which cause saubarachnoid seeding in children (5)
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"choroid plexus papilloma, ependymoma, PNET, astrocytoma (malignant), pineal region tumors"
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CNS primaries which cause saubarachnoid seeding in adults (3)
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"GBM, oligodendroglioma, lymphoma"
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Imaging features of classic schwannoma (3)
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"acute angle with dura, inhomogeneous enhancement, IAC extension"
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Extradural Choroid Plexus Masses (4)
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"papilloma, carcinoma, hemangioma, xanthogranuloma"
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Choroid Plexus Papilloma location and demographics
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"children (86%) = trigone, adults = 4th ventricle"
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Choroid Plexus Papilloma imaging features (5)
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"mulberry, hyperdense, low T1/mixed T2, common hemorrhage/calcification, +++enhancement, CSF seeding"
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"Choroid Plexus Carcinoma: location, features"
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"rare, lateral vents, CSF spread, invasion"
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"Choroid Plexus hemangioma: location, association, clinical"
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"lateral ventricles, Sturge-Weber, asymptomatic"
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"Choroid Plexus xanthogranuloma: location, appearance (2), clinical"
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"glomus of trigone, contain fat, can be bright on DWI, asymptomatic"
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Extradural non-neoplastic masses (4)
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"epidermoid, dermoid, teratoma, lipoma"
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Epidermoid imaging features (4)
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"CSF density, bright on FLAIR/DWI, - enhancement"
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Epidermoid common locations (4)
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"CP angle, suprasellar cistern, prepontine cistern, pineal region (OFF MIDLINE)"
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Dermoid imaging features (3)
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"fat/calcification, MIDLINE, can rupture"
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Intracranial teratoma features (1) and locations (2)
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"dermoid + enhancing nodule, pineal region, suprasellar region"
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Intracranial lipoma locations (4)
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"pericallosal, quadrigeminal plate cistern, suprasellar cistern, CPA"
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Pediatric Infratentorial Neoplasm Categories (3)
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"Astrocytic, Embryonal, Ependymal"
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Pediatric Infratentorial Astrocytic Neoplasms (2)
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"JPA, brainstem glioma"
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JPA locations (3)
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"posterior fossa, optic pathways, hypothalamus"
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JPA appearance (4)
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"benign, cyst + enhancing nodule, low T1, high T2"
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Brainstem glioma imaging features (3)
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"high T2, 2/3s enhance, cystic degeneration"
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Pediatric Infratentorial Embryonal Neoplasms (3)
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"PNET, medullomyoblastoma, rhabdoid tumor"
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Medulloblastoma (PNET of posterior fossa) demographics and frequency
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5-12 yo; 1/3 of posterior fossa tumors in children
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Medulloblastoma (PNET of posterior fossa) location and imaging features (6)
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"usually arise from vermis; solid, hyperdense, + enhancement, hypo T1, iso T2, CSF seeding"
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Ways to tell Medulloblastoma over ependymoma (2)
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Medulloblastoma is homogeneously hyperdense and also distorts the fourth ventricle; ependymoma more commonly has calcifications/hemorrhage and simply expands the fourth ventricle
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medullomyoblastoma features and location
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same as medulloblastoma with histological differences
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"rhabdoid tumor: location (2), imaging features (1), and demographics"
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"1/2 in posterior fossa, 40% are supratentorial; aggressive heterogeneous mass; first years of life"
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Ependymoma: demographics
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bimodal: <10; 4-5th decade
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Ependymoma: locations (4) and imaging features (4)
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"4th ventricle, spinal cord, supratentorial, intraparenchymal; hypo T1, iso T2, calcificatio/hemorrhage is common, mild enhancement"
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ependymoma: poorest prognosis based on location
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4th ventricle (50% 5-yr)
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Adult Infratentorial Neoplasm Categories (5)
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"Astrocytic, Embryonal, Ependymal, Neuronal/Glial, Metastases"
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Most common Infratentorial Astrocytic Neoplasm in an adult
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"GBM, oligodendroglioma, lymphoma"
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"Medulloblastoma in an adult: location, appearance, and course relative to children"
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"usually off midline; less well defined, less enhancement; usually more aggressive"
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"Subependymoma: locations (2), imaging features (3); course"
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"lateral recess of 4th vent > lateral ventricle; isodense, iso T1, hyper T2, most do not enhance; benign course"
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"hemangioblastoma: location (3), frequency, course, association (1), appearance"
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cerebellum > cord > medulla > cerebrum; most common infratentorial adult neoplasm; benign; VHL; cyst w/ enhancing mural nodule
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most common Infratentorial Neoplasm in an adult
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mets
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DDX for hemorrhagic CNS mets (7)
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"breast, choriocarcinoma, lung, melanoma, renal cell, retinoblastoma, thyroid"
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incomplete hemosiderin ring =
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hemorrhagic mets
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DDX for calcified CNS mets (3)
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"chondrosarcoma, osteosarcoma, mucinous adenocarcinoma (breast, stomach, colon, ovary)"
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calcified primary CNS neoplasm (9)
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"astrocytoma, choroid plexus papilloma, craniopharyngioma, ependymoma, ganglioglioma, meningioma, neurocytoma, oligodendroglioma, pineal region tumors"
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supratentorial astrocytic pediatric neoplasm (1)
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pleomorphic xanthoastrocytoma
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pleomorphic xanthoastrocytoma: location (1); demographics (1); clinical presentation (1); prognosis (1)
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periphery of temproal lobes; 2/3 < 18yo; seizures; 80% 5-yr survival
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pleomorphic xanthoastrocytoma: appearance (2)
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"homogeneously enhancing, cyst formation"
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supratentorial pediatric embryonal neoplasms (3)
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"supratentorial PNET, medulloepithelioma, ependymoblastoma"
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supratentorial PNET: appearance (5); course (1)
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"heterogeneous enhancement, cyst/hemorrhage/calcification, hyperdense, recurrence, subarachnoid seeding; bad prognosis"
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medulloepithelioma: location (2); course (1); appearance (2)
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temporal > parietal lobe; poor prognosis; aggressive
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ependymoblastoma: location (1); appearance (2); prognosis (1)
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"supratentorial; large/enhancing, necrosis; very poor"
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supratentorial pediatric neuronal/mixed glial tumors (4)
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"ganglioglioma, gangliocytoma, desmoplastic infantile ganglioglioma, DNET"
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ganglioglioma: most common location; demographics (2); course
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"temporal lobe; <30yo, most common mixed glioneuronal tumor; good prognosis"
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ganglioglioma: concern (1)
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degeneration into an aggressive lesion
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gangliocytoma: compare with ganglioglioma
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no malignant degeneration
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desmoplastic infantile ganglioglioma: appearance (2); location (2); course
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"cyst with meningeal base, rim enhancement; frontal/parietal lobes; benign"
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dysembryoplastic neuroepithelial tumor (DNET): location (2); presentation (1); age (1)
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temporal and frontal lobes; seizures; 10-20yo
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Dysembryoplastic neuroepithelial tumor (DNET): appearance (5)
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"involve gray>white, hypodense, cysts, bright T2, usually no enhancement"
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Dysembryoplastic neuroepithelial tumor (DNET): course
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unusual recurrence after resection
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Supratentorial adult tumor categories (6)
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"astrocytic, neuronal/mixed glial, oligodendroglial, neuroepithelial (?), hematopoietic, sarcoma"
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supratentorial adult astrocytic tumors (6)
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"astrocytoma, anaplastic astrocytoma, GBM, gliosarcoma, multicentric astrocytoma, subependymal giant cell astrocytoma"
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astrocytoma: frequency
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most common solitary intraaxial mass in an adult
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astrocytoma: WHO grading
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I: astrocytoma; II: diffuse astrocytoma; III: anaplastic; IV: GBM
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GBM: frequency
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twice as common as lower grade lesions
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DDX: corpus callosum mass lesions (7)
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"GBM, lymphoma, mets, white matter disorder (MS, PML, PRES), shear injury, stroke, lipoma"
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subependymal giant cell astrocytoma: location (1); demographics; association
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near foramen of Monro; 2-20yo; tuberous sclerosis
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subependymal giant cell astrocytoma: appearance (3);
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"intraventricular, enhancing, ventricular entrapment"
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Supratentorial adult neuronal/mixed glial tumors (1)
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central neurocytoma
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central neurocytoma: location (2); demographic (1); course
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lateral or third ventricle (septum pellucidum); mean age = 29; benign
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central neurocytoma: hard to distinguish between this and...
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oligodendroglioma
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central neurocytoma: appearance (5);
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"iso to gray matter, cystic, calcify, rare edema, mild/mod enhancement"
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supratentorial adult oligodendroglial tumors (3)
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"oligodendroglioma, mixed oligo/astro, anaplastic oligodendroglioma"
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"oligodendroglioma: location, age/gender, course"
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frontal and temporal lobes (adjacent to lateral/3rd ventricle); 40-50 M; benign when pure histologically
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oligodendroglioma: appearance (5)
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"calcification, soft tissue, cysts, HETEROGENEOUS SIGNAL, rare edema"
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oligodendroglioma: single feature which makes degeneration more likely:
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cyst formation indicates mixed histology
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mixed oligoastrocytoma: what % of oligodendrogliomas are mixed?
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50.%
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mixed oligoastrocytoma: what is the significance if they are mixed?
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higher risk of recurrence
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mixed oligoastrocytoma: what is the difference in appearance compared to regular oligodendroglioma? (2)
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"less likely to calcify, stronger enhancement"
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anaplastic oligodendroglioma: location (2)
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frontla and temporal lobes
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anaplastic oligodendroglioma: appearance (4)
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"hemorrhage, calcification, necrosis, avid enhancement"
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adult supratentorial neuroepithelial/unknown tumors (3)
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"gliomatosis cerebri, chordoid glioma, astroblastoma"
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gliomatosis cerebri definition
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involves at least 2 lobes
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gliomatosis cerebri WHO grade
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III
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gliomatosis cerebri prognosis
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BAD
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chordoid glioma: location (1); age; WHO grade
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hypothalamus; >30yo; II
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chordoid glioma: appearance (4)
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"hyperdense to gray matter, iso T1/T2, avid enhancement; hydrocephalus"
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Limbic encephalitis: etiology
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paraneoplastic syndrome
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limbic encephalitis: most common primary
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small cell lung
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limbic encephalitis: appearance (3)
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"high T2, +/- enhancement, often atrophy"
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limbic encephalitis: location
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Bilateral temporal lobes
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limbic encephalitis: best way to distinguish from herpes (1)
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no atrophy with herpes
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Primary CNS lymphoma: association (1)
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immunocompromised state
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Primary CNS lymphoma: test to distinguish from toxoplasmosis (2)
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thallium scan (lymphoma is thallium avid); MR perfusion (lymphoma is hypervascular)
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categories of pineal region tumors (2)
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germ cell and pineal cell
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germ celll pineal tumors in order of frequency (3)
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"germinoma, teratoma, choriocarcinoma"
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pineal cell origin tumors (3)
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"pineoblastoma, pineocytoma, pineal cyst"
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pineal germinoma: appearance (4)
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"hyperdense, iso T1, hypo T2, enhances"
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What is Parinaud's Syndrome? possible association?
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paresis of upward gaze (can be related to pineal region tumor)
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CNS teratoma: appearance (4); locations (2)
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"may contains fat, calcs, cysts, dermal appendages; pineal region > suprasellar region"
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pineal choriocarcinoma: serology test (1); common feature (1)
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HCG+; hemorrhage
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pineoblastoma: WHO grade; age; association (1)
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IV; <10; retinoblastoma (third eye)
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non-neoplastic CNS masses (6)
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"colloid cyst, neuroepithelial cyst, neuroenteric cyst, Lhermitte-Duclos, choristoma, amyloid"
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colloid cyst: location (1); presentation (1); age
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anterior 3rd ventricle; positional headache; 30-40yo
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colloid cyst: appearance on CT (variable MR)
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hyperdense
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neuroepithelial cyst: location (1); association (1)
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centerad anywhere on choroid plexus; prior infection
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neuroenteric cyst: location (1); appearance (1)
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intradural extramedullary space at cervicothoracic junction; high T1 signal
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Lhermitte-Duclos AKA...
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dysplastic gangliocytoma of the cerebellum
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choristoma definition
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normal tissue in an abnormal location
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CNS amyloid: location (2); appearance (3)
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"dural and intraparenchymal; low T2, bright T1; dense"
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Neoplastic Intramedullary lesions of the spine (5)
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"astrocytoma, ependymoma, hemangioblastoma, ganglioglioma, metastasis"
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spinal astrocytoma: common age; gender; location; prognosis
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"bimodal: children and 20-40yo; M>F; T-spine > C-spine; good for kids, worse for adults"
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spinal astrocytoma: features and appearance (5)
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"more eccentric than ependymoma, syrinx, involve an average of 7 segments, low T1/high T2"
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"spinal ependymoma: location, age, prognosis; length"
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C>T; 20-40; 80% 5-yr survival; 3.6 levels
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most common spinal intramedullary tumor in adults
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ependymoma
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most common spinal intramedullary tumor in children
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astrocytoma
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spinal ependymoma: features and appearance (5)
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"central, iso/hypo T1 and multinodular high T2, hemosiderin, + enhancement, syrinx"
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tumor arising from the filum in a 35yo male
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myxopapillary ependymoma
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spinal hemangioblastoma: appearance and location
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"highly vascular; C/T spine, cystic/enhancing nodular component, bright T2 with flow voids"
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spinal hemangioblastoma: what % are isolated?
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80.%
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spinal ganglioglioma: age; course; location; length
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mean age = 12; benign; C>>T; long segment of involvement (8 segments)
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mets to the spinal cord in children (9)
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"choroid plexus tumors, ependymoma, GBM, leukemia, Lymphoma, neuroblastoma, pineal region tumors, PNET, RB"
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mets to the spinal cord in adults (6)
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"GBM, hemangioblastoma, lymphoma, melanoma, lung/breast/renal/gastric, oligodendroglioma"
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Extramedullary intradural neoplasms of the spine (3)
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"meningioma, nerve sheath tumor, lipoma"
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"spinal meningioma: gender, location, association"
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F; T spine; NF2
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"spinal neurofibroma: association, appearance"
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NF1/2; iso T1; hyper T2; ++ enhancement
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DDX for NF with thickened/enhancing nerve roots (2)
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"Charcot-Marie-Tooth, Dejerine-Sottas"
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"Spinal lipoma: location, intra or extradural, association (2)"
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"T-spine, 60/40 intradural; myelodysplasia, tethered cord"
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fat-containing sacrococcygeal mass...
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"teratoma, look for associated abnormalities"
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