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48 Cards in this Set

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What percentage of tumors found within CNS is metastatic?
25% to 50%
Compare the relative prevalence of tumors within the parenchyma vs outside the parenchyma
Within is 5-6 times more common
Describe the prevalence of CNS tumors in children.
2nd most common form of neoplasm
Compare the relative prevalence of tumors between adults vs. children in respect to the tentorium.
In children , 70% located infratentorially.


In adults, 70% are located supratentorially
How are CNS tumors classified
By cell of origin
T/F - Histologically malignant tumors are also biologically malignant.
False.

Biologically malignant tumors may present as benign tumors histologically.
In determining the malignancy of tumors, what factors must be considered.
Aggressiveness of tumor cells

Location
Gliomas arise from what cells?
Glial cells

- astrocytes
- oligodendrites
- ependymal cells
T/F - Microgliomas are neuroglial tumors (gliomas).
Fasle.

They are lymphomas
Astrocytomas:
- Adults: common where?
- PEDS: common where?
- Gender factor?
Cerebral Hemisphere

Cerebellum (or Pons)

Males predominate 2:1
Astrocytomas:
- Genetic associations
Associated with:
- Oncogene activation
- Chromosomal Loci Deletion
Astrocytoma malignancy + growth rate:
- Describe diffuse
- Describe anaplastic
Less malignant (grows slowly)

More malignant (grows faster)
Describe the gross findings of DIFFUSE astrocytomas.
- texture
- composition
- boundary appearance
- cysts
Firm areas

Gray-white areas are whiter than normal

Not clearly demarcated from surrounding brain

May contain large or small cysts.
Describe the gross findings of ANAPLASTIC astrocytomas.
- texture
- size
- visual description
- associated with?
Soft areas

Larger areas

Pale areas

Hemorrhages
Describe the histopathological findings in diffuse astrocytomas.

- # of cells
- astrocyte cell appearance
- nuclei
- mitoses
- giant cells
- vascular component
Increase in number of cells bodies and fibers

Looks normal or nearly normal

Nuclei slightly larger and densely chromatized than normal

No mitoses

No giant cell

Blood vessels numerous, but NO proliferative character
Describe the histopathological findings in anaplastic astrocytomas.

- astrocyte cell appearance
- mitoses
- giant cells
- vascular component
- key characteristic
Recognizable as astrocytes, but clearly neoplastic

Mitoses present

Giant cells present

Blood vessels numerous, and mild vascular proliferation

NO necrosis
Prognosis of Astocytomas
- Diffuse
- Anaplastic
+5 years

18-36 months
Tumor grading in astrocytomas is based on what?
Most malignant areas
Pilocytic Astrocytomas

- Seen where?
- Characteristics of what?
- Prognosis
Cerebellum

Hamartoma

Excellent even with incomplete removal
Describe the GROSS findings of pilocytic astrocytomas.

- Boundary character
- Appearance
Well circumscribed

Appears as mural nodule in wall of large cyst
Describe the HISTOPATHOLOGIC findings of pilocytic astrocytomas.

- Similar to what other condition
- Boundary appearance
- Numerous in what cells? x3
Similar to diffuse astrocytomas, but...

Well circumscribed

Numerous bipolar cells

Numerous microcysts

Numerous Rosenthal fibers
50% of gliomas are what?
Glioblastoma Multiforme
Glioblastoma Multiforme:

- Gender
- Age of Peak incidence
- Location
- Prognosis
Males predominate

45-55 y.o.

Cerebral Hemisphere

Very poor - average life expectancy is 8 to 10 months
Gross findings of glioblastoma multiforme:

- Appearance
- Texture
- Associated with? x2
Variegated

Firm to soft

Necrosis and Hemorrhage
Histopathological findings of Glioblastoma Multiforme:

- tumor characteristic
- nucleus character
- associated with?
Highly anaplastic tumor with pleomorphism

Pseudopalisading nuclei around necrotic areas

Necrotic areas
5% to 15% of gliomas are what?
Oligodendrogliomas
Oligodendrogliomas

- gender
- age
- location
M = F

Rare in young and elderly

Cerebral white matter
Gross findings of oligodendrogliomas

- appearance
- boundary
- texture
- associated with? x3
Gray-pink

Well demarcated

Soft and fleshy

Cysts
Small hemorrhages
Calcification
Histopathologic findings of oligodendrogliomas:

- appearance
- very commonly associated with
- prognosis determining factor
- anaplastic changes include what?
Fried egg appearance

Calcification

Astrocytoma

Loss of heterozygosity for 1p and 19q
Oligodendrogliomas

- Prognosis
5 to 10 years
5% of gliomas are what?
Ependymoma
Most ependymomas are found where? Give percentage.
Posterior Fossa
(4th ventricle area)

60% to 70%
Symptoms of Ependymomas
Hydrocephalus
In adults, ependymomas are frequently located where?
Spinal cord
Ependymomas:

- occurs most frequently to?
Children and Young Adults

Especially those with NF type II
Gross findings of Ependymomas:

- Appearance
- Cysts
- Necrosis
- Hemorrhage
Gray and fleshy

Varies

Rare

Rare
Histopathologic findings of Ependymomas:

- Patterns x3
Cells form small canals as if trying to form ventricles

Branching papillae covered by ependymal epithelium

Prominent Perivascular Psuedorosettes
Prognosis of Ependymomas
Similar to astrocytomas

About 4 years survival rate
List all the neuroglial tumors. x5
1. Astrocytomas (diffuse + anaplastic)

2. Pilocytic astrocytoma

3. Glioblastoma multiforme

4. Oligodendrogliomas

5. Ependymomas
What tumors account for 1%-2% of all intracranial neoplasms?
Choroid Plexus Papilloma
Choroid Plexus Papilloma is most prevalent in what population group?
Young Males
Symptoms of Choroid Plexus Papilloma results from what? x2
1. Hemorrhage into papilloma

2. Tumor causing Hydrocephalus
Neuroblastoma is seen in many places, but more common in what anatomical area?
Frontal lobe
Neuroblastoma is most common in what population group?
Below the age of 10.
Small blue cell tumor is also known as what?
Neuroblastoma
Medulloblastoma arises in where?
Cerebellum
Prevalence of Medulloblastoma
2/3 in children (midline)
1/3 in 15-35 y.o. (lateral)

2:1 males
Medullablastoma is frequently spread via what? What does this lead to?
CSF

Hydrocephalus