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43 Cards in this Set
- Front
- Back
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Location: extra-axial
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meningoma
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Location: cerebral hemisphere
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grade II-III astrocytoma (glioblastoma too)
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Location: crossing the corpus callosum
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glioblastoma
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Location: optic nerve
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pilocytic astrocytoma (NF-1)
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Location: sella
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pituitary adenoma
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Location: peri-III ventricle
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pilocytic astrocytoma, glioblastoma
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Location: posterior fossa in children
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pilocytic astrocytoma, medulloblastoma, ependymoma
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Location: pons
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pontine glioma/astrocytoma
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Location: spinal cord
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low grade astrocytoma (grade I and II), ependymoma
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What are the 3 types of gliomas?
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astrocytoma, oligodendroglioma, and ependymoma
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Pilocytic astrocytoma:
What grade? Possible locations? |
Grade 1 (benign)
posterior fossa, optic n., thalamus, spinal cord, cerebrum, hypoth(in patients with neurofibrocytosis) |
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Pilocytic astrocytoma:
MOST COMMON IN CHILDREN Lesion appearance? |
discrete, well-circumscribed, often associated with a cystic area.
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Pilocytic astrocytoma:
Histo appearance? |
biphasic: piloid cells, microstatic areas
rosenthal fibers--thick, elongated, worm-like or "corkscrew" bundle, no mitosis, elongated cells with hair-like processes |
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Fibrillary astrocytoma and glioblastoma multiforme: an infiltrating glial tumor of the cerebral hemispheres--can reach the spinal cord.
What grade? Histo appearance? |
Grade II and III (malignant)
dense with nuclear pleomorphism (different sizes and shapes), mitosis, endothelial proliferation, necrosis, and pseudopalisading ( loss of structural and functional differentiation of normal cells). Also, ring enhancing appearance--nuclei line up around the necrosis. The cells can begin looking like glomeruli. Glioblastoma could result in butterfly glioma of the corpus callosum. |
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Pontine glioma:
COMMON IN CHILDREN What grade? Lesion appearance? |
Grade III-IV.
This tumor is an expansion in the pons that can squash the 4th ventricle. |
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Oligodendroglioma:
Histo appearance? |
Delicate vasculature, fried egg look (nucleus is the 'yolk')
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Ependymoma:
Lesion appearance? What is a common complication? Histo appearance |
A tumor coming from the ependymal lining of the ventricles.
It is common in the posterior fossa and can obstruct CSF outflow = HYDROCEPHALUS pseudorosettes (tumor cells encirculating blood vessels) |
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Myxopapillary ependymoma:
Lesion appearance? |
A cauda equina tumor--cells of the spinal cord become malignant and grow with mucin surrounding them.
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What is a common complication of choroid plexus papilloma (benign)?
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Hydrocephalus because the foramina are blocked.
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What are the nerve cell tumor types? A.k.a primitive neuroectodermal tumor (PNET)
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Medulloblastoma (common in children)--cerebellum
Neuroblastoma--cerebellum Retinoblastoma Pineoblastoma Esthesioneuroblastoma--olfactory bulb |
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Medulloblastoma:
Histo appearance? |
Dense "small blue cell tumor"--large nucleus and small cytoplasm, mitosis, apoptotic (karyorrhectic) cells, endothelial proliferation, necrosis, neuronal of glial differentiation, Horner-Wright rosettes, GFAP (Glial fibrillary acidic protein) positive cells, and abnormal nuclei that mold up against each other and are hyperchromatic.
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Medulloblastoma:
Describe some stats |
Makes up 1/3 of pediatric posterior fossa tumors
Peak incidence is 7 yrs old 70% of cases are younger than 16 yrs old. Comprises 1% of adult primary CNS tumors. |
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Medulloblastoma:
What are drop mets? |
This is seeding of cells that occurs via the CSF. This tumor can be present in the cerebellum, 4th ventricle, midbrain, or meniges. Thus, some tumor cells have access to the CSF.
ALSO: the location of the tumor may block flow of CSF and produce hydrocephalus. |
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What are the germ cell tumor types?
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Germinoma (dysgerminoma)--testes, but mostly occuring in the pineal gland. 99% of the patients with this are male.
Choriocarcinoma--chorionic membrane Embryonal carcinoma Teratoma (teratocarcinoma) Yolk sac tumor Suprasellar--mixed germ cell tumor (50% female) For germ cell tumors, irradiation alone can cure the patient. They can easily hemorrhage and cause hydrocephalus. |
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What are the tumors of covering structures?
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Meningioma
Schwannoma (neurolemoma) Neurofibroma |
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Meningioma: a tumor of the arachnoid cells (meningothelial cells)
Lesion appearance? |
Extra-axial, pushes into brain, attached to the dura, or attached to the cribiform plate, hyperostosis (excessive growth of bone) or invasion of the skull is common. These can also exist in the ventricles. These take a long time to develop until the patient comes acutely. The swelling can push on an artery and cause ischemia.
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Meningoma:
Histo appearance? |
Fibroblastic or meningiothelial cells, whorts (can't find a definition), psammoma bodies (calcific spherical structures), synictial nuclei.
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What are the nerve sheath tumors?
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Schwannoma (neurilemoma) and neurofibroma
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Neurofibroma:
Lesion appearance? |
Fibroblasts intertwine and separate the nerves. The separated end of the nerve bundle must be cut off--destroys the nerve.
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Schwannoma:
Lesion appearance? Histo appearance? |
A mass pushing on the nerve.
Verocay bodies--acellular areas composed of reduplicated basement membrane outlined by opposing rows of parallel nuclei. Antoni A and B (A=compact, B=loose) Can't find a defintion. |
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Neurofibromatosis:
Describe NF1 Histo appearance? |
A.k.a. von Recklinghausen syndrome
Chromosome 17q11.2 Neurofibromin Subcutaneous plexiform neurofibromas, axillary/inguinal freckling, cafe au lait spots, Lisch nodules (“iris hamartomas”) Hamartoma is an excessive but focal overgrowth of cells and tissues), and optic gliomas. |
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Neurofibromatosis:
Describe NF2 Histo appearance |
Chromosome 22q12
Merlin Bilateral schwannomas of CN VIII (acoustic neuroma), meningiomas, neurofibromas of spinal cord dorsal roots. |
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What are the spinal root tumors?
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Optic glioma--a swollen optic nerve
Plexiform neurofibroma--Schwann cells proliferate inside the nerve sheath, producing an irregularly thickened, distorted, tortuous structure. |
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What are the tumors of cell rest?
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Craniopharyngioma
Colloid cyst of 3rd ventricle Epidermoid/dermoid Chordoma |
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Craniopharyngioma:
Lesion appearance? |
Cells form a tooth formation on the sella turcica. This damages the pituitary and optic areas.
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Craniopharyngioma:
Histo appearance? |
Filled with "machinery oil," which can cause meningitis if it gets into the CSF. Also has cholesterol clefts.
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Colloid cyst of the 3rd ventricle:
Lesion appearance? |
Benign
A ball valve flops around and obstructs the foramen of Monro bilaterally. The obstruction mainly occurs at night when the ball moves posteriorly. This can cause hydrocephalus. |
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Epidermoid:
Lesion appearance? |
A benign cyst usually found on the skin. The cyst develops out of ectodermal tissue. Histologically, it is made of a thin layer of squamous epithelium.
The cyst may occur at the midline of the spinal cord after a spinal tap. |
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Chordoma:
Lesion appearance? |
Chordoma is a rare slow-growing malignant neoplasm thought to arise from cellular remnants of the notochord. The notochordal cells are preferentially left behind in the clivus and sacrococcygeal regions.
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Pituitary adenoma:
Lesion appearance? |
Arises from cells of the anterior lobe. A prolactinoma is most common. An enlarging pituitary can damage the sella turcica and optic area. Tumors may not be secretory. If they do become secretory, it appears at the breasts.
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What is the most common brain tumor?
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Metastatic--they go to the lungs.
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What cancers can metatisize in the brain?
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Lung cancer--a small percentage of a very large number.
Melanoma and choriocarcinoma--a high percentage of a very low number. |
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What are common symptoms of schwannomas?
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Diminished hearing, occurs in left pons (toward the inferior cerebellar hemisphere)
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