Neuro - Brain Tumors

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Histology - pseudopalisading: tumor cells border central areas of necrosis & hemorrhage

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Glioblastoma multiforme
(grade IV astrocytoma)

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Most common primary brain tumor in adults

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Glioblastoma multiforme
(grade IV astrocytoma)

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Adult tumor positive for GFAP

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Glioblastoma multiforme
(grade IV astrocytoma)

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Worst prognosis of any primary adult brain tumor

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Glioblastoma multiforme
(grade IV astrocytoma)

Typically 6-9 mos

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Metastasizes easily, can cross corpus callosum

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Glioblastoma multiforme
(grade IV astrocytoma)

"Butterfly glioma" crosses corpus callosum

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Second most common primary brain tumor in adults

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Meningioma

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Psammoma bodies

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Meningioma

Psammoma bodies = laminated calcifications, resembling rings of an onion or tree trunk

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From arachnoid cells

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Meningioma

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Third most common primary brain tumor in adults

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Schwannoma

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Commonly localized to the vestibulocochlear nerve

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Schwannoma

(Acoustic schwannoma, or acoustic neuroma)

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When bilateral, associated with neurofibromatosis type 2

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Schwannoma
(Bilateral acoustic schwannoma)

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S-100 positive

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Schwannoma

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Often at cerebellopontine angle

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Schwannoma

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Chicken-wire capillary pattern

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Oligodendroglioma

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Histology - "fried egg" cells, similar to those seen in HPV koilocytes or a seminoma

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Oligodendroglioma

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Often presents with amenorrhea, hypogonadism, gynecomastia, and/or galactorrhea

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Pituitary adenoma
specifically, prolactinoma (most common form)

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Bitemporal hemianopsia in an adult

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Pituitary adenoma

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Can cause hypo- or hyperpituitarism

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Pituitary adenoma

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Adult tumor derived from Rathke's pouch

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Pituitary adenoma

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Most common primary brain tumor in children

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Pilocytic astrocytoma

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Often infratentorial, but may be supratentorial

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Pilocytic astrocytoma

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Histology - Rosenthal fibers: eosinophilic, corkscrew fibers

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Pilocytic astrocytoma

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Childhood tumor positive for GFAP

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Pilocytic astrocytoma

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Most common malignant childhood tumor

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Medulloblastoma

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Histology - Rosettes or Homer-Wright pseudorosettes

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Medulloblastoma

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Associated with the APC (adenomatous polyposus coli) gene mutation in Turcot's syndrome

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Medulloblastoma

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Childhood tumor - can compress 4th ventricle and cause hydrocephalus

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Medulloblastoma or Ependymoma

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Childhood tumor arising from primitive neuroectoderm

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Medulloblastoma

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Most commonly found within the 4th ventricle

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Ependymoma

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Perivascular pseudorosettes

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Ependymoma

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May be associated with von Hippel-Lindau syndrome

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Hemangioblastoma

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Can produce erythropoietin

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Hemangioblastoma

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Histology - foamy cells with high vascularity

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Hemangioblastoma

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May be associated with polycythemia

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Hemangioblastoma

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Most common childhood supratentorial tumor

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Craniopharyngioma

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Childhood tumor arising from remnants of Rathke's pouch

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Craniopharyngioma

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Bitemporal hemianopia in a child

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Craniopharyngioma

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Infratentorial tumor in an adult

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Generally - either Schwannoma or Pituitary adenoma

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Childhood tumor positive for S100

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Pilocytic astrocytoma

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Most common cause of adult brain tumors

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METASTASES! Account for ~50% of tumors in brain

Often present at gray-white junction

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Most common origin of brain metastases

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Lung, Breast, Skin (melanoma), Kidney, GI

"Lots of Bad Stuff Kills Glia"