Neuro Path -2

Front 1

True or False. Brain tumors usually metastasize all over the body.

Back 1

False, they tend not to metastasize

Front 2

What percent of brain tumors are not primary (are metastasis) in adults?

Back 2

50% of adult tumors

Front 3

Where do metastases from the body usually land in the brain?

Back 3

At the gray-white border

Front 4

Where do most primary brain tumors in adults occur (anatomicaly)?

Back 4

Above tentorium cerebelli

Front 5

Put these three adult tumors in order from highest to lowest freuency: Glioblastoma multiforme, meningioma, and Schwannoma, and ependymoma

Back 5

G. Multiforme, Meningimoma, and Schwannoma last is ependymoma

Front 6

Where do most primary brain tumors occur in children (anatomiccally)?

Back 6

Below Tentorium cerebelli

Front 7

Do Meningiomas normally occur in chidlren or adults

Back 7

Adults

Front 8

How common are meningiomas and in what age group?

Back 8

2nd most common brain tumor in adults

Front 9

True or False. Male patients are more likely to get Meningiomas.

Back 9

False, Females get this more- estrogen receptors on them

Front 10

What tumor arises from arachnoidal cells and is usually located in a paragattal location?

Back 10

Meningioma

Front 11

What type of cells do menigiomas arise from?

Back 11

Arachnoid cells

Front 12

What type of brain tumor can present as spindle cells ocncentrically in a whorled pattern?

Back 12

Meningioma

Front 13

What type of brain tumor has psmomma bodies

Back 13

Meningioma

Front 14

What type of brain tumor has a large spectrum histologically, and usually is a grade I WHO lesion?

Back 14

Meningioma

Front 15

Are meningiomas resectable, and what is the rate of recurrence?

Back 15

Yes, IT depends on grade. Lower grade tumors have 7-20% recurrence

Front 16

Are meningimas benign or malignant?

Back 16

Most common benign tumor in adults

Front 18

What age group are pilocytic astrocytomas usually found in?

Back 18

Children

Front 19

What determines the prognosis of a pilocytic astrocytoma?

Back 19

Depending on whether its accessible to surgery or not (cerebellum=easy, hypothalamus=not easy)

Front 20

What childhood tumor can occur supratentorially, has Eosinophillic corkscrew fibers, and is characterzied by areas of soft and dense tissue?

Back 20

Pilocytic (low-grade) astrocytoma

Can occur supratentorially, but mostly in the posterior fossa
Corkscrew eoisinophilc fibers are called Rosenthal fibers

Front 21

What are the two main types of astrocytoma?

Back 21

Low grade- Pilocytic- kids and High-grade Glioblastoma multiforme -adults

Front 22

True or False. Pilocytic astrocytomas are usually not well-circumscribed, and have expanding borders.

Back 22

False, they are usually well circumscribed

Front 23

Where are most pilocytic astrocytomas found

Back 23

In the posterior fossa

Front 24

What childhood tumor has a gross appearance of both cystic and solid and what is the corresponding immunohistochemical marker for it?

Back 24

GFAP- pilocytic astrocytoma

Front 25

Are pilocytic astrocytomas benign or malignant?

Back 25

They are low grade benign tumors.and have a good prognosis

Front 26

True or False. Pilocytic Astrocytomas often progress to Glioblastoma Multiforme or other infiltrating astrocytomas.

Back 26

False, they are a different mutation altogether (17q)

Front 27

What type of tumor shows psudeopallisading tumor cells bordering cetnral areas of necrosis and hemorrhage?

Back 27

Glioblastoma multiorme- adults malignant

Front 28

What is the most common primary brain tumor?

Back 28

Glioblastoma multiorme- adults- malignant

Front 29

Whats the prognosis of Glioblastoma multiforme?

Back 29

less than 1 yr to live- bad prognosis

Front 30

What kind of cell do Glioblastoma multiforme arise from?

Back 30

Astrocytes = GFAP positive

Front 31

True or False. Glioblastoma multiforme always develops from dedifferentiation of a low grade astrocytoma.

Back 31

False. Sometimes it arises de novo

Front 32

What type of brain tumor commonly crosses corpus callosum and ?

Back 32

Glioblastoma multiorme- adults

Front 34

What type of brain tumor has fried egg cells which are round nuclei with a clear cytoplasm?

Back 34

Oligodendroma

Front 35

Which type of tumor has a chicken wire capillary appearance, with cells in the middle?

Back 35

Oligodendroma

Front 36

A tumor has fried egg cells. What lobe is it most common in?

Back 36

Frontal lobe

Front 37

A tumor has a chicken wire capillary pattern. Is it more common in kids or adults? And is it common or rare?

Back 37

Rare, adults

Front 38

True or False. Oligodendromas are usually rapidly growing.

Back 38

False. They are slow growing

Front 39

Whats a good pneumonic for oligodendromas?

Back 39

Come to the front slowly (slow growing) (frontal lobe) for fried eggs (oligodendrocyes) and chicken (chicken wire capillary). Adults only. (more common in adults)

Front 40

Are oligodendromas well or poorly circumscribed?

Back 40

poorly circumscribed, but better prognosis than G. multiforme

Front 41

What poorly differentiated tumor has a better prognosis: one with a fried egg appearance or one with psudeopallisading tumor cells around hemorrhage?

Back 41

Fried egg Oligodendroma is more responsive to therapy and better prognosis Than G. Multiforme

Front 42

What tumor has 1p and 19q loss (brain tumor)?

Back 42

Oligodendroma

Front 43

Someone has a brain tumor. What is most likely the type?

Back 43

Metastasis

Front 45

What are most primary CNS lymphomas: bcell or t cell?

Back 45

B cell Non-hodgkins

Front 46

IF someone has a primary CNS lymphoma what is the likely underlying disease?

Back 46

AIDS, and the tumor is caused by EBV

Front 47

Put the following brain metastasis in order from higest to lowest frequency. Lung, breast, kidney, skin, GI

Back 47

Lung>Breast>Skin>kidney>GI

Front 48

Whats the most common childbood brain tumor that is supratentorial?

Back 48

Craniopharyngioma

Front 49

What age group does the brain tumor that has peripheral pallisading nuclei with central reticular pattern have?

Back 49

Kids- Craniopharygioma

Front 50

A tumor has Wet keratin perals and is causing bitemporal hemianopsia. Is it benign or malignant?

Back 50

Benign Craniopharyngioma

Front 51

What type of cells do Craniopharyngiomas derive from?

Back 51

Rathke's pouch

Front 52

What is the prognosis for Craniopharngioma in kids?

Back 52

Mostly not recurring

Front 54

What type of tumor arises from neuronal precursors to Cerebellum?

Back 54

Medulloblastoma

Front 55

What is the most common brain tumor that is malignant in children?

Back 55

Medulloblastoma

Front 56

Where is a tumor that has small blue cells likely to be in a patient?

Back 56

Medulloblastoma in the Cerebellum

Front 57

What is a tumor that has small blue cells likely to be- solid or cystic?

Back 57

Solid tumor - medullomastoma

Front 58

A tumor displays rossete pattern with small blue cells on histology. Is it likely a kid or an adult?

Back 58

Kid- Medulloblastoma

Front 59

What type of tumor is likely to spread through CSF?

Back 59

Medulloblastoma - kids

Front 60

True or False. Medulloblastoma is a very malignat tumor in children, and the 5 yrs survival is almost 0%.

Back 60

False. Although medulloblastoma is very malignant, it is also radiosensitive. 5 yrs survival= 50%

Front 61

By definition, what do medulloblastomas arise in?

Back 61

Cerebellum

Front 62

Which cell layer of the cerebellum do medulloblastomas arise from?

Back 62

External granular cell layer

Front 64

What type of tumor is most commonly found around the 4th ventricle in children?

Back 64

Ependyoma

Front 65

Where do ependyomas most commonly occur in adults? In kids?

Back 65

Spinal cord- adults. 4th ventricle=kids

Front 66

A tumor displying perivascular psudeorossetes near a CSF filled space is found. There are no small blue cells and there are basal cilliary bodies) What is it?

Back 66

Ependyoma- worse prognosis in kids

Front 67

What two brain tumors often compress the 4the ventricle and lead to hydrocephalus?

Back 67

Meduloblastoma and Ependymoma

Front 69

What type of brain tumor is typically encapsulated and usualy associated with a peripheral nerve (nerve 8)?

Back 69

Schwannoma- usually acoustic neuroma

Front 70

A tumor is found a the cerebellopontine angle. What tumor marker is it most likely to show?

Back 70

S-100 Schwannoma (acoustic neuroma)

Front 71

What condition often has bilateral Schawnnomas?

Back 71

Neurofibromatosis Type II- Bilateral Acoustic neuromas

Front 72

A tumor shows pallisading around central pink areas and shows S-100 tumor marker. What are the bodies called, and how common is this tumor?

Back 72

3rd most common tumor-schwannoma, and they are called verrucay bodies

Front 73

What brain tumor doesn’t arise from the CNS, but rather the PNS

Back 73

Schwannoma- usually acoustic neuroma

Front 74

What are other nerve sheath tumors?

Back 74

Neurofibromas, and MPNST (malignant peripheral nerve sheath tumor)

Front 75

What does a uniltaral schwannoma in a child make you think about?

Back 75

Nuerofibromatosis type II. Also bilateral makes u think about this

Front 77

True or False. Neurofibromas, which rise from peripheral nerve sheaths, are well circumscribed.

Back 77

False, they are poorly circumscribed

Front 78

What are the two types of neurofibromas?

Back 78

Plexiform (diagnositc of NF1 or 2) and Diffuse

Front 79

Which type of neurofibromas make you worry about malignant transformation?

Back 79

Plexiform- Diagnostic of NF1

Front 80

What type of central nervous system tumors arise in Neurofibramotis Type 1?

Back 80

Pilocytic astrocytomas in the optic system (optic gliomas)

Front 81

IF a patient has an optic glioma what underlying disease do you always want to think about?

Back 81

Neurofibramatosis Type 1

Front 83

True of False. Neurofibramatosis type II typically have many neurofibromas.

Back 83

false, this is more in NF1

Front 84

True or False. Neurofbiramotis type I typically have many neurofibromas.

Back 84

True and about 5% of these undergo MPNST transformation (malignant)

Front 85

What type of tumors are mostly associated with NF2?

Back 85

Schwannomas- either vestibular or other (bilateral acoustic)

Front 86

Juvenile cataracts are associated with neurophakamotiss?

Back 86

NF2

Front 87

What sydrome can produce hemangiomas in the retina, and Pheochromocytoma?

Back 87

Von-hippel Lindau chromosome 3- Auto Dominant

Also Bilateral renal cell carcinomas- the more recognizable buzz word

Front 88

A patient has bilateral renal celle carcinomas, and pheochromocytoma. What other lesion are they likely to have?

Back 88

Hemangioblastoma in the retina

Front 89

What hormone can a tumor that is associated with foamy cells and high vasculairty produce?

Back 89

EPO causing secondary polycyth- This is hemangioblastoma

Front 90

Where are hemangioblastomas commonly found?

Back 90

In the cerebellum. If in retina- suggestive of VHL syndrome