Neuropathology Of Tumors Of The Cns

Front 1

what are the signs of increased intracranial pressure?

Back 1

headache
nausea
vomiting

Front 2

How will edema present?

Back 2

widened gyri and narrowed sulci

Front 3

what is a midline shift?

Back 3

herniation of the cingulate gyrus to the opposite cerebral hemisphere due to increased intracranial pressure

Front 4

what is the most medial part of the temporal lobe called?

Back 4

uncus

Front 5

what will uncal herniation cause?

Back 5

necrosis of the uncus
compression on CN III
Kernohan's notch

Front 6

how will CN III compression present?

Back 6

fixed dilated pupils

Front 7

what causes Kernohan's notch? how will it present?

Back 7

uncle herniation compressing the cerebral peduncles

presents with ipsalateral hemiparesis (ipsalateral to the tumor)

Front 8

what is the main concern with cerebellar tonsil herniation?

Back 8

compression of the medulla which causes depression of vital functions

Front 9

what is a duret hemorrhage?

Back 9

when the brain herniates downward into the foramen magnum due to increased intracranial pressure it can cause the tiny vessel of the pons to rupture. this is called a duret or pontine hemorrhage

Front 10

how will a midline shift or cingulate gryus herniation present?

Back 10

lower extremity weakness
urinary incontinence

Front 11

how will a duret hemorrhage present clinically?

Back 11

stupor
coma

Front 12

what are the 3 prognostic factors for CNS tumors? what is the best?

Back 12

age
location
grade

age is the best prognostic factor

Front 13

what is the most common tumor type seen in the CNS?

Back 13

astrocytomas

Front 14

what is a PNET? what is the most common type?

Back 14

Primitive Neural Ectodermal Tumor - a tumor that develops from a primitive stem cell that has not differentiated yet

Medulloblastoma is the most common type

Front 15

who is affected by glioblastomas?

Back 15

adults of old age

Front 16

who is affected by medulloblastoma?

Back 16

children

Front 17

what are the 3 grades of infiltrative astrocytomas?

Back 17

Diffuse astrocytoma - grade II
anaplastic astrocytoma - grade III
glioblastoma - grade IV

Front 18

what age group is affected by astrocytomas? where do they most commonly occur?

Back 18

30 - 50 y/o

cerebral cortex

Front 19

what immunohistochemical marker is associated with astrocytomas?

Back 19

GFAP

Front 20

what tumor has a gross appearance that makes it called the "butterfly glioma"?

Back 20

glioblastoma

Front 21

glioblastoma

Back 21

pseudopalisading appearance and glomeruloid vasculature histologically
butterfly appearance grossly
necrosis
hemorrhagic
vascular proliferation

Front 22

brain stem glioma

Back 22

affects children and young adutls
found in the brain stem
histologically looks like astrocytoma

Front 23

Pilocytic astrocytoma

Back 23

children and young adults
most commonly in cerebellum
astrocytes look like hair
abundant rosenthal fibers

Front 24

oligodendroglioma

Back 24

grade II
fried egg appearance
chicken wire vessels
affects 30-40 y/o with a long history of seizures

Front 25

what is the genetic alteration associated with oligodendroglioma?

Back 25

loss of heterozygosity of chromosome 1p and 19q

Front 26

ependymoma

Back 26

10-15 y/o
usually found near 4th ventricle
will find true rosettes
grade III

Front 27

what is a big concern with medulloblastoma?

Back 27

metastatic spread via the CSF

Front 28

myxopapillary ependymoma

Back 28

affect all ages but ave. is 36 y/o
more common in males
clinically present with low back pain for a long duration
arise from filum terminale

Front 29

medulloblastoma

Back 29

most common brain tumor of children
most commonly found in cerebellum
small blue cell tumor
homer wright rosettes

Front 30

primary CNS lymphoma

Back 30

seen in immunosuppressed (AIDS patients)
most commonly of B cell origin and associated with Ebstein-Barr virus
infiltrates parencyma and clusters around blood vessels

Front 31

what is meant by angiocentric pattern? in what pathology would you see it?

Back 31

the tendency to cluster around blood vessels

primary CNS lymphoma

Front 32

choriod plexus papilloma

Back 32

first decade of life
most commonly lateral and 4th ventricles

Front 33

meningioma

Back 33

adults
common in females
more common in spine than cranium
form as a lobulated firm mass attached to the dura
whorls and psammoma bodies
associated with NF 2

Front 34

which chromosome is associated with neurofibromatosis 2? which tumor is associated with NF 2?

Back 34

chromosome 22

meningioma
bilateral schwannomas of CN VIII are diagnostic

Front 35

what are the primary sites of CNS metastatic tumors?

Back 35

lung
breast
melanoma
kidney
GI

Front 36

what is meningeal carcinomatosis?

Back 36

diffuse infiltration by tumor cells in the meninges of the brain, spinal cord, and nerve roots

Front 37

which cancers are most likely to produce paraneoplastic syndromes that affect the CNS?

Back 37

lung
ovarian

Front 38

what nerve is most commonly involved in schwannoma?

Back 38

CN VIII - vestibulocochlear

Front 39

what is a schwannoma?

Back 39

a beging solitary well circumscibed mass attached to a nerve

Front 40

what disease or disorder are schwannomas associated with?

Back 40

NF 2 (on chromosome 22)

Front 41

what is the major difference between a schwannoma and a neurofibroma?

Back 41

schwannomas do not infiltrate the nerve while neuroribromas do

Front 42

what disease or disorder are neurofibromas associated with?

Back 42

neurofibromatosis 1

Front 43

ganglioglioma

Back 43

grade I/II
usually benign
8.5 - 25 y/o
usually in temporal lobe

Front 44

what is the difference between a ganglioglioma and a gangliocytoma?

Back 44

gangliocytomas are composed of mature ganglion cells alone while gangliogliomas has neoplastic glial cells

Front 45

central neurocytoma

Back 45

located in lateral ventricle
small round clear cells with uniform nuclei
calcifications

Front 46

neurofibromatosis 1

Back 46

chromosome 17
autosomal dominant inheritance
will cause neurofibromas all over the body
characteristic cafe-au-lait spots and Lisch nodules in the iris

Front 47

neurofibromatosis 2

Back 47

chromosome 22
autosomal dominant
associated with schwannomas and multiple meningiomas

Front 48

what does bilateral schwannoma tell you?

Back 48

the person has NF 2

Front 49

tuberous sclerosis

Back 49

chromosome 9 and 16
autosomal dominant
seizures, mental retardation, behavior problems, increased ICP
benign tumors, shagreen patches, hypopigmentation of the skin

Front 50

subependymal giant cell astrocytoma

Back 50

associated with tuberous sclerosis

Front 51

von Hippel-Lindau disease

Back 51

chromosome 3
autosomal dominant
associated with hemangioblastoma