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70 Cards in this Set

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  • Back
This accounts for 80% of all Adult Primary brain tumors
Diffuse Fibrillary Astrocytomas
-includes Glioblastoma Multiforme
When do most Diffuse Fibrillary Astrocytomas occur? What are the clinical manifestations?
40-60 years of age

Seizures, Headache, Focal signs
What defines the prognosis of Astrocytomas?
Microscopic appearance varies as to Grade:
Atypia = II
Mitoses = III
Endothelial proliferation &/or Necrosis = IV
Grade II Astrocytoma = low grade
-least frequent type
What is seen here?
Anaplastic Astrocytoma = Grade III = Mitoses
What is seen here?
Glioblastoma Multiforme
-Central areas of necrosis & hemorrhage surrounded by multiple tumor cells
-arranged in Pseudopalisading fashion
What is seen here?
Glioblastoma Multiforme
-varible, noncircumscribed lesion found in cerebral hemisphere
What is seen here?
Glioblastoma Multiforme
-ring with central area of necrosis
What is seen here?
What are the molecular genetic characteristics of Low Grade Astrocytomas?
1. inactivation of p53
2. overexpression of PDGF-A
What are the molecular genetic characteristics of High Grade Astrocytomas?
1. RB gene
2. P16/CDKNZA gene
3. 19q
What are Secondary Glioblastoma Multiforme's?
develop from Diffuse Astrocytomas

usually occur in younger patients

associated with p53 mutation
What are Primary Glioblastoma Multiforme's?
Begins as a highly malignant Glioblastoma Multiforme de novo

Usually occurs in older patients

associated with EGFR amplification
What is the therapy for Glioblastoma Multiforme? What is the prognosis?
Surgery + Radiation + Chemotherapy

8-10 month survival
Brain tumor that microscopically has Central areas of necrosis & hemorrhage surrounded by multiple tumor cells, arranged in a Pseuddopalisading fashion
Glioblastoma Multiforme
This is a low-grade Astrocytoma that is benign, slow-growing & usually occurs in the Cerebellum in Children
Pilocytic Astrocytoma
What are the most common sites of Pilocytic Astrocytoma?
1. Cerebellum
2. near Optic nerve
3. Wall of 3rd ventricle
Brain tumor that contains Rosenthal Fibers
Pilocytic Astrocytoma
Pilocytic Astrocytoma
-cyst with mural nodule

Good prognosis
What brain tumor is seen here?

What is the prognosis?
Pilocytic Astrocytoma
-Cerebellum = MC site
-piloid cells
-benign tumors of children
What is seen here?
What is the red arrow pointing at? What brain tumor?
Rosenthal fibers

Pilocytic Astrocytoma
Pleomorphic Xanthoastrocytoma
This brain tumor has large, bizarre cells with inflammation
What are the properties of Pleomorphic Xanthoastrocytoma's?
1. Superficial
2. Temporal lobe
3. Seizure history
4. large, bizarre cells
5. inflammation
6. Good prognosis
Brain tumor that has motononous fried-egg appearing cells that often contains calcifications
What % of Gliomas do Oligodendrogliomas represent? What age do they most often appear in?

4th-5th decades
1. Symptoms
2. Treatment
3. Prognosis
1. Seizures, headaches, long history of neurological symptoms
2. Surgery + radiotherapy + CHEMOTHERAPY
3. 5-10 years after diagnosis
What is seen here?
Where do Oligodendrogliomas most often occur?
Frontal Lobe
Oligodendroglioma = Frontal Lobe
Based on location, what brain tumor is this?
-sheets of uniform cells with "fried egg" appearance
-round nuclei with clear cytoplasm
What brain tumor is this?
-loss of arms 1p & 19q

Response to Chemotherapy
What brain tumor? What does this finding signify?
Tumor arising from the Ependyma of the Ventricular System
What age do Ependymomas most commonly occur in? What part of the brain do they most commonly occur in?

4th Ventricle
When Ependymomas occur in Adults, where do they often present?
Spinal Cord
What is the prognosis of Ependymomas?
Poor = 4 years after surgery
Brain tumor with Perivascular acellular regions with pseudorosettes; Rod-shaped blepharoplasts (basal ciliary bodies) found near the nucleus
-lesion has filled the 4th Ventricle
-occurs in children
What brain tumor is this?
-uniform cells with round nuclei set in a fibrillary stroma & arranged in a Perivascular Pseudorosette formation
What brain tumor is this?
An 8-year-old girl presents to your clinic complaining of severe headaches & blurry vision. During physical exam, you note bilateral papilledema. CT demonstrates a mass extending from the floor of the 4th Ventricle & dilated Lateral & Third Ventricles. You suspect that a CT-guided biopsy would demonstrate cells with Blepharoplasts in a perivascular pseudorosette arrangement
Neuronal tumor that most commonly occurs in the Temporal Lobe

Characterized by inflammation, EGB's & Rosenthal fibers

Glial component may become anaplastic
Neuronal tumor that is Ventricle associated
Central Neurocytoma
Neuronal tumor that usually produces a long seizure history. Is Quasi-hamartomatous & has a good prognosis
DNT = Dysembryoplastic Neuroepithelial Tumor
Central Neurocytoma = associated with Ventricles
What neuronal tumor is this?
Highly malignant Cerebellar tumor of Children associated with a deletion of short arm of chr. 17 (17p-)
Radiosensitive highly malignant brain tumor arising most commonly in children
Brain tumor that is a form of Primitive Neuroectodermal Tumor (PNET)
Where do Medulloblastoma's most commonly occur in children? Adults?
Children = Cerebellum midline

Adults = Cerebellar hemispheres
What is the 5-year survival rate for Medulloblastoma?
75% with total excision & radiation
Medulloblastoma = midline Cerebellum
What brain tumor is this?
What brain tumor is this?
-hypercellular sheets of anaplastic cells
-cells arranged in a rosette or perivascular pseudorosette formation
This is the #1 brain tumor in AIDS
Brain tumor that has both Neuronal & Glial differentiation. Can cause hydrocephalus & seed the CSF
Brain tumor that may be referred to as "small blue cell tumor"
What type of cells are primarily found in AIDS Lymphoma's? What is associated with AIDS Lymphoma?

What do you want to avoid giving patients at all costs who you suspect of having AIDS Lymphoma?
Steroids - b/c can "melt" away the tumor & all you see are T cells = fucks up the diagnosis on biopsy
AIDS Lymphoma
What is this?
List the properties of Germ Cell tumors of the brain
1. Usually Midline in the Pineal Gland (MC) or Suprasellar areas
2. most commonly in Young Men in Pineal Gland
3. Germinoma = Seminoma
4. Radiation & Chemosensitive
Suprasellar Germinoma
What is seen here?
Brain tumor that arises from Arachnoid cells external to the brain
The 2nd most common Primary intracranial neoplasm
What type of Meningioma carries a worse prognosis?
What gender do Meningiomas most commonly occur in? Why?
Women after age 30

tumors have Progesterone receptors
In what condition do people have Multiple Meningiomas?
Neurofibromatosis-2 = loss of NF2 gene on chr. 22
-Whorled pattern of tightly packed tumor cells
-calcified Psamomma bodies
What benign, slow-growing tumor is this?
Whorled pattern of tightly packed tumor cells & calcified Psamomma bodies
From where do most Metastases come from in the brain?
1. Lung
2. Breast
3. Skin
4. Kidney
5. GI tract
What brain tumor is this?
What is the most common brain malignancy?
What metastatic tumor is this?
These brain tumors are sharply demarcated & occur at the Gray-White jxn
What is Meningeal Carcinomatosis? What metastatic tumors tend to do this?
condition in which a solid tumor diffusely spreads to the leptomeninges

Small cell
Adenocarcinomas of the breast