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43 Cards in this Set
- Front
- Back
Which type of adult brain tumor occurs in the convexities of hemispheres (near the surfaces of the brain) and parasagittal region?
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Meningioma
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What kind of cells are involved in a Meningioma? Significance for location of tumor?
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- Arises from arachnoid cells
- Extra-axial (external to brain parenchyma) - May have dural attachment ("tail") |
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What are the symptoms and prognosis for a Meningioma?
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- Typically benign
- Often asymptomatic - May present with seizures or focal neurologic signs |
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How do you treat Meningioma?
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Resection and/or radiosurgery
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What is the histologic appearance of a Meningioma?
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- Spindle cells, concentrically arranged in a whorled pattern
- Psammoma bodies (laminated calcifications) |
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What type of adult brain tumor is often cerebellar and is associated with von Hippel-Lindau syndrome when found with retinal angiomas?
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Hemangioblastoma
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What brain tumor can lead to polycythemia? How?
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Hemangioblastoma - can produce erythropoietin → 2° polycythemia
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What is the histologic appearance of a Hemangioblastoma?
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Closely arranged, thin-walled capillaries with minimal interleaving parenchyma
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Which type of adult brain tumor is often found at the cerebellopontine angle and can be localized to CN VIII? Origin of cells?
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Schwannoma (if localized to CN VIII it is an acoustic schwannoma / acoustic neuroma)
- Schwann cell origin |
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Which adult brain tumor is S-100 (+)?
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Schwannoma
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How do you treat a Schwannoma?
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Resected or treated with stereotactic radiosurgery
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What should you think of if you see bilateral acoustic Schwannomas?
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NF-2
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Which adult brain tumor is often found in the frontal lobes?
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Oligodendroglioma
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What is the histologic appearance of an Oligodendroglioma?
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- Chicken-wire capillary pattern
- Oligodendrocytes = "fried egg" cells with round nuclei and clear cytoplasm - Often calcified |
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What type of adult brain tumor can put pressure on the optic chiasm causing bitemporal hemianopia?
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Pituitary Adenoma (most commonly a prolactinoma)
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What are the possible sequelae of a pituitary adenoma?
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Hyper or hypo-pituitarism
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What is the location of the adult brain tumors?
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- Glioblastoma Multiforme: cerebral hemispheres and corpus callosum
- Meningioma: external to brain parenchyma - Hemangioblastoma: cerebellar - Schwannoma: cerebellopontine angle, may localize to CN VIII - Oligodendroglia: frontal lobes - Pituitary adenoma: pituitary / optic chiasm |
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What are the types of childhood primary brain tumors?
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- Pilocytic (low-grade) astrocytoma
- Medulloblastoma - Ependymoma - Craniopharyngioma |
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Which type of childhood brain tumor is GFAP (+)?
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Pilocytic (low-grade) Astrocytoma
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Where are Pilocytic (low-grade) Astrocytoma usually found? Prognosis?
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- Most often in posterior fossa (eg, cerebellum), but can be supratentorial
- Benign with good prognosis |
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Which type of childhood brain tumor is associated with Rosenthal fibers (eosinophilic, corkscrew fibers)?
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Pilocytic (low-grade) Astrocytoma
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What is the gross and histologic appearance of Pilocytic (low-grade) Astrocytoma?
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- Usually well circumscribed
- Rosenthal fibers: eosinophilic, corkscrew fibers - Cystic + solid |
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Which type of childhood brain tumor is a form of primitive neuroectodermal tumor?
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Medulloblastoma
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What can a Medulloblastoma cause?
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- Can compress the 4th ventricle → hydrocephalus
- Can send "drop metastases" to spinal cord |
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What type of childhood brain tumor is associated with Homer-Wright rosettes? Prognosis?
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Medulloblastoma - highly malignant
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What is the gross and histologic appearance of Medulloblastoma?
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- Solid cerebellar tumor
- Homer-Wright rosettes - Small blue cells |
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What type of childhood brain tumor is derived from ependymal cells? Prognosis?
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Ependymoma - poor prognosis
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What can an Ependymoma cause?
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Most commonly found in 4th ventricle so it can cause hydrocephalus
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What type of childhood brain tumor is associated with perivascular rosettes
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Ependymoma
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What is the gross and histologic appearance of an Ependymoma?
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- Commonly in 4th ventricle
- Perivascular rosettes - Rod-shaped blepharoblasts (basal ciliary bodies) found near nucleus |
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What type of childhood brain tumor may be confused with a pituitary adenoma? Source?
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Craniopharyngioma - derived from remnants of Rathke pouch
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What is the prognosis and clinical syndrome caused by Craniopharyngioma?
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- Benign tumor
- May be confused with pituitary adenoma because they both cause bitemporal hemianopia |
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What is the most common childhood supratentorial brain tumor?
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Craniopharyngioma
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What is the histologic appearance of a Craniopharyngioma?
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Calcification is common (tooth-enamel like)
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What are the types of herniation syndromes?
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1. Cingulate (subfalcine) herniation under falx cerebri
2. Downward transtentorial (central) herniation 3. Uncal herniation 4. Cerebellar tonsillar herniation into foramen magnum |
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What type of herniation can compress the anterior cerebral artery?
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Cingulate (subfalcine) herniation under falx cerebri (#1)
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What type of herniation can compress the ipsilateral CN III causing a blown pupil and down and out gaze?
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Uncal Herniation (#3) - medial temporal lobe
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What type of herniation can compress the posterior cerebral artery causing contralateral homonymous hemianopsia)?
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Uncal Herniation (#3) - medial temporal lobe
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What type of herniation can compress the contralateral crus cerebri causing ipsilateral paralysis / false localization sign?
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Uncal Herniation (#3) - medial temporal lobe
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What type of herniation can compress the brainstem, inhibiting respiration, and possibly causing coma and death?
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Cerebellar tonsillar herniation into the foramen magnum (#4)
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What are the potential consequences of a cingulate (subfalcine) herniation under the falx cerebri?
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Can compress anterior cerebral artery
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What are the potential consequences of an uncal herniation?
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Compresses:
- Ipsilateral CN III → blown pupil and down and out gaze - Ipsilateral PCA → contralateral homonymous hemianopsia - Contralateral crus cerebri → ipsilateral paralysis, "false localization sign" |
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What are the potential consequences of a cerebellar tonsillar herniation into the foramen magnum?
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Coma and death result when these herniations compress the brain stem (and inhibit respiration)
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