Central Nervous System Tumors

Flashcards about Central Nervous System Tumors

List the different types of neuroepithelial tumors.

Astrocytic Tumors, Oligodendroglial Tumors, Mixed Gliomas, Ependymal Tumors, Choroid Plexus Tumors, Neuronal & Mixed Neuronal-Glial Tumors, Pineal Region Tumors, Embryonal Tumors.

Name some specific types of brain tumors from the Neuroglial, Neuronal, Embryonal, and Meningeal categories.

Astrocytoma, Oligodendroglioma, Ependymoma, Choroid plexus tumors, Ganglioglioma, Gangliocytoma, Central neurocytoma, Medulloblastoma, Neuroblastoma, Meningioma, Sarcoma, Hemangioblastoma, Germinoma, Teratoma, Adenoma, Carcinoma

What is a glioma?

A type of cancer that starts in the brain or spine arising from glial cells.

What are the main cells that Gliomas resemble?

Astrocytes, Oligodendrocytes, Ependymal cells, Cells from different types of glia

Name the variants and WHO grading of Astrocytic Tumors.

Pilocytic Astrocytoma, Diffuse Astrocytoma, Anaplastic Astrocytoma, Glioblastoma Multiform

Describe the gross appearance of an Astrocytoma.

Poorly defined, grayish white fleshy mass that infiltrates brain tissue.

What are the microscopic variants of Astrocytoma?

Fibrillary, Pilocytic, Protoplasmic (Gemistocytic)

Describe the histological features of Pilocytic Astrocytoma (Grade I).

Well-differentiated mature astrocytes.

Describe the histological features of Diffuse Astrocytoma (Grade II).

Moderate hypercellularity, mild nuclear atypia, no or minimal mitosis.

Describe the histological features of Anaplastic Astrocytoma (Grade III).

Increased cellularity and diffuse infiltration, increased nuclear atypia, increased mitotic activity.

Describe the histological features of Glioblastoma Multiform (Grade IV).

Vascular proliferation, necrosis, crowded anaplastic cells, multinucleated giant cells, marked nuclear atypia, marked mitosis.

Describe the key characteristics of a Pilocytic Astrocytoma microscopically.

Compact areas of elongated fibrillated cells alternating with microcystic areas of stellate astrocytes.

What are the variants and WHO grades of Oligodendroglial Tumors?

Oligodendroglioma, Anaplastic Oligodendroglioma

Describe the gross appearance of an Oligodendroglioma.

Well-defined grayish gelatinous mass with cystic foci; hemorrhage and calcification are often found.

Describe the microscopic appearance of an Oligodendroglioma.

Sheets of uniform cells with dense round nuclei, clear cytoplasm with perinuclear halo (honeycomb or fried egg appearance).

What are the variants and WHO grading of Ependymal Tumors?

Myxopapillary Ependymoma, Ependymoma, Anaplastic Ependymoma

What are the common sites for Ependymomas?

Ventricular system (mostly 4th ventricle then lateral ventricles), spinal cord.

Describe the microscopic appearance of an Ependymoma.

Oval monomorphic cells arranged in true rosette pattern (around empty spaces) or false rosette (around blood vessels).

Where do Myxopapillary Ependymomas typically occur?

Region of the filum terminale of spinal cord.

Describe the microscopic characteristics of a medulloblastoma.

Crowded small oval cells with enlarged hyperchromatic nuclei, scanty cytoplasm & frequent mitosis; may exhibit rosette formation.

What are the common sites for Meningiomas?

Usually attached to dura, sagittal sinus, posterior cranial fossa, along spinal cord, rarely cerebellopontine angle & ventricular system.

What are the variants and WHO grades of Meningioma?

Benign Meningioma, Atypical Meningioma, Anaplastic (Malignant) Meningioma

Describe the gross appearance of a Meningioma.

Well-defined encapsulated round or oval mass, firm, grayish white, with whorly appearance.

Describe the microscopic appearance of a Meningioma.

Whorled pattern of meningothelial cells (onion skin), and psammoma bodies.

Describe the gross appearance of a Schwannoma.

Firm, round or fusiform, well encapsulated mass, along one side of the nerves.

What are the two types of cells seen microscopically in Schwannomas and their characteristics?

Antoni type A (Verocay bodies): hypercellular area, formed of long spindle cells, having elongated parallel nuclei (Palisade manner). Antoni type B: hypocellular area, formed of large rounded pale cells in a loose stroma (honey combed appearance).

What are the Tumor-related Factors that affect the prognosis of CNS Tumors?

Histologic Grade, Tumor Stage, Tumor Type, Tumor Size, Tumor Site, Necrosis, Vascular Proliferation, Genetic alteration

What are the Host-related Factors that affect the prognosis of CNS Tumors?

Age, Pre-operative status

What are the Treatment-related Factors that affect the prognosis of CNS Tumors?

Extent of resection & incomplete resection, Adjuvant therapy