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70 Cards in this Set
- Front
- Back
This accounts for 80% of all Adult Primary brain tumors
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Diffuse Fibrillary Astrocytomas
-includes Glioblastoma Multiforme |
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When do most Diffuse Fibrillary Astrocytomas occur? What are the clinical manifestations?
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40-60 years of age
Seizures, Headache, Focal signs |
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What defines the prognosis of Astrocytomas?
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Microscopic appearance varies as to Grade:
Atypia = II Mitoses = III Endothelial proliferation &/or Necrosis = IV |
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Grade II Astrocytoma = low grade
-least frequent type |
What is seen here?
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Anaplastic Astrocytoma = Grade III = Mitoses
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What is seen here?
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Glioblastoma Multiforme
-Central areas of necrosis & hemorrhage surrounded by multiple tumor cells -arranged in Pseudopalisading fashion |
What is seen here?
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Glioblastoma Multiforme
-varible, noncircumscribed lesion found in cerebral hemisphere |
What is seen here?
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Glioblastoma Multiforme
-ring with central area of necrosis |
What is seen here?
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What are the molecular genetic characteristics of Low Grade Astrocytomas?
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1. inactivation of p53
2. overexpression of PDGF-A |
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What are the molecular genetic characteristics of High Grade Astrocytomas?
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1. RB gene
2. P16/CDKNZA gene 3. 19q |
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What are Secondary Glioblastoma Multiforme's?
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develop from Diffuse Astrocytomas
usually occur in younger patients associated with p53 mutation |
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What are Primary Glioblastoma Multiforme's?
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Begins as a highly malignant Glioblastoma Multiforme de novo
Usually occurs in older patients associated with EGFR amplification |
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What is the therapy for Glioblastoma Multiforme? What is the prognosis?
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Surgery + Radiation + Chemotherapy
8-10 month survival |
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Brain tumor that microscopically has Central areas of necrosis & hemorrhage surrounded by multiple tumor cells, arranged in a Pseuddopalisading fashion
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Glioblastoma Multiforme
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This is a low-grade Astrocytoma that is benign, slow-growing & usually occurs in the Cerebellum in Children
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Pilocytic Astrocytoma
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What are the most common sites of Pilocytic Astrocytoma?
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1. Cerebellum
2. near Optic nerve 3. Wall of 3rd ventricle |
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Brain tumor that contains Rosenthal Fibers
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Pilocytic Astrocytoma
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Pilocytic Astrocytoma
-cyst with mural nodule Good prognosis |
What brain tumor is seen here?
What is the prognosis? |
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Pilocytic Astrocytoma
-Cerebellum = MC site -piloid cells -benign tumors of children |
What is seen here?
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What is the red arrow pointing at? What brain tumor?
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Rosenthal fibers
Pilocytic Astrocytoma |
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Pleomorphic Xanthoastrocytoma
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This brain tumor has large, bizarre cells with inflammation
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What are the properties of Pleomorphic Xanthoastrocytoma's?
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1. Superficial
2. Temporal lobe 3. Seizure history 4. large, bizarre cells 5. inflammation 6. Good prognosis |
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Brain tumor that has motononous fried-egg appearing cells that often contains calcifications
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Oligodendrogliomas
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What % of Gliomas do Oligodendrogliomas represent? What age do they most often appear in?
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5-15%
4th-5th decades |
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OLIGODENDROGLIOMAS:
1. Symptoms 2. Treatment 3. Prognosis |
1. Seizures, headaches, long history of neurological symptoms
2. Surgery + radiotherapy + CHEMOTHERAPY 3. 5-10 years after diagnosis |
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Oligodendroma
-calcification |
What is seen here?
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Where do Oligodendrogliomas most often occur?
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Frontal Lobe
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Oligodendroglioma = Frontal Lobe
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Based on location, what brain tumor is this?
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Oligodendroglioma
-sheets of uniform cells with "fried egg" appearance -round nuclei with clear cytoplasm |
What brain tumor is this?
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Oligodendroglioma
-loss of arms 1p & 19q Response to Chemotherapy |
What brain tumor? What does this finding signify?
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Tumor arising from the Ependyma of the Ventricular System
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Ependymoma
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What age do Ependymomas most commonly occur in? What part of the brain do they most commonly occur in?
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Children
4th Ventricle |
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When Ependymomas occur in Adults, where do they often present?
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Spinal Cord
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What is the prognosis of Ependymomas?
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Poor = 4 years after surgery
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Brain tumor with Perivascular acellular regions with pseudorosettes; Rod-shaped blepharoplasts (basal ciliary bodies) found near the nucleus
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Ependymoma
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Ependymoma
-lesion has filled the 4th Ventricle -occurs in children |
What brain tumor is this?
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Ependymoma
-uniform cells with round nuclei set in a fibrillary stroma & arranged in a Perivascular Pseudorosette formation |
What brain tumor is this?
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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
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Ependymoma
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Neuronal tumor that most commonly occurs in the Temporal Lobe
Characterized by inflammation, EGB's & Rosenthal fibers Glial component may become anaplastic |
Ganglioglioma
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Neuronal tumor that is Ventricle associated
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Central Neurocytoma
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Neuronal tumor that usually produces a long seizure history. Is Quasi-hamartomatous & has a good prognosis
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DNT = Dysembryoplastic Neuroepithelial Tumor
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Central Neurocytoma = associated with Ventricles
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What neuronal tumor is this?
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Highly malignant Cerebellar tumor of Children associated with a deletion of short arm of chr. 17 (17p-)
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Medulloblastoma
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Radiosensitive highly malignant brain tumor arising most commonly in children
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Medulloblastoma
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Brain tumor that is a form of Primitive Neuroectodermal Tumor (PNET)
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Medulloblastoma
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Where do Medulloblastoma's most commonly occur in children? Adults?
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Children = Cerebellum midline
Adults = Cerebellar hemispheres |
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What is the 5-year survival rate for Medulloblastoma?
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75% with total excision & radiation
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Medulloblastoma = midline Cerebellum
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What brain tumor is this?
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What brain tumor is this?
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Medulloblastoma
-hypercellular sheets of anaplastic cells -cells arranged in a rosette or perivascular pseudorosette formation |
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This is the #1 brain tumor in AIDS
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Lymphoma
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Brain tumor that has both Neuronal & Glial differentiation. Can cause hydrocephalus & seed the CSF
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Medulloblastoma
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Medulloblastoma
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Brain tumor that may be referred to as "small blue cell tumor"
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What type of cells are primarily found in AIDS Lymphoma's? What is associated with AIDS Lymphoma?
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B-cells
EBV |
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What do you want to avoid giving patients at all costs who you suspect of having AIDS Lymphoma?
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Steroids - b/c can "melt" away the tumor & all you see are T cells = fucks up the diagnosis on biopsy
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AIDS Lymphoma
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What is this?
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List the properties of Germ Cell tumors of the brain
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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 |
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Suprasellar Germinoma
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What is seen here?
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Brain tumor that arises from Arachnoid cells external to the brain
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Meningioma
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The 2nd most common Primary intracranial neoplasm
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Meningioma
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What type of Meningioma carries a worse prognosis?
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Papillary
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What gender do Meningiomas most commonly occur in? Why?
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Women after age 30
tumors have Progesterone receptors |
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In what condition do people have Multiple Meningiomas?
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Neurofibromatosis-2 = loss of NF2 gene on chr. 22
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Meningioma
-Whorled pattern of tightly packed tumor cells -calcified Psamomma bodies |
What benign, slow-growing tumor is this?
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Whorled pattern of tightly packed tumor cells & calcified Psamomma bodies
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Meningioma
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From where do most Metastases come from in the brain?
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1. Lung
2. Breast 3. Skin 4. Kidney 5. GI tract |
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Meningioma
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What brain tumor is this?
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What is the most common brain malignancy?
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Metastases
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Melanoma
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What metastatic tumor is this?
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These brain tumors are sharply demarcated & occur at the Gray-White jxn
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Metastases
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What is Meningeal Carcinomatosis? What metastatic tumors tend to do this?
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condition in which a solid tumor diffusely spreads to the leptomeninges
Small cell Adenocarcinomas of the breast Lung |