Term
| clinical symptoms of CNS mass lesions |
|
Definition
1. altered level of consciousness
2. focal deficits, depending on location
3. seizure
4. elevated ICP and CSF protein
5. headache
6. papilledema |
|
|
Term
|
Definition
| anywhere within the brain parenchyma |
|
|
Term
|
Definition
| outside the brain parenchyma |
|
|
Term
| metastatic carcinoma tumors |
|
Definition
1. usually at the gray/white junction when axial
2. may be extra-axial (dural)
3. most common intracranial adult tumor
4. most commonly small cell carcinomas from epithelial tissue, i.e. lung, breast, kidney, GI, skin
5. sarcomas uncommon
6. predominance of location relates to blood flow (cerebrum>cerebellum>spinal cord); vertebral bodies more common than cord |
|
|
Term
| gross/radiology features of metastatic carcinoma |
|
Definition
1. tumor emboli most commonly found at the grey/white junction - appears as hemorrhage
2. may be more than one lesion
3. marked edema surrounding tumor (more edema than primary cancers) |
|
|
Term
|
Definition
1. 20% of primary CNS tumors
2. 40-65 yrs old
3. female 2:1
4. some have progesterone or estrogen receptors, can accelerate growth during pregnancy |
|
|
Term
| clinical features of meningioma |
|
Definition
1. benign, slow progression but can be locally aggressive and invade bone
2. clinical symptoms depend on location
3. may be found on external surface of brain, ventricular symptom, or on bony ridges where the dura is thick and prominent
4. prognosis is good with 25% recurrence b/c of incomplete excision |
|
|
Term
| pathological features of meningioma |
|
Definition
1. well circumscribed
2. may be focally mineralized
3. arachnoid-like cells with vacuolated nucleus
4. syncytium - sheets of cells without distinct borders
5. spindle-shaped cells - elongated cells with abundant cytoplasm
6. cellular whorls of arachnoid cells
7. psammoma bodies: concentric laminated calcifications |
|
|
Term
|
Definition
1. 10% of primary tumors
2. 35-60 years - younger age and multiple if part of neurofibromatosis complex
3. cranial nerves (VIII), sensory spinal nerves, peripheral nerves involved
4. favorable prognosis - benign and slow growing |
|
|
Term
| gross findings in schwannoma |
|
Definition
1. nerve focally enlarged and rubbery
2. tumor grows by expansion and is encased within the nerve - displaces nerve
3. usually can be shelled out sparing remaining nerve |
|
|
Term
| pathologic features of schwannoma |
|
Definition
1. spindle-cell proliferation with wavy appearance
2. Antoni A: cellular with palisading nuclei, very pink
3. Antoni B: mixed with loose, less cellular areas, bluish
4. Verocay body: palisading nuclei in parallel rows with intervening anuclear zone |
|
|
Term
| classification of circumscribed astrocytoma |
|
Definition
1. relatively well-circumscribed or cystic
2. usually low grade (I)
3. low tendency for anaplastic progression
4. favorable prognosis |
|
|
Term
| classification of diffuse astrocytoma |
|
Definition
1. infiltrative margin
2. 3 histologic grades (II-IV)
3. tendency to progress to more anaplastic forms
4. unfavorable prognosis |
|
|
Term
| epidemiology of circumscribed astrocytoma |
|
Definition
1. 10% of primary CNS tumors
2. childhood tumor
3. location in midline, especially the cerebellum or optic nerve |
|
|
Term
| Juvenile Pilocytic Astrocytoma: gross features |
|
Definition
1. well-demarcated, effacing adjacent structures
2. grey-white, rubbery to gelatinous
3. may be cystic, especially when in cerebellum
4. encapsulated congealed proteinacious content |
|
|
Term
| Juvenile Pilocytic Astrocytoma: pathologic features |
|
Definition
1. elongated spindle-shaped astrocytes (piloid)
2. biphasic pattern of hyper and hypodence areas with microcysts
3. condensed pink areas surrounding blood vessels |
|
|
Term
|
Definition
| pink beaded arrangement of astrocyte glial filaments common in circumscribed astrocytomas |
|
|
Term
| pathological features of Glioblastoma Multiforme (GBM) grade IV |
|
Definition
1. stains positively for the presence of the intermediate cytoskeletal filaments, GFAP (glial fibrillary acidic protein)
2. high cellularity
3. pleomorphism
4. hyperplastic vascularity
5. mitoses and necrosis |
|
|
Term
|
Definition
-poor prognosis, usually 6-12 months
-transformation of low grade tumor to high grade can be traced by cumulative gene abnormalities including loss of function p53 mutations and LOH of chromosome 10
-treatment is surgical debulking, radiation, and chemo (poor response) |
|
|
Term
| epidemiology of oligodendroglioma |
|
Definition
1. 5% of CNS tumors
2. 25-50 years
3. affects cerebral hemispheres
4. 40% have 5 year survival; progressive course over several years |
|
|
Term
| gross features of oligodendroglioma |
|
Definition
| poor circumscription, infiltrative, hemorrhage, focal calcification |
|
|
Term
| pathologic features of oligodendroglioma |
|
Definition
1. uniform, cellular pattern of oligodendrocytes with "fried egg" perinuclear halo appearance and calcifications
2. chicken-wire vascular pattern can be identified with factor VIII antibody against endothelial cells
3. if halos present, negative for GFAP |
|
|
Term
|
Definition
1. 5% of CNS tumors
2. 5-25 (brain) 20-50 (spinal cord)
3. present with symptoms of CSF obstruction
4. occur in 4th ventricle or distal spinal cord
5. 40-60% 5 year survival |
|
|
Term
| gross features of ependymoma |
|
Definition
| intraventricular, granular, friable, seeds CSF pathways |
|
|
Term
| pathologic features of ependymoma |
|
Definition
1. vascular tumor with uniform sheets of cells with small dark round nuclei in a glial fibrillary background
2. perivascular pseudorosettes - nuclei clustered around blood vessel with adjacent anuclear zone |
|
|
Term
| medulloblastoma epidemiology |
|
Definition
1. 5% CNS tumors
2. 5-20 yrs
3. rapid progession of cerebellar symptoms
4. 75% 5 yr survival, CSF seeding common |
|
|
Term
| pathologic features of medulloblastoma |
|
Definition
1. small, round blue cell tumor
2. primitive neuroectodermal cell precursors of glia and neurons (PNET)
3. Homer Wright rosettes |
|
|
