First Aid – Primary Brain Tumors (do pics first so flip)

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Adult brain tumor characteristics
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Most are supratentorial, half are metastases (well circumscribed at gray-white junction)
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Cause of clinical presentation
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Mass effects (seizures, dementia, focal lesions)
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Three most common adult primary brain tumors
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glioblastoma multiforme>meningioma>schwannoma
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grave prognosis (<1 year), cerebral hemispheres, can cross corpus callosum ("butterfly glioma") stain for GFAP, what term goes with this?
<img src="https://chmanchacentro.com/wp-content/uploads/2018/03/grave-prognosis.jpg" title="grave prognosis (<1 year), cerebral hemispheres, can cross corpus callosum ("butterfly glioma") stain for gfap, what term goes with this?" alt="grave prognosis (
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Glioblastoma multiforme pseudopalisading (pleomorphic tumor cells with central areas of necrosis and hemorrhage)
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Glioblastoma multiforme: how common? survival? location? stain? histo?
Glioblastoma multiforme: how common? survival? location? stain? histo?
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common; <1 year; cerebral hemispheres and can cross corpus callosum; GFAP; histo= pseudopalisdading pleomorphic tumor cells that border areas of necrosis and blood
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Meningioma – whorled, psammoma bodies
Meningioma - whorled, psammoma bodies
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Meningioma Spindle cells with a whorled pattern
Meningioma  Spindle cells with a whorled pattern
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CN VIII usually, schwann cell origin, resectable, usually found at cerebellopontine angle S-100 positive, bilateral in NF-2
CN VIII usually, schwann cell origin, resectable, usually found at cerebellopontine angle S-100 positive, bilateral in NF-2
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Antoni A and B
Antoni A and B
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Schwannoma
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Oligodendrocytes = fried eggs cells
Oligodendrocytes = fried eggs cells
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Oligodendroglioma
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relatively rare, slow growing, usually frontal lobes, chicken-wire capillary pattern with “fried-egg” oligodendrocytes often calcified
relatively rare, slow growing, usually frontal lobes, chicken-wire capillary pattern with
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oligodendroglioma
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Hyper or hypopituitarism
Hyper or hypopituitarism
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pituitary adenoma
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most commonly prolactinoma bitemporal hemiaopia (pressure on optic chiasm), hyper or hypopituitary sequelae from Rathke’s pouch
most commonly prolactinoma bitemporal hemiaopia (pressure on optic chiasm), hyper or hypopituitary sequelae from Rathke's pouch
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pituitary adenoma
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childhood peak incidence primary brain tumors
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pilocytic astrocytoma, medulloblastoma, ependymoma, hemangioblastoma, craniopharyngioma
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usually well circumscribed, most often in posterior fossa (in kids), may be supratentorial GFAP positive, benign, good prognosis Rosenthal fibers—eosinophilic, corkscrew fibers, cystic and solid; has a CYST with PROTRUDING NODULE
usually well circumscribed, most often in posterior fossa (in kids), may be supratentorial GFAP positive, benign, good prognosis Rosenthal fibers—eosinophilic, corkscrew fibers, cystic and solid; has a CYST with PROTRUDING NODULE
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pilocytic astrocytoma
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Rosenthal fibers
Rosenthal fibers
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pilocytic astrocytoma
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Solid, small blue cells. Radiosensitive
Solid, small blue cells. Radiosensitive
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Medulloblastoma
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A form of primitive neuroectodermal tumor (PNET); present with coordination problems; occurs in cerebellar vermis; compress 4th ventricle –> hydrocephalus
hydrocephalus” alt=”A form of primitive neuroectodermal tumor (PNET); present with coordination problems; occurs in cerebellar vermis; compress 4th ventricle –> hydrocephalus”>
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Medulloblastoma
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highly malignant cerebellar tumor—can compress 4th ventricle causing hydrocephalus PNET—primitive neuroectodermal tumor rosettes/pseudorosettes, solid, small blue cells, radiosensitive
highly malignant cerebellar tumor—can compress 4th ventricle causing hydrocephalus PNET—primitive neuroectodermal tumor rosettes/pseudorosettes, solid, small blue cells, radiosensitive
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medulloblastoma
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ependymal cell tumor usually in the 4th ventricle (hydrocephalus). poor prognosis perivascular pseudorosettes, rod-shaped blepharoplasts (basal ciliary bodies) near nucleus.
ependymal cell tumor usually in the 4th ventricle (hydrocephalus). poor prognosis perivascular pseudorosettes, rod-shaped blepharoplasts (basal ciliary bodies) near nucleus.
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Ependymoma
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Characteristic perivascular pseudorosettes. Rod-shaped blepharoplasts
Characteristic perivascular pseudorosettes. Rod-shaped blepharoplasts
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Ependymoma
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usually cerebellar—foamy cells and high vascularity associated with vHL syndrome if found with retinal angiomas can produce EPO causing secondary polycythemia see thin walled capillaries with minimal intervening parenchyma
usually cerebellar—foamy cells and high vascularity associated with vHL syndrome if found with retinal angiomas can produce EPO causing secondary polycythemia see thin walled capillaries with minimal intervening parenchyma
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Hemangioblastoma
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Foamy cells and high vascularity; associated with von Hippel-Lindau syndrome when found with retinal angiomas; can produce erythropoietin –> secondary polycythemia
secondary polycythemia” alt=”Foamy cells and high vascularity; associated with von Hippel-Lindau syndrome when found with retinal angiomas; can produce erythropoietin –> secondary polycythemia”>
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Hemangioblastoma
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From Rathke’s pouch (derived from outpouching of mouth), can have calcifications; benign; bitemporal hemianopsia
From Rathke's pouch (derived from outpouching of mouth), can have calcifications; benign; bitemporal hemianopsia
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Craniopharyngioma
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benign childhood tumor (most common childhood supratentorial tumor), confused with pituitary adenoma (because it can also cause bitemporal hemianopia). derived from remnants of Rathke’s pouch, calcification is common
benign childhood tumor (most common childhood supratentorial tumor), confused with pituitary adenoma (because it can also cause bitemporal hemianopia). derived from remnants of Rathke's pouch, calcification is common
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craniopharyngioma
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meningioma: how common? aggressive or benign? location? arises from? histo?
meningioma: how common? aggressive or benign? location? arises from? histo?
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common; benign; usually asymptomatic but can present with seizures; occurs in convexities of hemispheres and parasagittal region; arises from arachnoid cells and is extra axial (so external to brain parenchyma) and can have a dural attachment called a tail (see picture); histo= spindle cells concentrically arranged in whorled pattern; psammoma bodies are laminated calcifications
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brain tumor with estrogen r’s
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meningioma
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s100 + & location
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schwannoma; cerebellopontine angle usually but possible along any peripheral nerve; often with CN VIII–> vestibular schwannoma, see bilaterally with NF-2
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mneumonic for oligodendroglia
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“oh leg go my ego” for fried egg appearance
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pituitary adenoma
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prolactinoma; bitemporal hemianopsia due to pressure on optic chiasm; hyper or hypopituitarism are sequelae (prolactinoma –> hypogonadism)
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mnemonic for adult brain cancer causes
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MGM Studios Mets, Glioblastoma, Meningioma, Schwannoma (also have hemangioblastoma -von HL w/ retinal angiomas and can produce erythropoietin-; Oligodendroglia and Pituitary adenoma- prolactinioma)
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mnemonic for childhood brain cancer causes
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Animal Kingdom, Magic Kingdom, Epcot Astrocytoma, Medullobastoma, Ependymoma (also have craniopharyngioma)
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which brain tumor matches the following: pseudopalisading necrosis polycythemia neurofibromatosis type 2 assoc w/ von hippel-lindau foamy cells, high vascularity hyperprolactinemia –> galactorrhea, amenorrhea, anovulation
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glioblastoma multiforme hemangioblastoma schwannoma hemangioblastoma hemangioblastoma pituitary adenoma
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which brain tumor matches the following: psammoma bodies fired egg appearance perivascular pseudorosettes bitemporal hemianopia worst prognosis child w/ hydrocephalus homer-wright pseudorosettes
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meningioma oligodendroglia ependyoma pituitary adenoma (adult); craniopharyngioma (child) glioblastoma multiforme meduloblastoma or ependyoma meduloblastoma

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