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Brain Tumors
| Description | Tumor |
|---|---|
| Mostly likely tumor in a patient with juvenile cataracts who was found to have a mutation in the merlin gene on chromosome 22 | Schwannoma (most common tumor in neurofibromatosis type 2; they are usually bilateral; these patients are also at risk for meningiomas and ependymomas) |
| Frontal lobe tumor biopsy shows infiltrating cells with perinuclear halos and prominent delicate vasculature | Oligodendroglioma (perinuclear halos describe the clear cytoplasm surrounding the round nuclei of oligodendrocytes, and are said to have a "fried egg" appearance; the vasculature is said to have a chicken-wire capillary pattern; calcification is common) |
| Adult with "head fullness" and headaches when standing; T2-MRI shows lobulated mass that enhances with contrast and crosses the midline; immunostain is positive for glial fibrillary acidic protein | Glioblastoma multiforme (glial fibrillary acidic protein = GFAP = astrocyte stain) |
| Biopsy of a solid cerebellar brain tumor from a child shows gray matter with abundant fibrillary material surrounded by a wheel-shaped configuration of differentiated cells | Medulloblastoma (these arise from the cerebellar external granular layer; the pattern described is a Homer-Wright "pseudo"-rosette, which is also found in neuroblastomas; in contrast, "true" rosettes have an empty lumen and are found in retinoblastomas) |
| Tumor at cerebellopontine angle that stains positive for a protein that is 100% soluble in ammonium sulfate at neutral pH | Schwannoma (protein in question is S-100, the "S" actually stands for soluble and "100" for 100%; it is usually present in cells derived from neural crest, and may also be found in melanomas) |
| Most likely brain tumor in a patient with bilateral renal cell carcinoma and pheochromocytoma | Cerebellar hemangioblastoma (these are classic findings of Von Hippel-Lindau disease, an autosomal dominant deletion of the VHL tumor suppressor gene on chromosome 3; these patients also get cavernous hemangiomas in their skin, mucosa, retina, and organs) |
| Adult female with new-onset focal seizures is found to have a firm, non-invasive, multilobular, parasagittal brain tumor that expresses estrogen receptors and infiltrates the overlying bone | Meningioma (these arachnoid cell tumors are more common in females than males, and locations may include parasagittal, olfactory groove, or lesser wing of sphenoid; they may indent and compress the surface of the brain, but will not invade) |
| Biopsy of a solid tumor from the posterior fossa of a child on H&E stain shows eosinophilic and elongated corkscrew fiber bundles | Pilocytic astrocytoma (the description is characteristic of Rosenthal fibers; this tumor would also stain positive for GFAP) |
| Resectable tumor often localized to CN VIII | Schwannoma |
| Most common childhood supratentorial tumor | Craniopharyngioma (most childhood brain tumors are below the tentorium cerebelli, while most adult primary brain tumors are above) |
| Most common cause of hypopituitarism in adults | Nonfunctioning pituitary adenoma (I included this here, however, the pituitary gland is not actually part of the brain, anatomically speaking) |
| Most common cause of hypopituitarism in children | Craniopharyngioma |
| Benign cystic childhood tumor of neuroectoderm origin, most commonly in the cerebellum | Pilocytic astrocytoma |
| Cerebellar tumor in a patient which is found to have foamy cells and high vascularity; further workup demonstrates polycythemia and constitutive expression of HIF (hypoxia inducible transcription factor); his father suffered from a rare genetic disease | Cerebellar hemangioblastoma (the genetic disease is Von Hippel-Lindau and the tumor is producing erythropoietin) |
| Most common primary childhood brain tumor | Pilocytic astrocytoma |
| Most common primary malignant childhood brain tumor | Medulloblastoma |
| 2nd most common primary childhood brain tumor | Medulloblastoma |
| Arachnoid tumor that is resectable and external to the brain; typically in convexities of hemispheres or parasagittal region | Meningioma |
| A child with hydrocephalus is determined to have a solid tumor in the cerebellar vermis; biopsy shows primitive small blue cells | Medulloblastoma (these are highly malignant) |
| Most common primary adult brain tumor | Glioblastoma multiforme |
| 2nd most common primary adult brain tumor | Meningioma |
| Most common benign adult brain tumor | Meningioma |
| Most common brain malignancy | Metastasis |
| Most frequent metastatic brain tumor primary location | Lung |
| Childhood brain tumor of cells lining the ventricles characterized by perivascular pseudorosettes and rod-shaped blepharoplasts (basal ciliary bodies) found near the nucleus | Ependymoma (ependymomas & medulloblastomas both have rosette-like patterns; ependymomas are benign and of the ventricular lining, while medulloblastomas are malignant primitive small round blue cell cerebellar tumors and are more common) |
| Child with diabetes insipidus and bitemporal hemianopsia is found to have a cystic brain tumor with hemorrhage, calcification, and cholesterol crystals | Craniopharyngioma (benign Rathke's pouch [surface ectoderm] tumor; do not confuse with pituitary adenoma) |
| Pseudopalisading pleomorphic tumor cells border central areas of necrosis and hemorrhage | Glioblastoma multiforme |
| Spindle cells concentrically arranged in a whorled pattern with basophilic laminated calcifications | Meningioma (basophilic laminated calcifications = psammoma bodies; these are also found in thyroid papillary adenocarcinoma, ovarian papillary serous cystadenocarcinoma, and malignant mesothelioma) |
| Brain tumor in a child with precocious puberty, obstructive hydrocephalus, and paralysis of upward gaze | Germinoma of the pineal gland (this is the most common tumor of the pineal gland; they produce beta-hCG that causes precocious puberty, hydrocephalus due to acqueductal compression, and Parinaud's syndrome due to compression of the midbrain tectal area) |
| Tumor is usually benign and may present as a hemorrhagic mass; it arises in the fourth ventricle in children (causing hydrocephalus) or the cauda equina in adults (causing syringomyelia) | Ependymoma |
Created by:
kesselmb
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