Nervous System Tumors

This is a summary of the major tumors of the nervous system.

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ADDITIONAL TAGS:
Medulloblastoma
Pilocytic astrocytoma
Diffuse astrocytoma
Anaplastic astrocytoma
Glioblastoma
Oligodendrogliomas
Ependymomas
Meningiomas
Neurofibromas
Schwannomas
By James Heilman, MD - Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=16272952
Embryonal tumor
Meningeal tumor
Peripheral tumor
Astrocytoma
Gliomas

Medulloblastoma
Grade IV malignant tumor
Arises from external granular layer in cerebellum
Histo: small round blue cells; Homer-Wright rosettes; mitotically active
Located in the cerebellum
Can drop metastases to seed the CSF
Well-circumscribed (non diffuse, solid)
By Jensflorian - Own work, CC BY-SA 3.0, https://commons.wikimedia.org/wiki/File:Neuroblastoma_Homer_Wright_rosettes_HE.jpg
Pilocytic astrocytoma
Grade I
Imaging: Solid nodule with cystic component
Common in cerebellum, hypothalamus, and optic nerve
Well-circumscribed (non diffuse)
Histo: Rosenthal fibers, eosinophilic granular bodies
BRAF mutation
Tumor in hypthalmic region - By The Armed Forces Institute of Pathology - http://peir2.path.uab.edu/scripts/acdis.dll?cmd=see&fp=/dbih/AFIP/00405615.tif&fmt=jpg&q=100&h=512, Public Domain, https://commons.wikimedia.org/w/index.php?curid=6182037

ROSENTHAL FIBERS - By Marvin 101 - Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=5766818

Diffuse and anaplastic astrocytoma
Diffuse astrocytoma
Grade II malignant tumor
Diffuse
Most common in cerebral hemispheres
Histo: hypercellular
Molecular: no 1p/19p codeletion
Anaplastic astrocytoma
Grade III malignant tumor
Diffuse
Common location is cerebral hemispheres
Histo: hypercellular, increased mitotic activity
Molecular: no 1p/19p codeletion
Glioblastoma
Grade IV malignant tumor
Diffuse, infiltrative mass
Common location is cerebral hemispheres
Ring enhancement on imaging; internal necrosis
Histo: hypercellular, increased mitotic activity, microvascular proliferation, necrotizing, pseudopalisading
Molecular: EGFR, PTEN
Ring enhancing- By Christaras A - Created myself from anonymized patient MR, CC BY 2.5, https://commons.wikimedia.org/w/index.php?curid=1247038

Hypercellularity - By No machine-readable author provided. KGH assumed (based on copyright claims). - No machine-readable source provided. Own work assumed (based on copyright claims)., CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=516831

Oligodendrogliomas
Grade II-III malignant tumor
Common location is cerebral hemispheres
Histo: hypercellular, perinuclear halo (fried-egg appearance), negative for astrocyte marker
Molecular: 1p/19q co-deletions
Perinuclear halo - By Nephron - Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=7437415
Ependymomas
Grade II-III malignant tumor
Common in cerebellum and spinal cord
Well-circumscribed (non diffuse)
Can drop metastases to seed the CSF
Histo: perivascular rosettes, ependymal rosettes
Rosettes - By Nephron - Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=10714428
meningiomas
Grade I benign tumor
Tumor of adults, not children
More common in females
Might respond to hormone growth (progesterone/estrogen receptors)
Dural tails; extra-axial location
Can invade bone and less-commonly brain
Histo: cellular whorls, psammoma bodies (calcium deposits)
Whorls - By Nephron - Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=10728713

Dural tails
By Glitzy queen00 - http://en.wikipedia.org/wiki/Image:Contrast_enhanced_meningioma.jpg, Public Domain, https://commons.wikimedia.org/w/index.php?curid=2359385
Neurofibromas
Associated with neurofibromatosis type I
Cafe-au-lait spots, lisch nodules in eye
Histo: “shredded carrot appearance” of collagen strands
Lisch nodules - By Dimitrios Malamos - Own work, CC BY 4.0, https://commons.wikimedia.org/w/index.php?curid=45193921
Histo - By No machine-readable author provided. KGH assumed (based on copyright claims). - No machine-readable source provided. Own work assumed (based on copyright claims)., CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=443285

Schwannomas
Can be associated with NF2
Histo:
verocay bodies (palisading cells surrounding acellular zone)
biphasic neoplasm with Antoni A (hypercellular) and Antoni B (hypocellular) regions
Common: Vestibular schwannoma (aka acoustic neuroma) from CN VIII
Hearing problems and disequilibrium
Medulloblastoma
Pilocytic astrocytoma
Diffuse astrocytoma
Anaplastic astrocytoma
Glioblastoma
Oligodendrogliomas
Ependymomas
Meningiomas
Neurofibromas
Schwannomas
Biphasic histo - By Nephron - Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=17748282

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