Upload
caren-briggs
View
223
Download
1
Tags:
Embed Size (px)
Citation preview
CNS Neoplasm
Dr. Raid Jastania, FRCPCAssistant Professor, Faculty of
Medicine, Umm Alqura UniversityVice Dean, Faculty of Dentistry
Reference and Contact
• Robbins Basic Pathology• http://www.pathoma.com/
• [email protected]• http://uqu.edu.sa/staff/ar/4180114
Before We Start:
• 50 year old female presented with personality change, aggressive behaviour, persistent headache and confusion.
• She was referred to neurology clinic. Clinical assessment: no neurological deficit. CT scan of brain showed contrast enhanced lesion of 4 cm in the left frontal lobe with surrounding edema.
Before We Start:
• What is the diagnosis? Explain• How does cancer (neoplasm) develop?• What are the criteria of Malignancy?
At the end of the lecture you will be able to:
• List the most common neoplasms of the CNS.
• Explain the “cell of origin” of common CNS neoplasms.
• Explain the criteria of “malignancy/Benignity” in CNS neoplasms and the WHO grading system.
• Compare the pathological features of Astrocytoma, oligodendrogioma, ependymoma, meningioma and Medulloblstoma.
• List the most common metastatic tumors of the brain.
At the end of the lecture you will be able to:
• List the most common neoplasms of the CNS.
• Explain the “cell of origin” of common CNS neoplasms.
• Explain the criteria of “malignancy/Benignity” in CNS neoplsms and the WHO grading system.
• Compare the pathological features of Astrocytoma, oligodendrogioma, ependymoma, meningioma and Medulloblstoma.
• List the most common metastatic tumors of the brain.
CNS Neoplasm• 10-17 / 100,000 intracranial• 1-2 / 100,000 intraspinal• 50% Metastatic• Common primary CNS tumors:
• Glioblastoma Multiforme (GBM)• Astrocytoma• Oligodentroglioma• Ependymoma• Meningioma• Medulloblastoma• ?? Glioma
At the end of the lecture you will be able to:
• List the most common neoplasms of the CNS.
• Explain the “cell of origin” of common CNS neoplasms.
• Explain the criteria of “malignancy/Benignity” in CNS neoplsms and the WHO grading system.
• Compare the pathological features of Astrocytoma, oligodendrogioma, ependymoma, meningioma and Medulloblstoma.
• List the most common metastatic tumors of the brain.
Cells in the CNS
• Neuron / Ganglion• Glial Cells– Astrocyte– Oligodendrocyte– Ependymal cell– Meningothelial cell– ?Primitive cell– Schwann cell
At the end of the lecture you will be able to:
• List the most common neoplasms of the CNS.
• Explain the “cell of origin” of common CNS neoplasms.
• Explain the criteria of “malignancy/Benignity” in CNS neoplasms and the WHO grading system.
• Compare the pathological features of Astrocytoma, oligodendrogioma, ependymoma, meningioma and Medulloblstoma.
• List the most common metastatic tumors of the brain.
Malignancy Criteria
• What are the features of Malignancy?– Rapid rate of growth– Invasion– Anaplasia– Metastasis
• What about:– The brain contains critical/vital structures!– Metastasis of primary brain tumors is Rare– Pattern of growth: diffuse, pushing, infiltrative
WHO Grading System
• Grades:– Grade 1– Grade 2– Grade 3– Grade 4
• Criteria for grading:– Atypia, cellularity,
pleomorphism– Necrosis– Vascular proliferation– Mitotic activity
At the end of the lecture you will be able to:
• List the most common neoplasms of the CNS.
• Explain the “cell of origin” of common CNS neoplasms.
• Explain the criteria of “malignancy/Benignity” in CNS neoplasms and the WHO grading system.
• Compare the pathological features of Astrocytoma, oligodendrogioma, ependymoma, meningioma and Medulloblstoma.
• List the most common metastatic tumors of the brain.
Astrocytoma
• 80% of adult primary brain tumors
• 4th -6th decade• Cerebral hemisphere• Seizure, headache, focal
neurological deficit• Grades: 2, 3, 4• Mean survival: 5 years
Oligodendroglioma• 5-15% of Glioma• 4th -5th decade• Seizure• Cerebral hemisphere, white
matter• Better prognosis than
astrocytoma• Mean survival: 5-10y• Heterozytosity of
Chromosome 1p 19q with good response to chemotherapy
Ependymoma
• Arise next to ependymal surface
• Near fourth ventricle• In children and adult• Neurofibromatosis
type2• CSF spread• Prognosis variable
Medulloblastoma
• Children• Cerebellum• Undifferentiated, high
grade• Radiosensitive• 75% 5 year survival
Meningioma• Benign tumor• Adults• Arise from meningothelial cells• Vague, non localizing symptoms• Neurofibromatosis type2
At the end of the lecture you will be able to:
• List the most common neoplasms of the CNS.
• Explain the “cell of origin” of common CNS neoplasms.
• Explain the criteria of “malignancy/Benignity” in CNS neoplasms and the WHO grading system.
• Compare the pathological features of Astrocytoma, oligodendrogioma, ependymoma, meningioma and Medulloblstoma.
• List the most common metastatic tumors of the brain.
Metastasis
• Carcinoma: lung, breast, melanoma, kidney, GI
• Sharply demarcated• At gray-white matter
junction
At the end of the lecture you will be able to:
• List the most common neoplasms of the CNS.
• Explain the “cell of origin” of common CNS neoplasms.
• Explain the criteria of “malignancy/Benignity” in CNS neoplasms and the WHO grading system.
• Compare the pathological features of Astrocytoma, oligodendrogioma, ependymoma, meningioma and Medulloblstoma.
• List the most common metastatic tumors of the brain.