Adult brain tumors: Pathology review

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Adult brain tumors: Pathology review

Nervous system

Central nervous system disorders

Spina bifida

Chiari malformation

Dandy-Walker malformation

Syringomyelia

Tethered spinal cord syndrome

Aqueductal stenosis

Septo-optic dysplasia

Cerebral palsy

Spinocerebellar ataxia (NORD)

Transient ischemic attack

Ischemic stroke

Intracerebral hemorrhage

Epidural hematoma

Subdural hematoma

Subarachnoid hemorrhage

Saccular aneurysm

Arteriovenous malformation

Broca aphasia

Wernicke aphasia

Wernicke-Korsakoff syndrome

Kluver-Bucy syndrome

Concussion and traumatic brain injury

Shaken baby syndrome

Epilepsy

Febrile seizure

Early infantile epileptic encephalopathy (NORD)

Tension headache

Cluster headache

Migraine

Idiopathic intracranial hypertension

Trigeminal neuralgia

Cavernous sinus thrombosis

Alzheimer disease

Vascular dementia

Frontotemporal dementia

Lewy body dementia

Creutzfeldt-Jakob disease

Normal pressure hydrocephalus

Torticollis

Essential tremor

Restless legs syndrome

Parkinson disease

Huntington disease

Opsoclonus myoclonus syndrome (NORD)

Multiple sclerosis

Central pontine myelinolysis

Acute disseminated encephalomyelitis

Transverse myelitis

JC virus (Progressive multifocal leukoencephalopathy)

Adult brain tumors

Acoustic neuroma (schwannoma)

Pituitary adenoma

Pediatric brain tumors

Brain herniation

Brown-Sequard Syndrome

Cauda equina syndrome

Treponema pallidum (Syphilis)

Vitamin B12 deficiency

Syringomyelia

Friedreich ataxia

Neurogenic bladder

Meningitis

Neonatal meningitis

Encephalitis

Brain abscess

Epidural abscess

Cavernous sinus thrombosis

Creutzfeldt-Jakob disease

Central and peripheral nervous system disorders

Sturge-Weber syndrome

Tuberous sclerosis

Neurofibromatosis

von Hippel-Lindau disease

Amyotrophic lateral sclerosis

Peripheral nervous system disorders

Spinal muscular atrophy

Poliovirus

Guillain-Barre syndrome

Charcot-Marie-Tooth disease

Trigeminal neuralgia

Bell palsy

Winged scapula

Thoracic outlet syndrome

Carpal tunnel syndrome

Ulnar claw

Erb-Duchenne palsy

Klumpke paralysis

Sciatica

Myasthenia gravis

Lambert-Eaton myasthenic syndrome

Autonomic nervous system disorders

Orthostatic hypotension

Horner syndrome

Nervous system pathology review

Congenital neurological disorders: Pathology review

Headaches: Pathology review

Seizures: Pathology review

Cerebral vascular disease: Pathology review

Traumatic brain injury: Pathology review

Spinal cord disorders: Pathology review

Dementia: Pathology review

Central nervous system infections: Pathology review

Movement disorders: Pathology review

Neuromuscular junction disorders: Pathology review

Demyelinating disorders: Pathology review

Adult brain tumors: Pathology review

Pediatric brain tumors: Pathology review

Neurocutaneous disorders: Pathology review

Assessments

Adult brain tumors: Pathology review

USMLE® Step 1 questions

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Questions

USMLE® Step 1 style questions USMLE

of complete

A 54 year-old woman is brought to the emergency department due to a seizure. People in the homeless shelter who witnessed the event report that she fell to the ground and started having rhythmic jerking movement of the limbs. Her medical history is unknown. Physical examination reveals the patient to be dishevelled, confused, and barely responsive. Computed tomography of the head is obtained and shown below before (left) and after (right) the addition of contrast (shown below):  



Credit: Wikimedia Commons

Which of the following is the most likely origin of this patient's primary tumor?  

Transcript

Content Reviewers

Yifan Xiao, MD

Contributors

Maria Emfietzoglou, MD

Sam Gillespie, BSc

Elizabeth Nixon-Shapiro, MSMI, CMI

In the neurology ward, a 64-year old female, named Angela, came in complaining of morning headaches along with nausea and vomiting for the past few weeks. Her husband says that her personality has changed over the last few weeks and she seems more aggressive. Brain MRI revealed a mass in the frontal lobe.Tissue biopsy shows a pseudo-palisading pattern with necrosis in the middle and viable cells lining up in the periphery.

Now, next to Angela, there’s Jerry, a 59-year old male who’s also having morning headaches for the past few months. A brain MRI is ordered and reveals a mass on the brain surface, just under the dura mater. Tissue biopsy shows psammoma bodies.

Finally, there’s a 40-year old male, named Dan, who complains of ringing in the ears and hearing loss on one side. A brain MRI is done, and showed a mass on the cerebellopontine angle. Tissue biopsy shows a mass with biphasic appearance with alternating hypercellular and hypocellular regions. Tumor cells stain positively for S100.

Okay, Angela, Jerry, and Dan all had brain tumor. Brain tumors occur when there’s uncontrolled growth of abnormal cells within the brain. They are broadly classified into primary tumors originating from cells within the nervous system and metastatic tumors originating from cells outside the nervous system.

Now, brain tumors can occur in both children and adults. In this video, let’s focus on adult brain tumors. In adults, metastatic tumors are much more common than primary tumors, in fact, they account for more than half of the cases. In order of decreasing frequency, they metastasize from the lung, breast, melanoma from the skin, kidneys, and colon. Now, the most common primary brain tumor in adults is glioblastoma multiforme, which is a type of astrocytomas. Meningiomas and pituitary adenomas are next on the list. Less common brain tumors include oligodendrogliomas, hemangioblastomas, and Schwannomas. immunocompromised people, like organ transplant recipients or individuals with AIDS, are at high risk of primary central nervous system lymphoma caused by the Epstein-Barr virus.

Summary

Adult brain tumors are tumors that occur in adults. The most common type of adult brain tumor is glioma, which arises from the glial cells that support the nerve cells in the brain. Other types of adult brain tumors include meningiomas (tumors that arise from the meninges, which are the membranes surrounding the brain and spinal cord), schwannomas (tumors that arise from Schwann cells, which support the nerve fibers), and astrocytomas (tumors that arise from star-shaped cells called astrocytes).

Sources

  1. "Robbins Basic Pathology" Elsevier (2017)
  2. "Harrison's Principles of Internal Medicine, Twentieth Edition (Vol.1 & Vol.2)" McGraw-Hill Education / Medical (2018)
  3. "Hazzard's Geriatric Medicine and Gerontology, 7E" McGraw-Hill Education / Medical (2016)
  4. "Current Diagnosis and Treatment Surgery 14/E" McGraw-Hill Education / Medical (2015)
  5. "Clinical Genomics: Practical Applications for Adult Patient Care" McGraw Hill Professional (2013)
  6. "The MD Anderson Manual of Medical Oncology, Third Edition" McGraw-Hill Education / Medical (2016)
  7. "World Cancer Report 2014" B.W. Stewart and C.P. Wild (2014)
  8. "World Cancer Report 2014" B.W. Stewart and C.P. Wild (2014)
  9. "von Hippel–Lindau-associated malignancies: Mechanisms and therapeutic opportunities" Drug Discovery Today: Disease Mechanisms (2005)
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