CNS Tumors

Classification - Gliomas

o Astrocytoma • Fibrillary • Pilocytic

o Oligodendroglioma o Ependymoma

- Neuronal Tumorso Central neurocytoma o Ganglioglioma o Dysembryoplastic neuroepithelial tumor

- Poorly Differentiated Neoplasmso Medulloblastoma

- Other parenchymal tumors o Primary CNS lymphoma o Germ cell tumors

- Meningioma - Shwannoma - Metastatic tumors

Which Tumor ?

35 year old man complained of headache for the past 2 years , he also been having weakness in his left upper limb , he came to the neurologist because he had a seizure yesterday. MRI was performed ; mass in his cerebral hemisphere. he started chemotherapy and radiotherapy as resection was not feasible , 11 months later he passed away .

Which Tumor ?A mother brings her 5 year old son to the neurologist, he has been having tremors and was ataxic. MRI is shown . The tumor was resected. Histologic features of it : GFAP +ve Rosenthal fibers.

Source :http://emedicine.medscape.com/article/985927-workup#a0720

Glioblastoma

Glioblastoma

• Gross: Cyst filled with gelatinous material, and mural nodule. Micro: Cells with long, hair-like processes, Rosenthal fibers. GFAP positive

Pilocytic astrocytoma, grade I / IV

BRAIN TUMORS

WHO grading (biologic behavior) Astrocytomas (I - IV)

Anaplastic (III / IV) Glioblastoma (IV / IV)

Pilocytic (I / IV) Well-differentiated (II / IV)

Oligodendroglioma G II

Ependymoma G II

Medulloblastoma

A B

C

Meningioma G I

Schwannoma G I