Neurology

Adult Brain Tumors MGM Studios (mets, GM, Meningioma, Schwannoma)

-- 70% supratentorial

Gliobastoma Multiforme grave Px; found in cerebral hemispheres, can cross

(grade IV astrocytoma) corpus callosum (butterfly glioma); Pseudopalisading
pleomorphic tumor cells; areas of necrosis and
hemorrhage; astrocytoma, so GFAP stain

Meningioma arises from arachnoid cells; external to brain

(convexities of hemispheres and parasagital region;
spindle cells in whorled pattern; psammoma bodies

Schwannoma acoustic scwhannoma (CN 8, tinnitus, vertigo, hearing

loss); cerebellopontine angle; S100+; bilateral in NF
type 2 (auto dom)

Oligodendroglioma slow grower; frontal lobes; chicken wire capillary

pattern; “fried egg cells”; calcified

Pituitary Adenoma MC --> prolactinoma; bitemporal hemianopia;

hypogonadism, ammenorhea, galactorrhea; Rathkeʼs
pouch

Childhood Tumors Pilocytic is MC; 70% infratentorial

Pilocytic (low grade) well circumscribed (benign); may be supratentorial;

Astrocytoma GFAP+, S100+; Rosenthal fibers (eosinophilic
corkscrew fibers); cystic and solid areas; often in
cerebellum

Medulloblastoma (2nd MC) highly malignant cerebellar tumor; primitive

neuroectodermal tumor; compress 4th ventricle -->
hydrocephalus; Homer-wright pseudorossettes;
completely solid tumor; small blue cells; APC mutation
(beta-catenin), specifically Turcot syndrome

Ependymoma ependymal cells; found in 4th ventricle -->

hydrocephalus; perivascular pseudorossettes; rod-
shaped blepharoplasts (basal ciliary bodies)

Hemangioblastoma Foamy cells, high vascularity; cerebellar; Von Hippel-

Lindau Syndrome; retinal angiomas, renal cell
carcinoma; increased EPO --> polycythemia
Craniopharyngioma Benign; MCC supratentorial kid tumor; Rathkeʼs
pouch; bitemporal hemianopia; calcification;
hypopituaritism

Diff Dx of Brain Lesions

Ring-enhancing lesion mets, abscess, Toxoplasmosis, AIDS lymphoma

Uniformly enhancing lesion Lymphoma, meningioma, mets (usually ring though)

Heterogeneously Glioblastoma multiforme

enhancing lesion