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Central Nervous System

malignancies
Central Nervous
System
malignancies
CNS Functional Anatomy

URL: www.solinas.com/solinas/brain.html 7/18/03

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CNS Anatomy
C71.0
C75.3

C71.6 C75.1
C71
C71.7

C71.7

C72.0

URL: www.universalpeace.ca/principles.htm
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Intracranial Sites

Parietal lobe

C41.0
C71.0
Frontal lobe

C71.6
C71.7

C72.0

URL: mscenter.ucsf.edu/faq.htm 7/18/03


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Cerebrum

C71.0

C71.3

C71.1 C71.4

C71.2 C71.6

C71.7

URL: www.sciencebob.com/lab/bodyzone/brainprint.html
7/18/03
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Cerebellum, Brain Stem

C71.0

C71.3

C71.1 C71.4

C71.6

C71.2

C71.7

URL: www.sciencebob.com/lab/bodyzone/brain.html
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Pineal and Pituitary Glands

C75.3

C71.6

C75.1

C71.7
C72.0

URL: training.seer.cancer.gov/module_anatomy/unit6_3_endo_gl
7/18/03
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Cranial Nerves

I=C72.2, II=C72.3,
VIII=C72.4, Others=C72.5

URL: faculty.washington.edu/chudler/cranial.html 7/18/03


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Meninges
C71.0 C70.0

C70.0

URL: www.cardioliving.com/consumer/Stroke/Hemorrhagic_Stroke.sht
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Tentorium

C70.0

C70.0

URL: neurosurgery.mgh.harvard.edu/abta/primer.htm
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Spinal Cord

C70.1 C72.0

URL: www.merck.com/pubs/mmanual/figures/182fig1.htm
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Spinal Cord Anatomy
31 pairs of spinal nerves
8 cervical
12 thoracic
5 lumbar
5 sacral
1 coccygeal
C & L enlargements
Conus tapers to ~L1/2
Filum terminale- attaches todorsum of 1st
coccygealvertebra
Cellular Classification
Neuroepithelial tumors
Astrocytomas
Oligodendroglioma
Ependymomas
Pineal parenchymal tumors
Other CNS tumors
Sellar tumors
Hematopoetic tumors
Germ cell tumors
Meningiomas
Tumors of cranial nerves
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Glial Tumors
Glial tissue: supportive tissue of
brain made up of astrocytes and
oligodendrocytes

Glial tumors assigned ICD-O-3


histology codes from glioma series
Codes 938 through 948

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Glial Tumors
Astrocytic tumors
Noninfiltrating
Juvenile pilocytic (M9421)
Subependymal (M9383)
Infiltrating
Well-differentiated mildly and moderately
anaplastic astrocytoma (M9401)
Anaplastic astrocytoma
Glioblastoma multiforme (M9440)
Brain stem gliomas (M9380)

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Glial Tumors
Ependymal tumors
Myxopapillary and well-differentiated
ependymoma (M9394)
Anaplastic ependymoma (M9392)
Ependymoblastoma (M9392)
Oligodendroglial tumors
Well-differentiated oligodendroglioma
(M9450)
Anaplastic oligodendroglioma (M9451)
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Glial Tumors
Mixed tumors
Mixed astrocytoma-ependymoma
Mixed astrocytoma-oligodendroglioma
Mixed astrocytoma-ependymoma-
oligodendroglioma
Other Gliomas
Ganglioneuromas (M9490)
Optic Nerve Gliomas

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Non-Glial Tumors
Pineal region tumors
Parenchymal tumors
Pineocytoma (M9361)
Pineoblastoma (M9362)
Pineal Astrocytoma (M9400)
Germ cell tumors
Germinoma (M9064)
Embryonal carcinoma (M9070)
Choriocarcinoma (M9100)
Teratoma (M9080)

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Non-Glial Tumors
Meningiomas
Meningioma: Benign (M953_)
Malignant meningiomas
Anaplastic meningioma
Hemangiopericytoma (M9150)
Papillary meningioma (M9538)
Choroid plexus tumors
Choroid plexus papilloma (M9390)
Choroid plexus carcinoma
Choroid plexus meningioma (M9538)
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Other CNS Tumors
Craniopharyngioma (M9350)
Rathke Pouch tumor

Chordomas (M9370)

Schwannoma (M9560)
Acoustic Schwannoma/Neuroma

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Other CNS Tumors
Embryonal tumors
Retinoblastoma (M9510)
Primitive neuroectodermal tumors
(PNET)
Meduloblastoma (M9470)
Neuroblastoma (M9500)

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Other CNS Tumors
Lymphoma (M9590)
Arise from
Indigenous brain histiocytes (microglia)
Rare lymphocytes in meninges
High incidence in patients with AIDS
Vascular tumors
Rare, nonmalignant tumors
Arise from blood vessels of brain and
spinal cord
Hemangioblastoma (M9161) most
common vascular tumor
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Other CNS Tumors
Cysts and Tumor-like lesions
Reportable
Dermoid cyst (M9084)
Granular cell tumor (M9580)
Rathke pouch tumor (M9350)
Not reportable
Epidermoid cyst
Colloid cyst
Enterogenous cyst
Neuroglial cyst
Plasma cell granuloma
Nasal glial herterotopia
Rathke cleft cyst
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Childhood vs Adult Tumors
CNS tumor histology and location
are different in adult and children

50% of childhood CNS tumors are


infratentorial

Meduloblastoma: most common CNS


histology in children
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Childhood Brain Tumors
Most common solid tumor in
childhood
50% are infratentorial
Common infratentorial tumors:
Cerebellar astrocytoma
Meduloblastoma
Ependymoma
Brain stem glioma
Atypical teratoid tumor
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Cellular Classification
Childhood Brain Tumors
Supratentorial tumors in children
Craniopharyngioma Glioblastoma multiforme
Germ cell tumor Low-grade or anaplastic
Diencephalic and ependymoma
hypothalamic glioma Choroid plexus tumors
Low grade astrocytoma Pineal parenchymal tumors
Mixed glioma Ganglioglioma
Anaplastic astrocytoma Desmoplastic infantile
Oligodendroglioma ganglioglioma
PNET Dysembryoplastic
Meningioma neuroepithelial tumor

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Cellular Classification
Childhood Brain Tumors

The histopathology of childhood


spinal tumors is not different from
the histopathology of childhood
brain tumors.

Primary spinal cord tumors


comprise approximately 1% to 2%
of all childhood CNS tumors.
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