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Neuropathology Review Questions

Neuropathology Review Questions. 11/30/12. Match the tumor with the description. Antoni A areas Antoni B areas Verocay bodies Axons present between tumor cells Plexiform type strongly associated with NF1. Neurofibroma Schwannoma Both Neither. Schwannoma. Schwannoma. Schwannoma.

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Neuropathology Review Questions

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  1. Neuropathology Review Questions 11/30/12

  2. Match the tumor with the description Antoni A areas Antoni B areas Verocay bodies Axons present between tumor cells Plexiform type strongly associated with NF1 • Neurofibroma • Schwannoma • Both • Neither Schwannoma Schwannoma Schwannoma Neurofibroma Neurofibroma

  3. Schwannoma • Neoplasticschwann cells in two basic patterns • Antoni A • Compact • Spindle cells • Collagen abundant • Antoni B • Loose • Stellate round cells • Microcysts

  4. Schwannoma • Verocay bodies • In Antoni A areas • Anuclear areas with palisading cells

  5. Schwannoma • Benign • No sex predominance • Mean age 40-50 years • Occasionally multiple • With NF2 or schwannomatosis • Neural crest origin • Frequently affect sensory nerves • May be cystic, hemorrhagic • S100 positive

  6. Schwannoma • Intracranial • Superior vestibular nerve • Internal acoustic meatus at root entry zone • Trigeminal nerve • Middle fossa, posterior fossa or both • Spinal • Intraspinal or dumbell shaped • Head & Neck • Posterior mediastinum • Retroperitoneum • Flexor surfaces of extremities

  7. Neurofibroma • Peripheral nerve sheath tumor • Mix of Schwann cells, perineuralcells, fibroblasts • Hypocellular with mucoid matrix • Collagen bundles follow nerve fibers • Entrapped axons, ganglion cells • Tactilelike structures • Resemble Meissnerian corpuscles

  8. Neurofibroma • Any age • No sex predominance • Not intracranial • Solitary cutaneous nodules • From small terminal nerves • Potential for malignant transformation

  9. Neurofibroma Types • Cutaneous • Painless, unencapsulated • Solitary, low malignant potential • Multiple = NF1 • Intraneural • Large nerve trunks • NF1 (plexiform = pathognomonic for NF1) • “bag of worms” • Malignant potential

  10. Match the time period after an infarct with the histologic appearance Lipid laden macrophages first appear Fibrillaryastrocytes at periphery Gemistocyticastrocytes at periphery Polymorphonuclear infiltrate Neuronal necrosis first apparent • 12-24h • 1-2d • 5-7d • 10-20d • >3mo 5-7d >3mo 10-20d 1-2d 12-24h

  11. Infarction • 12-24 hours • Ischemic neuronal necrosis • Possibly as little as one hour • Softening & discoloration • Circumscribed pallor

  12. Infarction • 1-2 days: PMN infiltration • 2-5 days: Astrocyte retraction balls, BBB breakdown, edema • 5 days: Macrophages (gitter cells), neovascularization • 2 weeks: Gemistocyticastrocytes • 3 months: Fibrillaryastrocytes, preservation of outer cortical layer

  13. Infarct

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