Classic Presentations

Question 1

Budd-Chiari

Answer 1

Posthepatic Venous Thrombosis

Question 2

Ring Enhancing Lesions

Answer 2

• Toxoplamosis
• Abscess
• CNS lymphoma
• Glioblastoma Multiforme

Question 3

Adult brain tumor: Astrocyte lineage, GFAP ⊕. “Pseudopalisading” pleomorphic tumor cells border central areas of necrosis and hemorrhage. Found in cerebral hemispheres . Can cross corpus callosum.

Answer 3

Glioblastoma Multiforme (Grade IV Astrocytoma)

Question 4

Adult brain tumor: “Fried egg” cells— round nuclei with clear cytoplasm. Often calcified. slow growing. Most often in frontal lobes. “Chicken-wire” capillary pattern.

Answer 4

Oligodendroglioma

Question 5

Adult brain tumor: spindle cells concentrically arranged in a whorled pattern; psammoma bodies (laminated calcifications). Most often occurs near surfaces of brain and in parasagittal region. Extra-axial (external to brain parenchyma) and may have a dural attachment (“tail”).

Answer 5

Meningioma

Question 6

Adult brain tumor: Closely arranged, thin-walled capillaries with minimal intervening parenchyma. Most often cerebellar G . Associated with von Hippel-Lindau syndrome when found with retinal angiomas. Can produce erythropoietin 2° polycythemia.

Answer 6

Hemangioblastoma

Question 7

Adult Brain Tumor: S-100 ⊕. Classically at the cerebellopontine angle K , but can be along any peripheral nerve. Often localized to CN VIII in internal acoustic meatus

Answer 7

Schwannoma

Question 8

Child brain tumor: Glial cell origin, GFAP ⊕. Rosenthal fibers—eosinophilic, corkscrew fibers. well circumscribed. In children, most often found in posterior fossa (eg, cerebellum). May be supratentorial.

Answer 8

Pilocytic Astrocytoma

Question 9

Child brain tumor: Form of primitive neuroectodermal tumor (PNET). Homer-Wright rosettes (small blue cells surround pale neurofibrils). Most common malignant brain tumor in childhood. Commonly involves cerebellum, Can compress 4th ventricle, causing noncommunicating hydrocephalus. Can send “drop metastases” to spinal cord.

Answer 9

Medulloblastoma (similar to Neuroblastoma in Adrenal Medulla)

Question 10

Child brain tumor: perivascular rosettes. Rod-shaped blepharoplasts (basal ciliary bodies) found near the nucleus. Most commonly found in 4th ventricle. Can cause hydrocephalus.

Answer 10

Ependymoma

Question 11

child brain tumor: Derived from remnants of Rathke pouch. Calcification is common. Cholesterol crystals found in “motor oil”—like fluid within tumor. Most common childhood supratentorial tumor.

Answer 11

Craniopharyngioma

Question 12

Child brain tumor: Similar to germ cell tumors. Tumor of pineal gland. Can cause Parinaud syndrome (compression of tectum → vertical gaze palsy); obstructive hydrocephalus (compression of cerebral aqueduct); precocious puberty in males (β-hCG production).

Answer 12

Pinealoma

Question 13

Nest of abundant clear cytoplasm in kidney glomeruli, hx of smoking, polycythemia

Answer 13

Renal Cell Carcinoma

Question 14

Incr. AFP

Answer 14

Yolk-Sac Tumor, Hepatocellular CA

Question 15

Neurofibroma 1

Answer 15

Café-au-lait spots F , cutaneous neurofibromas G , optic gliomas, pheochromocytomas, Lisch nodules (pigmented iris hamartomas H ).

Question 16

NF2

Answer 16

2 ears, 2 eyes, and 2 parts of the brain.

Question 17

Cafe au lait (u/l), polyostotic firbrous dysplasia, precocious puberty, endocrine changes

Answer 17

McCune-Albright (GPCR mut.)

Question 18

CAG repeat expansion

Answer 18

Huntington (AD): Caudate loses ACh + GABA

Question 19

GAA

Answer 19

Friedrich-Ataxia: GAAit

Question 20

Dilated Cardiomyopathy causes

Answer 20

Wet Beriberi, DMD, T. cruzi, Doxorubicin

Question 21

Hereditary nephritis, hearing loss, cataracts

Answer 21

Alport Syndrome (mut. Collagen IV)

Question 22

Cleft Lip, Palate, Holopros or microcephalic, polydactyly, cutis aplasia

Answer 22

Patau (Trisomy 13)