Neuropathology

Question 1

Answer 1

Alzheimer’s Disease

Granulovacuolar degeneration, neurofibrillary tangle, hirano body

Question 2

Answer 2

Pick Disease

Spares the superiortemporal gyrus

Spherical intracellular inclusions

Question 3

Answer 3

Acute Disseminated Encephalomyelitis

-Inflammatory and demyelinating features shown in the image

Question 4

Answer 4

Hypertensive intracerebral hemorrhage

Basal ganglionic hemorrhage & rupture into ventricular system

Question 5

Answer 5

Friedreich Ataxia

Tract degeneration in dorsal spinocerebellar columns and posterior columns

Question 6

Answer 6

Wernicke Encephalopathy

Mamillary bodies are congested and discolored

Question 7

Answer 7

Laminar necrosis, due to hypoxic/ischemic injury.

Question 8

Answer 8

Aspergillosis infection. Septate Hypae branch at acute angles

Question 9

Answer 9

Pompe Disease - severe vacuolar myopathy due to extensive glycogen storage

Question 10

Answer 10

CADASIL - numerous accumulations of granular osmiophilic material (GOM) shown in electron micrograph

Question 11

Answer 11

Progressive Supranuclear Palsy - Globose neurofibrillary tangles and positive astrocytic inclusions

Question 12

Answer 12

Dementia with Lewy Bodies. Notice the Amyloid Plaques

Question 13

Answer 13

Schwannoma - tumor contains a verocay body

Question 14

Answer 14

Polyarteritis Nodosa - acute vasculitis involving an epineural artery

Question 15

Answer 15

Multiple Sclerosis - sharply demarcated plaque of myelin loss and small lesions adjacent to the ventricles

Question 16

Answer 16

Hypothalamic hamartoma - disorganized hypocellular collection of mature neurons and glia appear as a discrete mass in floor of 3rd ventricle

Question 17

Answer 17

Duchenne Muscular Dystrophy - degenerating fibers undergoing phagocytosis, hypercontracted fibers, excessive fibrosis, variation in fiber size

Question 18

Answer 18

Cerebral Amyloid Angiopathy
- note large lobar hemorrhage

Question 19

Answer 19

Ependymoma - classic perivascular pseudo-rosettes and ependymal canal-like structures

Question 20

Answer 20

Huntington Disease - Marked Caudate Atrophy

Question 21

If you see these in a child, what are they and what do you look for further?

Answer 21

These are multiple meningiomas, look for NF2

Question 22

Answer 22

Hemangioblastoma, note the capillaries

Question 23

45 year old woman

Answer 23

Cerebellopontine angle tumor, most likely a Schwannoma aka Neurilemoma

Question 24

Answer 24

Schwannoma: note the Antoni A (more cellular, palisading nuclei with surrounding pink areas with rows of nuclei in parallel array called Verocay bodies) and Antoni B which has looser stroma, fewer cells, and myxoid change

Question 25

Schwannomas, Meningioma, Glioma. Of these, what do they stain for the following? S-100, EMA, GFAP?

Answer 25

Schwannoma, Some Meningiomas, and Gliomas are positive for S-100. Only Meningiomas are positive for EMA Only Gliomas are positive for GFAP

Question 26

What disease, what disorder, gene, how is it passed?

Answer 26

Neurofibromatosis - an autosomal dominant disorder 1:4000, but 50% are from a spontaneous Neurofibromin mutation 17q12

Question 27

Answer 27

Neurofibroma - bundles of Schwann cells and fibroblasts embedded in a watery mucoid matrix "shredded carrots" appearance

Question 28

57 year old male presents with lower back pain, lower extremity weakness, and urinary incontinence. Noted to have a mass filum terminale

Answer 28

Paraganlioma - encapsulation and fibrosis of vessels and hypervascularity. "Nested appearance" of cells.

Question 29

Answer 29

Chordoma: Lobules of tumor in myxoid stroma. Cells are arranged in strands, cords, sheets, clusters, etc

Question 30

Answer 30

Chondrosarcoma - cells lie individually in lacunae

Question 31

Answer 31

Adenoma compressing a normal gland (i.e. pituitary adenoma). The normal gland is upper left

Question 32

Answer 32

Craniopharyngioma producing hydrocephalus. Derived from Rathke's Cyst

Question 33

Answer 33

Epidermoid cyst. Dry keratin on the left, then an epithelial-like lining on right.

Question 34

A child presents with vision loss, or maybe obstructive hydrocephalus

Answer 34

Pilocytic astrocytoma. * Most common glial tumor in childhood * Rosenthal fibers - biphasic, compact and loose microcystic areas, coarse pilocytic cell processes * usually in the cerebellum (67%), hypothalamus, optic chiasm, or optic nerve

Question 35

Answer 35

Perivascular pseudorosettes seen in ependymomas

Question 36

Answer 36

"Butterfly" Glioma - glioblastoma