Pathology of CNS Neoplasms

Question 1

What neoplasm is said to have “motor oil-like” cysts and a “wet keratin” histologic appearance?

Answer 1

Craniopharyngiomas

Question 2

What is the histologic appearance of an oligodendroglioma?

Answer 2

Cleared cytoplasm forming “halos” with thin capillaries resembling “chicken wire”

Question 3

What neoplasm has a whorld pattern on histological testing?

Answer 3

Meningioma

Question 4

Elongated cytoplasmic process “hair cells” and Rosenthal fibers are histological findings associated with what CNS neoplasms?

Answer 4

Pilocytic astrocytoma

Question 5

What is the most common CNS tumor?

Answer 5

Meningioma

Question 6

von Hippel-Lindau disease is associated with a mutation of what gene?

Answer 6

VHL gene

Question 7

What clinical findings may be seen with a subependymal giant cell astrocytoma?

Answer 7

Growth within the lateral ventricles that may cause hydrocephalus

Question 8

Dysembryoplastic Neuroepithelial tumors (DNET) are rich in what protein?

Answer 8

Muchin

Question 9

The BRAF gene is associated with what neoplasm that arises in the temporal lobe?

Answer 9

Ganglioglioma

Question 10

Meningiomas are more common in women. Why is this?

Answer 10

The tumor expresses a variety of hormone receptors, such as progesterone, which are higher in women

Question 11

Early puberty in children may be associated with the presence of what neoplasm?

Answer 11

Pineal gland tumor

Question 12

True/False. Meningiomas compress, but do not invade the brain.

Answer 12

True - they are often attached to the dura with symptoms dependent upon the area of the brain impacted

Question 13

Meningiomas may occur due to several different etiologies. What are possible etiologies?

Answer 13

Mutation of NF2, Neurofibromatosis Type 2, Radiation complications

Question 14

Astrocytomas are a type of neuroepithelial tumor that occur after the first decade. What cells do they arise from?

Answer 14

Astrocytes (glial cell precursors)

Question 15

What is the WHO grade of a medulloblastoma?

Answer 15

Grade IV

Question 16

What is the most common neoplasm in immunosuppressed persons?

Answer 16

Primary CNS Lymphoma

Question 17

These tumors secrete melatonin.

Answer 17

Pineal gland tumors

Question 18

What is the histologic appearance of an ependymoma?

Answer 18

True and pseudo rosettes

Question 19

What tumor is associated with Homer Wright rosettes and “small round blue cells?”

Answer 19

Medulloblastoma

Question 20

Where do most ependymomas occur?

Answer 20

Spinal cord

Question 21

Choroid plexus tumors often cause hydrocephalus. How does their presentation differ in children and adults?

Answer 21

In children, they occur in the lateral ventricles. In adults, they occur in the fourth ventricle

Question 22

Hemangiomas are highly vascular tumors often found in the cerebellum. What disease is associated with increased risk of hemangiomas?

Answer 22

von Hippel-Linadu disease

Question 23

Choroid plexus tumors primarily occur in children. What is the WHO grade?

Answer 23

Grade III

Question 24

Metastatic tumors of the CNS most often originate where in the body?

Answer 24

Breast or Lungs

Question 25

What rare neoplasm is Grade I and is associated with epilepsy?

Answer 25

Dysembryoplastic Neuroepithelial tumor (DNET)

Question 26

Where do most adult CNS neoplasms occur?

Answer 26

Cerebral hemispheres above the tentorium

Question 27

What are the most common CNS neoplasms in adults?

Answer 27

Meningiomas & Gliomas

Question 28

Where do most pediatric CNS neoplasms occur?

Answer 28

In the posterior fossa

Question 29

Ependymomas are associated with what gene?

Answer 29

NF2 on Chromosome 22

Question 30

What type of neoplasm is described as having a "butterfly" shape with pseudopalisading necrosis?

Answer 30

Glioblastoma

Question 31

A polyploid or cauliflower-like papillary lesion is likely due to what neoplasm?

Answer 31

Choroid plexus tumor

Question 32

True/False. Most CNS cysts are asymptomatic.

Answer 32

True. They are often found incidentally

Question 33

What is the most common embryonal tumor?

Answer 33

Medulloblastoma, located in the cerebellum

Question 34

This type of neoplasm is associated with Tuberous Sclerosis in children.

Answer 34

Subependymal Giant Cell Astrocytoma (SEGA)

Question 35

Epstein-Barr virus is associated with what neoplasm?

Answer 35

Primary CNS Lymphoma

Question 36

What biomarker is most associated with Primary CNS Lymphomas?

Answer 36

CD20 (B-cell marker)

Question 37

This neoplasm is associated with mutations of isocitrate dehydrogenase (IDH) genes on chromosomes 1 & 19.

Answer 37

Oligodendroglioma

Question 38

What is the etiology of craniopharyngiomas?

Answer 38

Arise from remnants of Rathke's pouch