CNS Pathology case based MCQs-2 CASE : The spinal MRI of a 22-year old male with neurofibromatosis type-2 showed a hyperintense lesion. The lesion was resected and histopathologic section is shown in image. Question 1: What is the diagnosis? A. MedulloblastomaB. Ependymoma C. RetinoblastomaD. Central neurocytoma Question 2: Which of the following statements is true regarding this tumor? A. They are predominantly supratentorialB. Posterior fossa tumors in adults have a good prognosisC. Spinal tumors have a bad prognosisD. IDH 1 and 2 mutations are present in 100% cases. Question 3: Identify the variant of the tumor shown in the image below. A. TancyticB. MyxopapillaryC. SubependymomaD. Anaplastic Question 4: Which of the following statements is true regarding tancytic ependymoma? A. GFAP negativeB. Abundant rosettesC. Can be confused with pilocytic astrocytoma D. WHO Grade 1 Question 5: Identify the FALSE statement regarding the variant of ependymoma shown below Image credit- http://www.twitter.com/DrAldehyde A. WHO Grade 1B. Arises from filum terminaleC. Aggressive clinical courseD. Mucin stains positive Question 6: TRUE statement regarding recent molecular classification (WHO CNS 2021 5th edition ) of ependymoma is A. Spinal ependymomas with MYCN have a good prognosis B. ZFTA Fusion- favorable prognosisC. YAP Fusion- poor prognosisD. Spinal ependymomas with NF 2 mutation- favorable prognosis ANSWER- Question 1 Correct answer is B- Ependymoma Ependymomas are characterized by perivascular rosettes and ependymal rosettes which have an empty central lumen Types of rosettes ANSWER- Question 2 CORRECT ANSWER IS B 🐱 Majority of of Ependymomas are infratentorial. 🐱Posterior fossa tumors in children have a poor prognosis (PF-A)- associated with loss of H3K27me, whereas Posterior fossa tumors in adults have a god prognosis (PF-B)- H3K27me is retained. 🐱 Spinal ependymomas have a good prognosis, whereas a small number of ependymomas associated with MYCN have a poor outcome. 🐱IDH 1 and 2 are associated with astroctyomas and oligodendroglomas but nor ependymomas. ANSWER-Question 3 CORRECT ANSWER IS A Diagnosis is TANCYTIC EPENDYMOMA, 🐱 Tancytes are cells with fibrillary processes which line ventricles along with ependymal cells. Types of tancytes ANSWER – Question 4 Correct They are GFAP positive 🐱Confused with pilocytic astrocytoma because of the prominent fibrillary projections 🐱It is a GRADE II Ependymoma 🐱 Ependymal rosettes and pseudorosettes are scanty in tanytic ependymoma, which makes diagnosis challenging. ANSWER- Question 5 Correct answer is C💀Diagnosis is myxopapillary ependymoma💀It is a Grade II Tumor according to latest WHO💀It is common in adults and arises from the filum terminale💀It is clinically indolent ( nor aggressive)💀Stains for Mucin is positive. Mucin stains positive in myxopapillary ependymoma ANSWER – Question 6 Correct answer is D Spinal ependymomas with NF2 mutation has a good prognosis Summary of latest molecular updates in ependymoma Share this:FacebookTelegramWhatsAppMoreLinkedInTwitterLike this:Like Loading...
CENTRAL CHROMATOLYSIS Central chromatolysis is a condition seen in neurons with axonal reaction. Lets look at the details now. Axonal reaction is a change observed in the cell body during regeneration of the axon; it is best seen in anterior horn cells of the spinal cord when motor axons are cut or seriously damaged. The increase in protein synthesis that occurs in response to the injury is reflected in enlargement and rounding up of the cell body, peripheral displacement of the nucleus, enlargement of the nucleolus, and dispersion of Nissl substance from the center to the periphery of the cell (central chromatolysis). Below is a pictorial difference between normal neurons and neurons with axonal reaction. REVIEW QUESTIONS 1. Axonal reaction is visible in which of the which of the following regions of the central nervous system? A. Posterior horn cells of the spinal cord B. Anterior horn cells of the spinal cord C. Cerebral cortex D. Cerebellum CLICK HERE TO REVEAL THE ANSWER Answer is B: Axonal reaction is a change observed in the cell body during regeneration of the axon; it is best seen in anterior horn cells of the spinal cord when motor axons are cut or seriously damaged 2. Dispersion of nissil substance to the periphery of a neuron is characteristic of which of the following? A. Axonal reaction B. Wallerian degeneration C. Neuronal degeneration D. Red neurons. CLICK HERE TO REVEAL ANSWER Answer is A: The process described in the question is central chromatolysis and is associated with axonal reaction. Share this:FacebookTelegramWhatsAppMoreLinkedInTwitterLike this:Like Loading...
Central nervous system (CNS) tumors pathology mcq pdf with answers CNS pathology questions with answers- DOWNLOAD PDF Central nervous system tumors pathology mcq pdf with answers – Useful for NEET-SS Oncopathology, DM Histopathology, NIMHANS- Neuropathology fellowships and FRCPath-Histopathology. 1623746003900_0_Central-nervous-system-Pathology-mcqs-for-FRCPathDownload ATTEMPT CNS TUMORS PATHOLOGY QUESTIONS IN QUIZ MODE You may join telegram channel for topicwise mcqs- Pathology mcqs For pathology mcqs, quizzes, interesting facts and updates – Visit HOME – Pathology for all Join the Facebook page for daily questions- Pathology mcq Useful for NEET-SS Oncopathology, DM Histopathology, FRCPath, and Hematopathology fellowships. RECENT BLOGS PARIS SYSTEM FOR REPORTING URINARY CYTOLOGY MCQs by Pathology MCQs 22 Mar 2022 Breast Pathology MCQ 1 by Pathology MCQs 12 Mar 2022 CNS Pathology case based MCQs-2 by Pathology MCQs 23 Feb 2022 Share this:FacebookTelegramWhatsAppMoreLinkedInTwitterLike this:Like Loading...
5 ways to differentiate Lewy body and Pick body in a brain biopsy or during autopsy Degenerative brain diseases are seldom biopsied. They are diagnosed predominantly during autopsies. Lewy body and Pick body are particularly difficult to distinguish. Lewy bodies: They are seen in Parkinson’s disease as well as dementia with lewy bodies. Cortical lewy bodies are characteristic of dementia with lewy bodies whereas lewy bodies in the basal ganglia are seen in Parkinson’s disease. Pick bodies: They are seen fronto-temporal dementia. As the name suggests, they can be seen in frontal and temporal areas. Here are 5 ways to differentiate lewy body and pick body based on light microscopy, immunohistochemistry and electron microscopy. 1. STAINING Pick bodies are slightly more basophilic compared to Lewy body. PICK BODY – WITH SLIGHTLY BASOPHILIC APPEARANCE LEWY BODY WITH EOSINOPHILIC APPEARANCE 2. PRESENCE OR ABSENCE OF A CENTRAL DOT Lewy body has an eosinophilic central dot, as in the above picture which pick body lacks. 3. PRESENCE OR ABSENCE OF A PERIPHERAL HALO Lewy body has a peripheral halo wheras Pick body doesn’t PERIPHERAL HALO IN LEWY BODY 4. IMMUNOHISTOCHEMICAL STAINS Lewy body stains positive with anti-alpha synuclein antibodies. Pick body stains positive with anti-tau antibodies. 5. ELECTRON MICROSCOPY On electron microscopy Lewy body is composed of fuzzy deposits on filaments that radiated from a central core. Pick body is composed of random filaments of smooth contour. Electron microscopy findings of Lewy body Electron microscopic findings of Pick body That’s all the ways to differentiate PICK BODY AND LEWY BODY Liked the page? Why not leave a tip for it’s creators For YouTube video click If you are interested in illustrations click below Share this:FacebookTelegramWhatsAppMoreLinkedInTwitterLike this:Like Loading...
5 ways to differentiate gliosis and glioma. 5 ways to differentiate Gliosis and Glioma Gliosis is often confusing and challenging to differentiate from glioma. Adding to the trouble, is the fact that gliomas often accompany gliosis. Therefore it is essential to differentiate gliosis and gliomas. 5 ways to differentiate gliosis and glioma Gliosis is also seen in demyelinaying diseases and infections Ideally ‘gliosis with glioma’ and ‘gliosis without glioma’ shoud be differentiated, but to keep things simple let’s look at a few clues to tell the two apart. GLIOMAS Vs GLIOSIS 1. MITOSIS Mitosis naturally is characteristic of multiplying cells. Hence mitosis is lower in gliosis when compared to glioma. As a general rule the Ki67 proliferation index does not exceed > 5% in gliosis. This isn’t entirely useful, because low grade gliomas do not show mitosis. Ki-67 stains may be useful to quantify mitosis by immunohistochemistry. 2. MARGINS This is probably the most important differentiating fearure. GLIOMAS- EXPAND GLIOSIS- CONTRACTS However important this finding is, it is difficult to confirm without serial radiographs. 3. CELLULAR DENSITY Gliosis- cellular density is even Glioma- cellular density is uneven 4. NUCLEUS Gliosis- nuclei of cells don’t touch each other. Glioma- nuclei of cells often touch each other. 5. IMMUNOHISTOCHEMICAL MARKERS Gliosis- negative for markers such as IDH and p53. Glioma- positive for markers such as IDH and p53. IDH and p53 are not positive in many gliomas but, when they are positive they can be diagnostic. In this context it would be fitting to discuss quickly about a condition which often mimicks brain tumor- GLIOMATOSIS CEREBRI Gliomatosis cerebri is a rare primary brain tumor. It is commonly characterized by diffuse infiltration of the brain with neoplastic glial cells that affect various areas of the cerebral lobes. Gliomatosis cerebri behaves like a malignant tumor that is very similar to Glioblastoma. Though it is not an easy task to differentiate gliomas and gliomas, hope these tips would be of some use. Thank you! To read similar posts click here Click here for YouTube video Liked the page? Why not leave a tip for it’s creators Share this:FacebookTelegramWhatsAppMoreLinkedInTwitterLike this:Like Loading...