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...
Characteristics of Epithelial-Mesenchymal transition Epithelial Mesenchymal Transition EMT- Epithelial mesenchymal transition It is integral to breast and prostrate cancers.EMT is controlled by SNAIL and TWIST proteins.Down regulation of epithelial markers and upregulation of mesenchymal markers.E cadherin expression is slilencedStrong migratory potential Share this:FacebookTelegramWhatsAppMoreLinkedInTwitterLike this:Like Loading...
DM Hematopathology- PGIMER recall questions This quiz contains recall questions from DM hematopathology PGIMER, entrance exam. PART 1- 40 General pathology questions with a single option (No negative marking – 4 marks for a correct answer). PART 2- 40 Hematopathology questions with multiple options. (Correct answer- four marks and wrong answer minus one mark). START QUIZ Share this:FacebookTelegramWhatsAppMoreLinkedInTwitterLike this:Like Loading...
Differences between Kimura disease and Angiolymphoid hyperplasia with eosinophilia Kimura disease and Angiolymphoid hyperplasia with eosinophilia (ALHE) are often confused and need to be differentiated. Here are a few differences. 1.AGE Kimura’s disease is a chronic inflammatory condition of unknown cause that affects young to middle-aged patients, most often males of Asian descent. Whereas, ALHE is more common in females. 2.LOCATION Kimura disease patients usually have a mass in the head and neck region with involvement of subcutaneous tissue, soft tissue, salivary glands, and single or multiple regional lymph nodes. ALHE also commonly involves the head and neck region, particularly behind the ears. 3.HISTOLOGY Key histologic features of kimura disease includes florid follicular hyperplasia that may contain a proteinaceous precipitate (IgE in a follicular dendritic network pattern) and vascularization of the germinal centers. The interfollicular areas show prominent high endothelial venules with a mixture of lymphocytes, plasma cells, eosinophils, and mast cells. Follicle lysis is often present, and eosinophilic abscesses are characteristic within germinal centers as well as in the paracortex. ALHE on the other hand, is a vascular neoplasm characterized by the proliferation of blood vessels lined by plump endothelial cells with abundant eosinophilic cytoplasm, imparting a hobnail appearance. This lesion is part of the spectrum of what have been called histiocytoid or epithelioid hemangiomas, and is a low-grade vascular tumor. There is a dense, mixed inflammatory cell infiltrate consisting of lymphocytes, plasma cells, and eosinophils. 4. IMMUNOHISTOCHEMISTRY Reticular pattern of IgE is seen in KIMURA disease. However, immunohistochemistry in ALHE is positive for CD 31, CD 34 and Factor VIII in the vascular component. 5.PERIPHERAL BLOOD EOSINOPHILIA Peripheral blood examination shows eosinophilia and increased serum IgE levels in kimura disease but not so much in ALHE. FIND A QUICK SUMMARY BELOW REVIEW QUESTION 1. A 20- year- old Asian male has eosinophilia and high levels of IgE with cervical lymphadenopathy. Excisional biopsy of the lymph node demonstrates follicular hyperplasia, intense eosinophilia and eosinophilic microabscesses. h e most likely diagnosis is: A. Kimura disease B. Kikuchi- Fujimoto disease C. Eosinophilic leukemia D. Hypereosinophilic syndrome CLICK TO REVEAL ANSWER Answer is A- Kimura disease like Kikuchi disease is seen more ot en in the Asian population. h e etiology is not known. h is is a chronic inl ammatory disorder of the subcutaneous tissue and af ects regional lymph nodes. h e cervical area is the most common site to be involved. Histology of the af ected lymph nodes demonstrates follicular hyperplasia, eosinophilia with eosinophilic microabscesses and ini ltration of the germinal centers. Increase in vessels may also be seen. Warthin Finkeldey giant cells may also be present. 2. All are true about kimura disease except A. Affects asians B. Affects females C. Peripheral eosinophilia is present D. Elevated levels of IgE are seen CLICK HERE TO REVEAL ANSWER Answer is B- Kimura disease is more common in males. Share this:FacebookTelegramWhatsAppMoreLinkedInTwitterLike this:Like Loading...
MELANOMA QUIZ- SOME KEY POINTS AND REVIEW Answer these multiple choice questions in melanoma given below. CLICK HERE TO ACCESS MELANOMA MCQS Here are some key points to help you answer them. Share this:FacebookTelegramWhatsAppMoreLinkedInTwitterLike this:Like Loading...