neuropathology review questions 11/30/12. match the tumor with the description neurofibroma...
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Neuropathology Review Questions
11/30/12
Match the tumor with the description
• Neurofibroma• Schwannoma• Both• Neither
1. Antoni A areas2. Antoni B areas3. Verocay bodies4. Axons present between tumor
cells5. Plexiform type strongly
associated with NF1
SchwannomaSchwannoma
Neurofibroma
Schwannoma
Neurofibroma
Schwannoma
• Neoplastic schwann cells in two basic patterns– Antoni A• Compact• Spindle cells• Collagen abundant
– Antoni B• Loose• Stellate round cells• Microcysts
Schwannoma
• Verocay bodies– In Antoni A areas– Anuclear areas with palisading cells
Schwannoma
• Benign• No sex predominance• Mean age 40-50 years• Occasionally multiple– With NF2 or schwannomatosis
• Neural crest origin• Frequently affect sensory nerves• May be cystic, hemorrhagic• S100 positive
Schwannoma
• Intracranial– Superior vestibular nerve
• Internal acoustic meatus at root entry zone
– Trigeminal nerve• Middle fossa, posterior fossa or both
• Spinal– Intraspinal or dumbell shaped
• Head & Neck• Posterior mediastinum• Retroperitoneum• Flexor surfaces of extremities
Neurofibroma
• Peripheral nerve sheath tumor– Mix of Schwann cells,
perineural cells, fibroblasts
• Hypocellular with mucoid matrix
• Collagen bundles follow nerve fibers
• Entrapped axons, ganglion cells
• Tactilelike structures– Resemble Meissnerian
corpuscles
Neurofibroma
• Any age• No sex predominance• Not intracranial• Solitary cutaneous nodules– From small terminal nerves
• Potential for malignant transformation
Neurofibroma Types• Cutaneous– Painless, unencapsulated– Solitary, low malignant potential
• Multiple = NF1
• Intraneural– Large nerve trunks– NF1 (plexiform = pathognomonic for NF1)– “bag of worms”– Malignant potential
Schwannoma Neurofibroma
Extremities Trunk
Eccentric to nerve Incorporates nerve
Globular Globular, fusiform or diffuse
Encapsulated No capsule
Tan-yellow, opaque Gray-tan, opalescent
Occasionally cystic Non-cystic
Highly cellular Low-moderate cellularity
Antoni A/B Uniphasic pattern
Axons absent Axons present
Schwann cells Multiple cells
No mast cells Mast cells present
Rare malignancy Malignant potential
NF2 association NF1 assosciation
Match the time period after an infarct with the histologic appearance
• 12-24h• 1-2d• 5-7d• 10-20d• >3mo
1. Lipid laden macrophages first appear
2. Fibrillary astrocytes at periphery3. Gemistocytic astrocytes at
periphery4. Polymorphonuclear infiltrate5. Neuronal necrosis first apparent
5-7d
>3mo
12-24h
10-20d1-2d
Infarction
• 12-24 hours– Ischemic neuronal
necrosis• Possibly as little as one
hour
– Softening & discoloration
– Circumscribed pallor
Infarction
• 1-2 days: PMN infiltration• 2-5 days: Astrocyte retraction balls, BBB
breakdown, edema• 5 days: Macrophages (gitter cells),
neovascularization• 2 weeks: Gemistocytic astrocytes• 3 months: Fibrillary astrocytes, preservation of
outer cortical layer
Infarct