Neuropathology 1,2,3 Flashcards

1
Q

A 43-year-old South Asian man is brought
into the emergency department with general-
ized seizures and fever >38 (101F). CT head
does not show any abnormality. LP is per-
formed with an opening pressure of 22 cm
H2O and CSF analysis shows: WCC 748
(Polymorphs 113, Lymphocytes 635), RBC
28, normal protein and normal glucose.
Which one of the following is the most likely
cause?
a. Enterovirus
b. Listeria monocytogenes
c. Mycobacterium tuberculosis
d. Streptococcus pneumoniae
e. Wegener’s granulomatosis

A

a. Enterovirus

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2
Q

A 45-year-old woman presents with sudden
onset headache and photophobia. CT head
is unremarkable and she undergoes a lumbar
puncture. CSF analysis shows WCC 3, RBC
15000 and subarachnoid hemorrhage cannot
be excluded due to the presence of oxyhemo-
globin. CSF xanthochromia is detected by
which one of the following assays
a. Fluorescence in situ hybridization
b. Immunoprecipitation
c. Light microscopy
d. Spectroscopy
e. Western blotting

A

b. Immunoprecipitation

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3
Q

Which one of the following is the most appropriate marker for tumor proliferation?
a. GFAP
b. Ki-67
c. LDH
d. P53
e. S100

A

b. Ki-67

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4
Q

Which one of the following pathologies is most likely to exhibit the finding shown?
a. Ataxia telangiectasia
b. Neurofibromatosis-1
c. Neurofibromatosis-2
d. Sturge-Weber syndrome
e. Tuberous sclerosis

A

b. Neurofibromatosis-1

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5
Q

Which one of the following is most accurate
regarding tumors with 0-6-methylguanine-
DNA methyltransferase methylation?
a. More susceptible to alkylating agents
b. More susceptible to antimetabolites
c. More susceptible to antitumor antibiotics
d. More susceptible to topoisomerase
inhibitors
e. More susceptible to ribunucleotide reduc-
tase inhibitors

A

a. More susceptible to alkylating agents

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6
Q

Which one of the following genetic muta-
tions are associated with improved brain
tumor prognosis?
a. Loss of 1p/19q
b. Loss of 1p/22q
c. Loss of 1p/10q
d. Loss of 1p/10q
e. Loss of 1p/10q

A

a. Loss of 1p/19q

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7
Q

Which one of the following types of cerebral
edema is seen in malignant hypertension?
a. Cytotoxic
b. Hydrostatic
c. Interstitial
d. Osmotic
e. Vasogenic

A

b. Hydrostatic

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8
Q

Cerebral ischemia is usually seen when global
cerebral blood flow is below:
a. 60 ml per 100 g tissue per min
b. 50 ml per 100 g tissue per min
c. 40 ml per 100 g tissue per min
d. 30 ml per 100 g tissue per min
e. 20 ml per 100 g tissue per min

A

e. 20 ml per 100 g tissue per min

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9
Q

Which one of the following descriptions sug-
gest WHO grade II astrocytoma?
a. Microcystic change
b. Nuclear atypia and hyperchromasia
c. >10 mitoses per high power field
d. Numerous mitoses and anaplasia
e. Microvascular proliferation or necrosis

A

b. Nuclear atypia and hyperchromasia

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10
Q

Which one of the following best describes the finding below?
a. Ash-leaf (macule)
b. Café-au-lait spot
c. Plexiform neurofibroma
d. Port wine stain
e. Shagreen patch

A

a—Ash-leaf spot

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11
Q

Which one of the following best describes
the finding below?
a. Cowden syndrome
b. Gorlin syndrome
c. MEN1
d. Tuberous sclerosis
e. Von Hippel Lindau

A

d. Tuberous sclerosis

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12
Q

Which one of the following genetic mutations
is most likely seen with the finding below?
a. 9q34/16p13
b. 3p25
c. 17p13
d. 9q22
e. 5q21

A

a. 9q34/16p13

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13
Q

Which one of the following best describes
the finding shown?
a. Angiofibroma
b. Collagenoma
c. Neurofibroma
d. Neuroma
e. Periungual fibroma

A

e. Periungual fibroma

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14
Q

Which one of the following findings are most
likely associated with the clinical feature below?
a. Brainstem arteriovenous malformation
b. GI polyps
c. Optic glioma
d. Retinal hamartoma
e. Sensorineural deafness

A

e. Sensorineural deafness

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15
Q

Which one of the following best describes
the finding shown?
a. Cowden syndrome
b. McCune-Albright syndrome
c. Neurofibromatosis type 1
d. Neurofibromatosis type 2
e. Rhabdoid tumor syndrome

A

c. Neurofibromatosis type 1

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16
Q

Which one of the following best describes
the finding shown?
a. Acanthosis nigricans
b. Legius syndrome
c. Muenke syndrome
d. Neurofibromatosis type 2
e. Pfeiffer syndrome

A

b. Legius syndrome

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17
Q

Which one of the following best describes
the finding shown?
a. Cowden syndrome
b. Legius syndrome
c. Neurofibromatosis type 1
d. Rhabdoid tumor syndrome
e. Tuberous sclerosis complex

A

c. Neurofibromatosis type 1

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18
Q

Which one of the following is most likely in
the image shown?
a. Basal cell naevus syndrome (Gorlin)
b. Hereditary Hemorrhagic Telangiectasia
c. Neurofibromatosis type 2
d. Sturge-Weber syndrome
e. Tuberous sclerosis

A

c. Neurofibromatosis type 2

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19
Q

Which one of the following is most likely in the image shown?
a. Crouzon syndrome
b. Familial adenomatous polyposis syndrome
c. Gardener’s syndrome
d. Gorlin syndrome
e. Osler-Weber-Rendu syndrome

A

d. Gorlin syndrome

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20
Q

Molecular assays of NS tumors:
a. B-cell and T-cell receptor gene rearran-
gement
b. BRAF-KIAA1549 gene fusion/
duplication
c. Chromosome 1p/19q loss
d. EGFR gene amplification/10q loss
e. EWSR1 gene rearrangement
f. MGMT promotor methylation status
g. Monosomy chromosome 6
h. MYC gene amplification
i. SMARCB1 gene loss/INI1 protein absent
j. Wnt signaling pathway upregulation

For each of the following descriptions, select the
most appropriate answers from the list above.
Each answer may be used once, more than once
or not at all.
1. Diagnosis of atypical teratoid/rhabdoid
tumor
2. Response to alkylating agents in high grade
glioma
3. Found in most pilocytic astrocytomas

A

1—i, 2—f, 3—b

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21
Q

Tumor syndromes:
a. APC
b. MEN1
c. NF-1
d. NF-2
e. PTCH
f. PTEN
g. SMARCB1
h. TP53
i. TSC1/TSC2
j. VHL

For each of the following descriptions, select the
most appropriate answers from the list above.
Each answer may be used once, more than once
or not at all.
1. Gliomas and medulloblastoma
2. AT/RT
3. Hemangioblastoma

A

1—a: APC (Turcot syndrome), 2—g: SMARCB1 (Rhabdoid tumor predisposition syndrome),
3—j: VHL (Von Hippel Lindau)

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22
Q

Tumor markers:
a. Alpha-fetoprotein (AFP)
b. Beta-2-microglobulin
c. Beta-human chorionic gonadotropin
d. CA-125
e. CA15-3/CA27.29
f. CA19-9
g. Calcitonin
h. CEA
i. Chromogranin-A
j. Cytokeratin fragment 21-1
k. HE-4
l. LDH
m. PSA

For each of the following descriptions, select the
most appropriate answers from the list above.
Each answer may be used once, more than once
or not at all.
1. Neuroendocrine tumors
2. Multiple myeloma
3. Liver and germ cell cancers

A

1—i: Chromogranin A, 2—b: Beta-2-microglobulin, 3—a: Alpha-fetoprotein

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23
Q

Cytopathology of neurones and glia:
a. Central chromatolysis
b. Cowdry type A intranuclear inclusions
c. Flexner Wintersteiner rosette
d. Hirano Bodies
e. Homer-Wright rosette
f. Inclusion bodies
g. Lewy bodies
h. Negri bodies
i. Neurofibrillary tangles
j. Perivascular pseudorosette
k. Pick Bodies
l. Pick Cells
m. Schiller-Duval bodies
n. Verocay bodies

For each of the following descriptions, select the
most appropriate answers from the list above.
Each answer may be used once, more than once
or not at all.
1. Schwannoma
2. Ependymoma
3. Retinoblastoma
4. Rabies virus
5. Alzheimer’s disease

A

1—n: Verocay, 2—j: Pseudorosette, 3—c: Flexner Wintersteiner rosette, 4—h: Negri bodies, 5—i:
Neurofibrillary tangles

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24
Q

Which one of the following is most likely
based on the image shown below?
a. Congestive edema
b. Diffuse cytotoxic edema
c. Focal cytotoxic edema
d. Interstitial edema
e. Vasogenic edema

A

e—Vasogenic edema secondary to GBM.
Widened gyri, narrowing of sulci, compression of ventricles may be focal or diffuse.
Vasogenic edema often associated with focal
lesions, tumors, abscess.

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25
Q

Which one of the following is most likely
based on the image shown below?
a. Arachnoid granulations
b. Calcification
c. Dural metastasis
d. Meningitis
e. Venous thrombosis

A

a—Arachnoid granulations. These whitish
granular structures are located at the superior
medial aspect of the cerebral hemispheres
near the sagital sinus. They function in resorption of CS.

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26
Q

Which one of the following is most likely
based on the image shown below?
a. Hydrocephalus
b. Subfalcine herniation
c. Tonsillar herniation
d. Transtentorial herniation
e. Upwards herniation

A

b—Subfalcine herniation

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27
Q

Which one of the following is most likely
based on the image shown below?
a. Brain stem compression
b. Demyelination
c. Infarction
d. Primary brainstem hemorrhagic stroke
e. Subarachnoid hemorrhage

A

a—Brain stem compression.

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28
Q

Which one of the following is most likely
based on the image shown below?
a. Alobar holoprosencephaly
b. Arhinencephaly
c. Lobar holoprosencephaly
d. Semilobar holoprosencephaly
e. Syntelencephaly

A

c—Lobar holoprosencephaly

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29
Q

Which one of the following is most likely
based on the image shown below?
a. Chiari I malformation
b. Chiari II malformation
c. Dandy-Walker Malformation
d. Joubert syndrome
e. Rhombencephalosynapsis

A

b—Chiari II malformation—small cerebellum
with marked tonsillar and vermian herniation

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30
Q

Which one of the following is most likely
based on the image shown below?
a. Chiari malformation III
b. Craniospinal rachischisis
c. Dandy-Walker malformation
d. Semilobar holoprosencephaly
e. Syntelencephaly

A

c—Dandy-Walker malformation

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31
Q

Which one of the following is most likely
based on the image shown below?
a. Focal cortical dysplasia
b. Lissencephaly type 1
c. Lissencephaly type 2
d. Pachygyria
e. Pick’s disease

A

d—Pachygyria—enlarged gyri adjacent to
sylvian fissure.

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32
Q

Which one of the following is most likely
based on the image shown below?
a. Acute diffuse hypoxia
b. Canavan disease
c. Carbon monoxide poisoning
d. Cerebral amyloid angiopathy
e. Pachygyria

A

a. Acute diffuse hypoxia

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33
Q

Which one of the following is most likely
based on the image shown below?
a. Huntington’s disease
b. Intraventricular hemorrhage
c. Multiple sclerosis
d. Multiple system atrophy
e. Periventricular leukomalacia

A

e—Periventricular leukomalacia (hemorrhagic). Areas of periventricular necrosis
may undergo extensive hemorrhage

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34
Q

Which one of the following is most likely
based on the image shown below?
a. Left ACA infarct
b. Left pericallosal infarct
c. Left SCA infarct
d. Right PCA infarct
e. Right pericallosal infarct

A

d—Right PCA infarct. Remote infarct in
region of right posterior cerebral artery
appears as a depressed, cavitated area.

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35
Q

Which one of the following is most likely
based on the image shown below?
a. Brain contusion
b. CNS lymphoma
c. Malignant infarction
d. Non-accidental injury
e. PRES

A

c—Malignant infarction. A massive
right cerebral infarct (recent) resulted in
hyperemia, swelling, and right cingulate gyrus
herniation.

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36
Q

Which one of the following is most likely
based on the image shown below?
a. Cerebral Toxoplasmosis
b. HSV encephalitis
c. Mycotic aneurysm
d. Rosenthal fibers
e. Tuberculous meningitis

A

c—Mycotic aneurysm. Vasoinvasive fungi
are revealed by Gomori methenamine silver
(GMS) stain

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37
Q

Which one of the following is most likely
based on the image shown below?
a. Arteriovenous malformation
b. Capillary telangiectasia
c. Caverous hemagioma
d. Developmental venous anomaly
e. Dural arteriovenous fistula

A

d—DVA—congenital venous malformation

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38
Q

Which one of the following is most likely
based on the image shown below?
a. Aneurysmal subarachnoid hemorrhage
b. Contrecoup contusion
c. Hemorrhagic stroke
d. Ischemic stroke
e. Vasculitis

A

b—Contrecoup contusions.

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39
Q

Which one of the following is most likely
based on the image shown below?
a. Kernicterus
b. Multicystic encephalopathy
c. Pontosubicular necrosis
d. Status marmoratus
e. Ulegyria

A

a—Kernicterus

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40
Q

Which one of the following is most likely
based on the image shown below?
a. Germinal matrix hemorrhage
b. Hydrancephaly
c. Lissencephaly
d. Multicystic encephalopathy
e. Porencephalic cyst

A

e—Porencephaly cyst

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41
Q

Which one of the following is most likely
based on the image shown below?
a. Agyria
b. Cobblestone cortex
c. Pachygyria
d. Porencephaly
e. Schizencephaly

A

e—Schizencephaly

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42
Q

Which one of the following is most likely in a
patient where the findings shown affect mul-
tiple (3 or more) lobes of the brain?
a. Cerebral infarct
b. Gliomatosis cerebri
c. Kernicterus
d. Periventricular leukomalacia
e. Primary CNS lymphoma

A

b—Gliomatosis cerebri

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43
Q

Which one of the following is most likely
based on the image shown below?
a. Idiopathic intracranial hypertension
b. NF-1
c. Retinal detachment
d. Retinoblastoma
e. Terson’s syndrome

A

b—NF-1

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44
Q

Which one of the following is most likely
based on the image shown below?
a. Diffuse astrocytoma
b. Germinal matrix hemorrhage
c. Perventricular heterotopia
d. Tuberous sclerosis
e. Von Hippel-Lindau

A

d—Tuberous sclerosis

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45
Q

Which one of the following is most likely
based on the image shown below?
a. Fourth ventricular subependymoma
b. Duret hemorrhage
c. Infarct of cerebellar vermis
d. Myxopapillary ependymoma
e. Tanycytic ependymoma

A

a—Fourth ventricular subependymoma

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46
Q

Which one of the following is most likely
based on the image shown below?
a. Atypical teratoid/rhabdoid tumor
b. Cerebral abscess
c. Choroid plexus papilloma
d. Intraventricular meningioma
e. Mesial temporal sclerosis

A

a—Atypical teratoid/rhabdoid tumor

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47
Q

Which one of the following is most likely
based on the image shown below?
a. Ependymoma
b. Glioblastoma multiforme
c. Meningioma
d. Oligodendroglioma
e. Supratentorial PNET

A

c—Meningioma

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48
Q

Which one of the following is most likely
based on the image shown below?
a. Arteriovenous malformation
b. Choroid plexus papilloma
c. Glioma
d. Intracranial aneurysm
e. Meningioma

A

e—This intraventricular meningioma arose from the choroid plexus on the left side. It had histologic features of a fibrous meningioma

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49
Q

Which one of the following is most likely
based on the image shown below?
a. Abscess
b. Aneurysm
c. Arachnoid cyst
d. Glioma
e. Schwannoma

A

e—Schwannoma.

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50
Q

Which one of the following is most likely
based on the image shown below?
a. Dermoid cyst
b. Diffuse astrocytoma
c. Hemorrhagic stroke
d. Intraventricular meningioma
e. Primary CNS lymphoma

A

e—Primary CNS lymphoma

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51
Q

Which one of the following is most likely
based on the image shown below?
a. Cerebral abscess
b. Cystic Meningioma
c. Ex-vacuo dilatation
d. Germinoma
e. Hemangioblastoma

A

e—Hemangioblastoma

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52
Q

Which one of the following is most likely
based on the image shown below?
a. Colloid cyst
b. Optic glioma
c. Pineal cyst
d. Pituitary adenoma
e. Sheehan’s syndrome

A

d—Large soft tan-brown pituitary adenoma

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53
Q

Which one of the following is most likely
based on the image shown below?
a. Arachnoid cyst
b. Dermoid cyst
c. Epidermoid cyst
d. Pineal cyst
e. Rathke’s cleft cyst

A

e—Rathke’s cleft cyst

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54
Q

Which one of the following is most likely
based on the image shown below?
a. Colloid cyst
b. Craniopharyngioma
c. Epidermoid cyst
d. Pituitary adenoma
e. Teratoma

A

a—Colloid cyst of third ventricle

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55
Q

Which one of the following is most likely
based on the image shown below?
a. Cerebral vasculitis
b. Multifocal glioma
c. Multiple abscesses
d. Multiple metastasis
e. Neurofibromatosis

A

d—Multiple metastasis.

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56
Q

Which one of the following is most likely
based on the image shown below?
a. Epidermoid
b. Hemangioblastoma
c. Lhermitte-Duclos disease
d. Melanoma
e. Teratoma

A

d—Melanoma

57
Q

Which one of the following is most likely
based on the image shown below?
a. Arachnoid villus
b. Choroid plexus
c. Ecchordosis physaliphora
d. PICA aneurysm
e. Schwannoma

A

c—Ecchordosis physaliphora

58
Q

Which one of the following is most likely
based on the image shown below?
a. Cerebral malaria
b. Cysticercosis
c. Herpes encephalitis
d. Purulent meningitis
e. Subdural empyema

A

d—Purulent meningitis

59
Q

Which one of the following is most likely
based on the image shown below?
a. Cavum septum pellucidae
b. Periventricular leukomalacia
c. Subependymal giant cell astrocytoma
d. Subependymal heterotopia
e. Ventriculitis

A

e—Ventriculitis

60
Q

Which one of the following is most likely
based on the image shown below?
a. Mycobacterium Tuberculosis
b. Pseudomonas
c. Spirochetes (Lyme disease)
d. Staphylococcus aureus
e. Streptococcus pneumoniae

A

a—Mycobacterium Tuberculosis

61
Q

Which one of the following is most likely
based on the image shown below?
a. Aspergillosis
b. Candidiasis
c. Cryptococcosis
d. Cystercicosis
e. Toxoplasmosis

A

c—Cerebral cryptococcosis

62
Q

Which one of the following is most likely
based on the image shown below?
a. Aspergillosis
b. Cerebral abscess
c. Cerebral malaria
d. Hyatid disease
e. Listeria encephalitis

A

a—Aspergillosis

63
Q

Which one of the following is most likely
based on the image shown below?
a. Cavernoma
b. Cerebral metastasis
c. Developmental venous anomalies
d. Neurocysticercosis
e. Neuronal migration disorder

A

d—Neurocysticercosis

64
Q

Which one of the following is most likely
based on the image shown below?
a. Amoebic meningoencephalitis
b. Diffuse subarachnoid hemorrhage
c. Meningeal carcinomatosis
d. Post-radiotherapy change
e. Tuberculous meningitis

A

a—Amoebic meningoencephalitis.

65
Q

Which one of the following is most likely
based on the image shown below?
a. CMV ventriculitis
b. HIV encephalitis
c. HSV encephalitis
d. Hypoxic-ischemic encephalopathy
e. TORCH infection

A

a—Cytomegalovirus ventriculitis and
encephalitis

66
Q

Which one of the following is most likely
based on the image shown below?
a. Cortical tuber
b. Diffuse astrocytoma
c. Pleomorphic xanthoastrocytoma
d. Progressive multifocal leukoencephalopathy
e. Rabies encephalitis

A

d—Progressive multifocal leukoencephalopathy

67
Q

Which one of the following is most likely
based on the image shown below?
a. Alzheimer’s disease
b. Huntington’s disease
c. Lhermitte-Duclos disease
d. Parkinson’s disease
e. Wilson’s disease

A

a—Alzheimer’s disease

68
Q

Which one of the following is most likely
based on the image shown below?
a. Alzheimer’s disease
b. Focal cortical dysplasia
c. Lissencephaly type 2
d. Parkinson’s disease
e. Pick disease

A

e—Pick disease

69
Q

Which one of the following is most likely
based on the image shown below?
a. Amyotrophic lateral sclerosis
b. Cord infarction
c. Guillain-Barre syndrome
d. Radiation myelopathy
e. Transverse myelitis

A

a—Amyotrophic lateral sclerosis

70
Q

Which one of the following is most likely
based on the image shown below?
a. Double cortex syndrome
b. Hippocampal atrophy
c. HSV encephalitis
d. Huntington’s disease
e. Toxic leukoencephalopathy

A

d—Huntington’s disease.

71
Q

Which one of the following is most likely
based on the image shown below?
a. Amyotrophic lateral sclerosis
b. Cord infarction
c. Friedreich’s ataxia
d. Multiple sclerosis
e. Subacute combined degeneration

A

c—Friedreich’s ataxia.

72
Q

Which one of the following is most likely
based on the image shown below?
a. Alzheimer’s dementia
b. Cortical tubers
c. Periventricular leukomalacia
d. Subependymal heterotopia
e. Vascular dementia

A

e—Vascular dementia

73
Q

Which one of the following is the main feature demonstrated in this histological section?
a. Herring bodies
b. Hirano bodies
c. Neuritic plaques
d. Rosenthal fibers
e. Verocay bodies

A

d—Rosenthal fibers (RFs)

74
Q

Which one of the following areas in the brain
is most likely demonstrated in this histological section?
a. Caudate nucleus
b. Cortex
c. Optic nerve
d. Posterior pituitary
e. Thalamus

A

d—Posterior pituitary

75
Q

Which one of the following is most likely
demonstrated in this histological section?
a. Creutzfeldt-Jakob disease
b. Gemistocytic astrocytoma
c. Lymphoma
d. Oligodendroglioma
e. Pineoblastoma

A

b—Gemistocytic astrocytoma

76
Q

Which one of the following is the main
feature demonstrated in this histological
section?
a. Anaplastic astrocytoma
b. Pituitary adenoma
c. Psammomatous meningioma
d. Schwannoma
e. Teratoma

A

a—Anaplastic astrocytoma (WHO III)

77
Q

Which one of the following is the most likely
diagnosis demonstrated in this histological
section?
a. Diffuse astrocytoma
b. Germinoma
c. Glioblastoma multiforme
d. Schwannoma
e. Secretory meningioma

A

c—Glioblastoma multiforme

78
Q

Which one of the following is the most likely
diagnosis demonstrated in this histological
section?
a. Atypical meningioma
b. DNET
c. Glioblastoma multiforme
d. Medulloblastoma
e. Primary CNS lymphoma

A

c—Glioblastoma Multiforme (“glomeruloid
tuft” or microvascular proliferation)

79
Q

Which one of the following features is demonstrated in the center of this histological section?
a. Balloon cells
b. Fried egg cells
c. Glomeruloid microvascular proliferation
d. Mitotic figure
e. Pseudopalisading necrosis
6 NEUROPATHOLO

A

d—Mitotic figure (center—late anaphase)

80
Q

Which one of the following is the most likely
diagnosis demonstrated in this histological
section?
a. DNET
b. Gemistocytic astrocytoma
c. Glioblastoma multiforme
d. Medulloblastoma
e. Oligodendroglioma

A

e—Oligodendroglioma

81
Q

Which one of the following is the most likely
diagnosis demonstrated in this histological
section?
a. Anaplastic astrocytoma
b. Anaplastic oligodendroglioma
c. Glioblastoma multiforme
d. Renal metastasis
e. Secretory meningioma

A

b—Anaplastic oligodendroglioma

82
Q

Which one of the following is the most likely
diagnosis demonstrated in this histological
section?
a. Choroid plexus papilloma
b. Gliomatosis cerebri
c. Normal white matter
d. Pineocytoma
e. Teratoma

A

b—Gliomatosis cerebri

83
Q

Which one of the following is most likely
based on the histology below (low magnification showed microcystic areas)?
a. Anaplastic oligodendroglioma
b. Ependymoma
c. Fibrous meningioma
d. Medulloblastoma
e. Pilocytic astrocytoma

A

e—Pilocytic astrocytoma

84
Q

Which one of the following is the most likely
diagnosis demonstrated in this histological
section?
a. Alexander’s disease
b. Oligodendroglioma
c. Pleomorphic xanthoastrocytoma
d. Psammomatous meningioma
e. Reactive gliosis

A

c—Pleomorphic xanthoastrocytoma

85
Q

This histological section from an intraventricular tumor is most likely to be which one of the following
a. Chordoma
b. Choroid plexus papilloma
c. Pineoblastoma
d. Pituitary adenoma
e. Subependymal giant cell astrocytoma

A

e—Subependymal giant cell astrocytoma

86
Q

This child presented with seizures and a
known mutation on chromosome 16p13. A
supratentorial lesion was resected with the
histological appearance shown below. Which
one of the following diagnoses is most likely?
a. Gorlin syndrome
b. NF-2
c. Tuberous sclerosis complex
d. Turcot syndrome
e. Von Hippel-Lindau syndrome

A

C—Tuberous sclerosis complex

87
Q

Which one of the following is the most likely
diagnosis demonstrated in this histological
section?
a. Anaplastic oligodendroglioma
b. Ependymoma
c. Glioblastoma multiforme
d. Medulloblastoma
e. Retinoblastoma

A

b—Ependymoma

88
Q

Which one of the following diagnoses is most
likely from this histological section?
a. Central neurocytoma
b. Chordoid glioma
c. Ependymoma
d. Pleomorphic xanthoastrocytoma
e. Subependymal giant cell astrocytoma

A

c—Ependymoma

89
Q

Which one of the following is the most likely
diagnosis demonstrated in this histological
section?
a. Central neurocytoma
b. Ependymoma
c. Pilocytic astrocytoma
d. Pituitary adenoma
e. Retinoblastoma

A

e—Retinoblastoma

90
Q

Which one of the following is shown in this
histological section?
a. Ependymal rosette
b. Flexner-Wintersteiner rosette
c. Homer Wright rosette
d. Neurocytic rosette
e. Perivascular pseudorosette

A

c—Homer Wright rosette

91
Q

Which one of the following is the most likely
diagnosis demonstrated in this histological
section?
a. Central neurocytoma
b. Craniopharyngioma
c. Germinoma
d. Papillary ependymoma
e. Subependymal giant cell astrocytoma

A

d—Papillary ependymoma

92
Q

Which one of the following is the most likely
diagnosis demonstrated in this histological
section?
a. Atypical meningioma
b. Choroid plexus papilloma
c. Clear cell ependymoma
d. Glioblastoma multiforme
e. Schwannoma

A

c—Clear cell ependymomas

93
Q

Which one of the following is the most likely
diagnosis demonstrated in this histological
section from a spinal cord lesion?
a. Chordoma
b. Oligodendroglioma
c. Pituitary adenoma
d. Retinoblastoma
e. Tanycytic ependymoma

A

e—Tanycytic ependymomas

94
Q

Histology of this fourth ventricular tumor
extending out of foramen of Luscka laterally
is most likely to represent which one of the
following?
a. Anaplastic ependymoma
b. Atypical teratoid/rhabdoid tumor
c. Pilocytic astrocytoma
d. Pineoblastoma
e. Pontine glioma

A

a—Anaplastic ependymoma

95
Q

A 65-year-old male with sciatica undergoes
excision of an L3/4 spinal lesion. Which
one of the following is most likely based on
histological appearances below?
a. Chordoma
b. Gemistocystic astrocytoma
c. Myopapillary ependymoma
d. Pineocytoma
e. Schwannoma

A

c—Myxopapillary ependymoma

96
Q

Histology of this lateral ventricular tumor in
a 65-year-old patient is most likely to represent which one of the following?
a. Choroid plexus carcinoma
b. Choroid plexus papilloma
c. Ependymoma
d. Meningioma
e. Subependymoma

A

e—Subependymoma

97
Q

Which one of the following is the most likely
diagnosis demonstrated in this histological
section from ventricular lesion?
a. Chordoid glioma
b. Chordoma
c. Choroid plexus papilloma
d. Hypothalamic hamartoma
e. Yolk sac tumor

A

c—Choroid plexus papilloma

98
Q

Histology of this lateral ventricular tumor in a child with Li-Fraumeni syndrome is most likely to represent which one of the following?
a. Choroid plexus carcinoma
b. Hemangioblastoma
c. Hemangiopericytoma
d. Intraventricular meningioma
e. Subependymal giant cell astrocytoma

A

a—Choroid plexus papilloma

99
Q

A 3 year old child with known chromosome
17p loss presents with a posterior fossa tumour
with the histological appearance shown.
Which one of the following is most likely?
a. Cortical tuber
b. Embryonal carcinoma
c. Gemistocytic astrocytoma
d. Medulloblastoma
e. Meningioma

A

d—Medulloblastoma

100
Q

In the context of positive INI-1 staining (not shown), this histological section from a posterior fossa tumor is most likely to represent
which one of the following?
a. Atypical teratoid/rhabdoid tumor
b. Hemangioblastoma
c. Large cell/anaplastic medulloblastoma
d. Nodular/desmoplastic medulloblastoma
e. Pilocytic astrocytoma

A

c—Large cell/anaplastic medulloblastoma

101
Q

This INI-1 positive (not shown) tumor arising in the right frontal lobe of a 1 year old is most likely to represent which one of the
following?
a. Chordoma
b. Germinoma
c. Glioblastoma multiforme
d. Supratentorial primitive neuroepithelial
tumor (PNET)
e. Teratoma

A

d—Supratentorial PNET

102
Q

This histological section from a suprasellar
lesion is INI-1 negative but positive for
vimentin and epithelial membrane antigen.
Which one of the following are most likely:
a. Atypical teratoid/rhabdoid tumor
b. Chordoma
c. Craniopharyngioma
d. Pituitary adenoma
e. Pure germinoma

A

a—Atypical teratoid/rhabdoid tumor

103
Q

Which one of the following is the most likely
diagnosis demonstrated in this histological
section?
a. Chordoma
b. Ganglioglioma
c. Meningioma
d. Oligodendroglioma
e. Schwannoma

A

b—Ganglioglioma cell tumors

104
Q

Which one of the following is the most likely
diagnosis demonstrated in this histological
section?
a. Central neurocytoma
b. Dysembryoplastic neuroepithelial tumor
c. Fibrillary astrocytoma
d. Meningothelial meningioma
e. Pineoblastoma

A

b—Dysembryoplastic neuroepithelial tumor
(DNET)

105
Q

Which one of the following is the most likely
diagnosis demonstrated in this histological
section?
a. Central neurocytoma
b. Chordoma
c. Glioblastoma multiforme
d. Hemangioma
e. Oligodendroglioma

A

. a—Central neurocytoma

106
Q

Which one of the following is the most likely
diagnosis demonstrated in this histological
section?
a. Antoni B Schwannoma
b. Hemangioblastoma
c. Hemangiopericytoma
d. Neurofibroma
e. Pilocytic astrocytoma

A

c—Hemangiopericytomas

107
Q

Which one of the following is the most likely
diagnosis demonstrated in this histological
section?
a. Choroid plexus papilloma
b. Glioblastoma multiforme
c. Meningothelial meningioma
d. Pineoblastoma
e. Pituitary adenoma

A

c—Meningiomas

108
Q

Which one of the following is the most likely
diagnosis demonstrated in this histological
section?
a. Antoni A Schwannoma
b. Fibrillary astrocytoma
c. Fibrous fibroblastic meningioma
d. Malignant peripheral nerve sheath tumor
e. Medulloblastoma

A

c—Fibrous (fibroblastic) meningioma:

109
Q
  1. Which one of the following is the most likely
    diagnosis demonstrated in this histological
    section?
    a. Angiocentric glioma
    b. Central neurocytoma
    c. Chordoma
    d. Medulloblastoma
    e. Psammomatous meningioma
A

e—Psammomatous meningiomas

110
Q

Which one of the following is the most likely
diagnosis demonstrated in this histological
section?
a. Germinoma
b. Glioblastoma multiforme
c. Retinoblastoma
d. Schwannoma
e. Secretory meningioma

A

e—Secretory meningioma

111
Q

Which one of the following is the most likely
diagnosis demonstrated in this histological
section?
a. Angiomatous meningioma
b. Choroid plexus papilloma
c. Glioblastoma multiforme
d. Hemangiopericytoma
e. Psammomatous meningioma

A

a—Angiomatous meningioma:

112
Q

Which one of the following is the most likely
diagnosis demonstrated in this histological
section?
a. Atypical meningioma
b. Atypical teratoid/rhabdoid tumor
c. Diffuse astrocytoma
d. Medulloblastoma
e. Schwannoma

A

a—Atypical meningiomas

113
Q

Which one of the following is the most likely
diagnosis demonstrated in this histological
section?
a. Anaplastic astrocytoma
b. Chordoid meningioma
c. Choroid plexus papilloma
d. Oligodendroglioma
e. Pituitary adenoma

A

b—Chordoid meningioma

114
Q

Which one of the following is the most likely
diagnosis demonstrated in this histological
section?
a. Chordoma
b. Clear cell meningioma
c. Gemistocytic astrocytoma
d. Pilocytic astrocytoma
e. Pituitary adenoma

A

b—Clear cell meningioma

115
Q

Which one of the following is the most likely
diagnosis demonstrated in this histological
section?
a. Anaplastic meningioma
b. Central neurocytoma
c. Gemistocytic astrocytoma
d. Hemangiopericytoma
e. Medulloblastoma

A

a—Anaplastic meningiomas

116
Q

Which one of the following is the most likely
diagnosis demonstrated in this histological
section?
a. Choroid plexus carcinoma
b. Fibrillary astrocytoma
c. Oligodendroglioma
d. Parkinson’s disease
e. Rhabdoid meningioma

A

e—Rhabdoid meningioma

117
Q

Which one of the following is the most likely
diagnosis demonstrated in this histological
section?
a. Central neurocytoma
b. Choroid plexus papilloma
c. Medulloblastoma
d. Oligodendroglioma
e. Papillary meningioma

A

e—Papillary meningioma

118
Q

Which one of the following is the most likely
diagnosis demonstrated in this histological
section?
a. Angiocentric glioma
b. Neurofibroma
c. Primary CNS lymphoma
d. Psammomatous meningioma
e. Pseudopsammomatous bodies

A

b—Neurofibromas

119
Q

Which one of the following is the most likely
diagnosis demonstrated in this histological
section?
a. Astrocytoma
b. Germinoma
c. Neurofibroma
d. Schwannoma
e. Teratoma

A

c—Neurofibroma

120
Q

Which one of the following is the most likely
diagnosis demonstrated in this histological
section?
a. Antoni A schwannoma
b. Epidermoid
c. Malignant peripheral nerve sheath tumor
d. Meningioma
e. Neurenteric cyst

A

a—Schwannomas

121
Q

This dumbbell shaped mass in the spinal cord
most likely represents which one of the
following?
a. Antony B schwannoma
b. Malignant peripheral nerve sheath tumor
c. Myxopapillary ependymoma
d. Neurofibroma
e. Tanycytic ependymoma

A

a—Antony B schwannoma

122
Q

Which one of the following is the most likely
diagnosis demonstrated in this histological
section?
a. Bunina bodies
b. Hirano bodies
c. Lewy bodies
d. Pick bodies
e. Verocay bodies

A

e—Verocay bodies

123
Q

Which one of the following is the most likely
diagnosis demonstrated in this histological
section?
a. Angiocentric glioma
b. Atypical teratoid/rhabdoid tumor
c. Choriocarcinoma
d. Malignant peripheral nerve sheath tumors
e. Secretory meningioma

A

d—Malignant peripheral nerve sheath tumor
(MPNST)

124
Q

Deep cerebral lesion with the histological
appearance shown is most likely to be which
one of the following?
a. Angiofibromatous meningioma
b. Germinoma
c. Hemangiopericytoma
d. Primary CNS lymphoma
e. Toxoplasmosis

A

d—Primary CNS lymphoma

125
Q

Which one of the following is the most likely
diagnosis demonstrated in this histological
section?
a. Choroid plexus carcinoma
b. DNET
c. Gemistocytic astrocytoma
d. Oligodendroglioma
e. Pineocytoma

A

e—Pineocytoma

126
Q

A pineal region mass with the histological
appearance shown is most likely to be which
one of the following?
a. Choriocarcinoma
b. Ependymoma
c. Germinoma
d. Pineal parenchymal tumor of intermediate differentiation
e. Teratoma

A

d. Pineal parenchymal tumor of intermediate differentiation

127
Q

A child with a RB1 mutation develops a
supratentorial lesion with the histological
appearance shown. Which one of the following is most likely?
a. Fibrillary astrocytoma
b. Germinoma
c. Pilocytic astrocytoma
d. Pineoblastoma
e. Secretory meningioma

A

d—Pineoblastoma

128
Q

Which one of the following is the most likely
diagnosis demonstrated in this histological
section?
a. Anaplastic astrocytoma
b. Epidermoid
c. Germinoma
d. Hemangioblastoma
e. Oligodendroglioma

A

c—Germinoma

129
Q

Which one of the following is the most likely
diagnosis demonstrated in this histological
section?
a. AT/RT
b. Chordoma
c. Metastatic melanoma
d. Pituitary adenoma
e. Teratoma

A

e—Teratoma

130
Q

Which one of the following is the most likely
diagnosis demonstrated in this histological
section?
a. Craniopharyngioma
b. Creutzfeldt-Jakob disease
c. Pick’s disease
d. Teratoma
e. Yolk sac tumor

A

e—Yolk sac (endodermal sinus) tumor.

131
Q

Which one of the following is the most likely
diagnosis demonstrated in this histological
section?
a. DNET
b. Embryonal carcinoma
c. Fibrillary astrocytoma
d. PNET
e. Rhabdoid meningioma

A

b—Embryonal carcinoma

132
Q

Which one of the following is the most likely
diagnosis demonstrated in this histological
section?
a. Choriocarcinoma
b. Clear cell meningioma
c. Pick bodies
d. Progressive nuclear palsy
e. Renal cell carcinoma metastasis

A

a—Choriocarcinoma

133
Q

Which one of the following is the most likely
diagnosis demonstrated in this histological
section?
a. Central neurocytoma
b. Hemangioblastoma
c. Neurofibroma
d. Schwannoma
e. Secretory meningioma

A

b—Hemangioblastoma

134
Q

Which one of the following is the most likely
diagnosis demonstrated in this histological
section?
a. Craniopharyngioma
b. Pineocytoma
c. Pituitary adenoma
d. Psammomatous meningioma
e. Teratoma

A

c—Pituitary adenomas

135
Q

Which one of the following is the most likely
diagnosis demonstrated in this histological
section?
a. Adamantinomatous craniopharyngioma
b. Chordoma
c. Dermoid cyst
d. Pineal parenchymal tumor of intermediate differentiation
e. Rhabdoid meningioma

A

a—Adamantinomatous Craniopharyngioma

136
Q

Which one of the following is most likely
based on the image shown below?
a. Astrocytoma
b. Caseous necrosis
c. Cerebral abscess
d. Cerebral metastasis
e. Tumefactive demyelination

A

a—Astrocytoma

137
Q

Which one of the following is most likely
based on the image shown below?
a. Germinal matrix hemorrhage
b. Kernicterus
c. Periventricular leukomalacia
d. Wilson’s disease
e. X-linked adrenoleukodystrophy

A

a—Germinal matrix hemorrhage (16-18
weeks of gestation)

138
Q

Which one of the following is most likely
based on the image shown below?
a. Cortical dysplasia
b. Periventricular nodular heterotropias
c. Polymicrogyria
d. Ventriculitis
e. X-linked lissencephaly

A

b—Periventricular nodular heterotropias.

139
Q

Which one of the following CNS manifesta-
tions are associated with the condition sug-
gested below?
a. Aqueduct stenosis
b. DNET
c. Leptomeningeal angiomatosis
d. Skull base meningioma
e. Sphenoid wing dysplasia

A

c. Leptomeningeal angiomatosis