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MS2 - MBB > Neuropathology > Flashcards

Neuropathology Flashcards

1
Q

What is your Dx?

A

Epidural hematoma

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2
Q

Which vessels are damaged to produce a subdural hematomas?

A

Bridging veins

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3
Q

What is the germinal matrix? What is the clinical significance of it?

A

A region of cells involved in brain development; exist near the lateral ventricles. The region is vulnerable to hypoxia (which happens a lot with premature infants) and hemorrhage.

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4
Q

Subarachnoid hemorrhages most commonly occur as a result of rupture of…?

What is a common clinical sign/symptom of subarachnoid hemorrhage?

A

Rupture of a berry aneurysm in the circle of Willis.

Sudden onset terrible headache (thunderclap headache) is a common symptom.

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5
Q

What is the most common underlying cause of intracerebral hemorrhage?

Where in the brain do these most commonly occur?

A

Hypertension + arteriosclerosis –> vessel hemorrhage.

Most commonly occur in basal structures of the brain.

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6
Q

Rank the cell types found in gray matter with respect to their vulnerabilities to hypoxia.

A

Neurons are most vulnerable

Oligodendrocytes

Astrocytes

Vessels

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7
Q

Rank the cell types found in white matter with respect to their vulnerabilities to hypoxia.

A

Oligodentrocytes are most vulnerable

Astrocytes

Vessels

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8
Q

Which two areas in the brain are particularly susceptible to hypoxia in both kids and adults?

A

CA1 aka Sommer’s sector of the hippocampus

Purkinje cells of the cerebellum

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9
Q

Describe the histologic and cellular features of brain parenchyma after suffering from an infarct at 1 day post-infarct (acute phase), 1 day through 2 weeks post-infarct (subacute phase), and beyond 2 weeks post-infarct.

A

Acute: red neurons (necrotic neurons are highly eosinophilic)

1 day - 2 weeks: tons of neutrophils and macrophages

2+ weeks: astrogliosis (scar/cavitary lesion)

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10
Q

You’re a pathologist and need to determine the time of death for some reason and you’re only given this histo slide. How long ago did this brain tissue suffer from ischemia?

A

1 day - 2 weeks ago

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11
Q

You’re a pathologist and need to determine the time of death for some reason and you’re only given this histo slide. How long ago did this brain tissue suffer from ischemia?

A

1 day ago (or earlier)

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12
Q

What are the risk factors for developing arteriole brain infarcts?

A

Hypertension, diabetes, old age

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13
Q

In which region of the brain do lacunar infarcts most commonly happen?

A

In or near the basal ganglia

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14
Q

Rickettsial infection may lead to regional brain infarcts involving ________ (type of vessel), leading to _______ hemorrhages.

A

capillaries –> petechial hemorrhages

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15
Q

Regional brain infarcts involving veins often occur in patients who are _________.

What is the gross appearance of these?

A

hypercoagulable (cancer, dehydration, phlebitis)

Triangular shaped. If they involve the superior saggital sinus, there will be bilateral lesions in the cerebral hemispheres.

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16
Q

What is cerebral amyloid angiopathy?

A

Idiopathic deposition of amyloid in small arteries and arterioles of the brain.

17
Q

Compare where primary CNS neoplasms occur within the brain for adults vs. kids.

A

Adults - supratentorial

Kids - infratentorial

18
Q

Name two infiltrative primary CNS neoplasms that occur in adults, and kids, respectively.

A

Adults: diffuse gliomas, primary CNS lymphomas

Kids: medulloblastomas, ependymomas

19
Q

Name the non-infiltrative primary CNS neoplasms that occur in adults, and kids, respectively.

A

Adutls: meningioma, schwannoma, metastatic disease -> brain

Kids: pilocytic astrocytoma, craniopharyngioma

20
Q

What are the most common presenting signs/symptoms of primary CNS neoplasms?

A

New onset of seizures, focal neurologic signs

21
Q

Astrocytomas and oligodendrogliomas are neoplasms of _____ cells.

A

glial

22
Q

GBM is a high grade neoplasm of ________ (cell type).

How do these appear grossly on imaging?

What are some histological characteristics of these?

A

neoplasm of astrocytes

CT: butterfly lesion (crosses midline)

Histology: pseudopalisading necrosis, vascular proliferation

23
Q

Your 81 year old senator patient presents with new onset seizures, so you cut their brain out to make the diagnosis histologically. What is your Dx?

A

GBM

24
Q

What is a predisposing factor for developing a primary CNS lymphoma? How is it treated?

A

Being immunocompromised is a predisposing factor (ex. HIV)

Steroids, chemo for Tx

25
Q

What kind of primary CNS neoplasm is seen here?

A

Primary CNS lymphoma

26
Q

Which hereditary cancer syndrome is associated with multiple meningiomas? What do these tumors characteristically have on CT imaging?

A

NF2

Dural tail

27
Q

Where do schwannomas/acoustic neuromas usually occur?

A

Vestibular branch of CN VIII

28
Q

Which hereditary cancer syndrome is associated with bilateral schwannomas?

A

NF2

29
Q

Describe three histopathologic characteristics of schwannomas.

A

Verocay bodies, Antoni A (densely cellular regions), Antoni B (less densely cellular regions)

30
Q

What is your Dx?

A

Metastasis to the brain (usually from a carcinoma). Could be a GBM, but look for them butterflies for those.

31
Q

What are the most common presenting signs/symptoms of primary CNS neoplasms in kids and why?

A

Ataxia and nausea/vomiting, cuz they occur near the cerebellum

32
Q

What type of primary CNS neoplasm are these found in?

A

Pilocytic astrocytoma

33
Q

What kind of tumor is this? Are these treatable via resection?

A

Pilocytic astrocytoma - yeah treatable with surgery

34
Q

Your patient presents with multiple neurofibromas and malignant peripheral nerve sheath tumors. You suspect a hereditary cancer syndrome, which encodes the _________ gene on chromosome _____.

A

NF1 is associated w/ neurofibromas and malignant peripheral nerve sheath tumors.

NF1 gene on ch. 17 encodes the neurofibromin protein

35
Q

What gene, chromosome, and associated neoplasms are seen in patients with NF2 syndrome?

A

NF2 gene on ch. 22 encodes merlin/schwannomin

It is also called MISME syndrome:

Multiple Inherited

Schwannomas

Meningiomas

Ependymomas

36
Q

Is NF2 syndrome associated with neurofibromas?

A

No

37
Q

Name the genes and tumors associated with tuberous sclerosis.

A

TSC1 hamartin or TSC2 tuberin

Cortical tubers

Hamartomas

Subependymal giant cell astrocytoma

38
Q

Name the genes, chromosome, and tumors associated with Von Hippel-Lindau disease.

A

VHL on chromosme 3

Cortical tubers

Hemangioblastoma

Renal cell carcinoma

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MS2 - MBB (8 decks)

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