1. Neuropathology Review Questions
11/30/12

2. Match the tumor with the description
Antoni A areas
Antoni B areas
Verocay bodies
Axons present between tumor cells
Plexiform type strongly associated with NF1
Schwannoma
Neurofibroma
Schwannoma
Both
Neither
Schwannoma
Schwannoma
Neurofibroma
Neurofibroma

3. Schwannoma Neoplastic schwann cells in two basic patterns Antoni A
Compact
Spindle cells
Collagen abundant
Antoni B
Loose
Stellate round cells
Microcysts

4. Schwannoma Verocay bodies In Antoni A areas
Anuclear areas with palisading cells

5. 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

6. Schwannoma Intracranial Spinal Head & Neck Posterior mediastinum
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

7. 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

8. Neurofibroma Any age No sex predominance Not intracranial
Solitary cutaneous nodules
From small terminal nerves
Potential for malignant transformation

9. Neurofibroma Types Cutaneous Intraneural Painless, unencapsulated
Solitary, low malignant potential
Multiple = NF1
Intraneural
Large nerve trunks
NF1 (plexiform = pathognomonic for NF1)
“bag of worms”
Malignant potential

10. 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

11. Match the time period after an infarct with the histologic appearance
Lipid laden macrophages first appear
Fibrillary astrocytes at periphery
Gemistocytic astrocytes at periphery
Polymorphonuclear infiltrate
Neuronal necrosis first apparent
12-24h
1-2d
5-7d
10-20d
>3mo
5-7d
>3mo
10-20d
1-2d
12-24h

12. Infarction 12-24 hours Ischemic neuronal necrosis
Possibly as little as one hour
Softening & discoloration
Circumscribed pallor

13. 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

14. Infarct