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Neuropathology Review Questions
11/30/12
![Page 2: Neuropathology Review Questions 11/30/12. Match the tumor with the description Neurofibroma Schwannoma Both Neither 1.Antoni A areas 2.Antoni B areas](https://reader036.vdocument.in/reader036/viewer/2022062421/56649ce45503460f949b117b/html5/thumbnails/2.jpg)
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
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Schwannoma
• Neoplastic schwann cells in two basic patterns– Antoni A• Compact• Spindle cells• Collagen abundant
– Antoni B• Loose• Stellate round cells• Microcysts
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Schwannoma
• Verocay bodies– In Antoni A areas– Anuclear areas with palisading cells
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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
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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
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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
![Page 8: Neuropathology Review Questions 11/30/12. Match the tumor with the description Neurofibroma Schwannoma Both Neither 1.Antoni A areas 2.Antoni B areas](https://reader036.vdocument.in/reader036/viewer/2022062421/56649ce45503460f949b117b/html5/thumbnails/8.jpg)
Neurofibroma
• Any age• No sex predominance• Not intracranial• Solitary cutaneous nodules– From small terminal nerves
• Potential for malignant transformation
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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
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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
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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
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Infarction
• 12-24 hours– Ischemic neuronal
necrosis• Possibly as little as one
hour
– Softening & discoloration
– Circumscribed pallor
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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
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Infarct