Neuropathology – 01

Author: Murat Gokden, M.D.

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1. Which of the following types of meningioma has the worst prognosis based on histological features?

Chordoid

Fibroblastic

Secretory

Rhabdoid

Metaplastic

2. Which of the following is true regarding acute neuronal injury?

Eosinophilic neuronal necrosis is the earliest light microscopic sign

It can be reversible if detected by brain biopsy

Red neurons can be seen as early as 2 hours after injury

It represents the typical injury pattern associated with toxic-metabolic insults

Healing neurons can be identified as chromatolytic

3. A 64-year-old man died as a result of an assault, which involved blunt trauma to the head by a baseball bat, after remaining comatose for two days. The lesion shown in this image:

Is encephalomalacia due to trauma

Is a remote infarct with hemorrhagic component

An organized abscess cavity

Is a remote intraparenchymal hematoma secondary to trauma

Is an acute hemorrhage

4. Which of the following cell types originate outside the central nervous system?

Neurons of the dentate gyrus

Oligodendrogliocytes

Ependymocytes

Microgliocytes

Astrocytes

5. Which of the following is correct regarding the brain tumor shown in the picture?

Clear cytoplasm due to glycogen accumulation is typical

It has a high propensity to infiltrate the leptomeninges, since most arise in the cortex

If identified, losses of 1p and 19q indicate better response to treatment

Microcalcifications are helpful to the diagnosis, but are present in only 20 % of cases

Most are WHO Grade II; however, some can be WHO Grade IV

6. Which of the following is correct regarding the brain tumor shown in the picture?

This is an undifferentiated tumor, although neuronal and glial markers can be expressed

It has a high propensity to infiltrate throughout the brain parenchyma

This is a highly malignant tumor with 5-year survival rate of less than 10%

The most common location is the pineal region of young adults

Losses of 22p is the most common genetic alteration

7. A 40-year-old HIV-positive man was found to have multiple periventricular white matter lesions. Which of the following is most likely?

Glioblastoma

Cryptococcosis

Toxoplasmosis

Chronic lymphocytic leukemia

Multiple sclerosis

8. Which of the following is correct regarding the brain tumor shown in the picture?

It typically occurs in the cerebral hemispheres in the elderly

It is a relatively well-circumscribed tumor, rendering gross total resection possible

It is considered as a WHO Grade II tumor

In spite of gross total resection, the prognosis is grim

Typical gross appearance is a solid, well-circumscribed mass

9. The microscopic picture shows the entorhinal cortex from the autopsy of a 75-year-old woman. Which of the following is true regarding this process?

It presents with rapidly progressing dementia

Gross examination of the brain rarely provides any clues

Most common location for this finding is cerebellum

Definitive diagnosis is by autopsy

This feature is pathognomonic for this disease process

10. Which of the following is true regarding the anomaly depicted in the image?

It is usually associated with iris abnormalities

Cerebellum, brain stem and pituitary gland may be unaffected

It is due to hindbrain abnormalities

Spinal cord is unaffected

It occurs due to problems within the 3rd month of gestation

11. A 74-year-old man died as a result of lobar pneumonia. At autopsy, cerebellum showed atrophy of the vermis. This condition:

Is reversible with intensive therapy

Predominantly affects granule cell layer

Is the result of chronic methanol intoxication

Can lead to cerebellar dysfunction in about 20% of cases

Is the result of an acute intoxication

12. The image is from the temporal lobe of a 5-year-old. This process:

Produces a granulomatous reaction in most cases

Requires electron microscopic examination for definitive diagnosis

Typically involves the temporal lobe

Causes temporary neurological deficits that leads to death within a period of 8 to 12 years

Is of unknown etiology

13. The lesion shown in the image is from the brain of a 35-year-old, otherwise healthy woman. Which of the following is correct?

It is characterized by multiple lesions of various ages

Presents with typical initial neurological signs and symptoms

It is a rare disorder in this age group

It most commonly involves basal ganglia

It is a dysmyelinating process

14. Based on this image, this process:

Is highly contagious among medical personnel

Is difficult to suspect due to ill-defined clinical picture

Is primarily sporadic

Evolves within a span of decades, with eventual death

Is a specific form of viral encephalopathy

15. Which of the following is correct regarding the central nervous system tumors?

Supratentorial tumors are common in children

Biologic behavior does not necessarily correlate with histology

Hematogenous spread is common in high grade tumors due to vascular proliferation

The annual incidence is 2/100,000 for intracranial tumors

Meningioma is the most common primary brain tumor

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