CNS Pathology

Created by Mo

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What is the Fibroblastic pattern?

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The Fibroblastic pattern refers to a histological appearance characterized by the proliferation of fibroblast-like cells, often seen in certain types of tumors, indicating a reactive or neoplastic process.

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Histological Classification of CNS Tumors

What is the Fibroblastic pattern?

The Fibroblastic pattern refers to a histological appearance characterized by the proliferation of fibroblast-like cells, often seen in certain types of tumors, indicating a reactive or neoplastic process.

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Astrocytomas and Their Subtypes

What is a Low grade Astrocytoma?

A Low grade Astrocytoma is a type of brain tumor that arises from astrocytes and is characterized by slow growth and a lower degree of malignancy compared to high-grade tumors.

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Primary CNS Tumors

What are primary tumors in the context of CNS tumors?

Primary tumors account for half to three quarters of all CNS tumors and 20% of all pediatric tumors.

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Primary CNS Tumors

What is the significance of multicentricity in metastatic melanoma?

Multicentricity refers to the presence of multiple tumor sites within the same organ or tissue, indicating a more aggressive disease course in metastatic melanoma.

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Neuronal Tumors and Their Types

What is Central neurocytoma?

Central neurocytoma is a rare, typically benign brain tumor that arises from neuronal precursors, often found in the lateral ventricles of the brain.

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Embryonal Neoplasms in Pediatric Patients

What is Medulloblastoma?

Medulloblastoma is a type of aggressive brain tumor that primarily affects children, originating in the cerebellum and often spreading to other parts of the central nervous system.

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Germ Cell Tumors in the CNS

What are Germ Cell Tumors?

Tumors of the young, with 90% occurring during the first 2 decades, primarily located along the midline, most commonly in the pineal and suprasellar regions.

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Astrocytomas and Their Subtypes

What are pilocytic astrocytomas?

Relatively benign tumors that are more common in children and young adults, typically located in the cerebellum, third ventricle, optic pathways, spinal cord, and occasionally in the cerebral hemispheres.

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Ependymomas and Their Locations

What is an Ependymoma?

Ependymoma is a type of tumor that arises from ependymal cells, which line the ventricles of the brain and the central canal of the spinal cord. It can occur in both children and adults and is classified as a primary central nervous system tumor.

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Meningiomas and Their Histological Patterns

What is Psammomatous?

Psammomatous refers to a type of tumor characterized by the presence of psammoma bodies, which are calcified structures often found in certain types of tumors, particularly meningiomas.

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Astrocytomas and Their Subtypes

What are Pilocytic astrocytomas?

Pilocytic astrocytomas are a type of brain tumor characterized by bipolar cells with long, thin 'hairlike' processes that are GFAP-positive, along with the presence of Rosenthal fibers, eosinophilic granular bodies, and microcysts. Necrosis and mitoses are rare in these tumors.

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Astrocytomas and Their Subtypes

What defines a Glioblastoma?

Glioblastoma has a histologic appearance similar to that of anaplastic astrocytoma, but it also features necrosis (often with pseudopalisading nuclei) or vascular proliferation.

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Ependymomas and Their Locations

What is an Ependymoma?

A type of tumor that arises next to the ependymal-lined ventricular system, including the central canal of the spinal cord, commonly found near the fourth ventricle in the first two decades of life and in the spinal cord in adults.

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Astrocytomas and Their Subtypes

What is an Astrocytoma?

Astrocytoma is a type of tumor that arises from astrocytes, the star-shaped glial cells in the brain and spinal cord.

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Astrocytomas and Their Subtypes

What does expanded white matter of the left cerebral hemisphere indicate in relation to low-grade astrocytoma?

Expanded white matter of the left cerebral hemisphere may indicate the presence of a low-grade astrocytoma, as these tumors can cause localized swelling and changes in the brain's structure.

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Histological Classification of CNS Tumors

What are Gliomas?

Gliomas are tumors classified histologically based on their resemblance to different types of glial cells, including astrocytomas, oligodendrogliomas, and ependymomas.

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Meningiomas and Their Histological Patterns

What are Psammomatous bodies in Meningiomas?

Numerous psammoma bodies.

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Genetic Mutations in CNS Tumors

What virus is nearly always positive in Metastatic/Primary Central Nervous System Lymphoma?

The oncogenic Epstein-Barr virus.

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Oligodendrogliomas and Their Characteristics

How does the prognosis of Oligodendrogliomas compare to that of astrocytomas?

Oligodendrogliomas have a better prognosis than patients with astrocytomas of similar grade.

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Oligodendrogliomas and Their Characteristics

What is an Anaplastic oligodendroglioma?

Anaplastic oligodendroglioma is a more aggressive subtype of oligodendroglioma classified as WHO grade III/IV, characterized by higher cell density, nuclear anaplasia, and increased mitotic activity.

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Primary CNS Tumors

What is Primary CNS Lymphoma?

Primary CNS Lymphoma is a type of cancer that originates in the central nervous system, specifically in the brain or spinal cord, and is characterized by the presence of lymphoma cells.

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Astrocytomas and Their Subtypes

What is Glioblastoma?

A densely cellular tumor characterized by necrosis and pseudopalisading of tumor cell nuclei.

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Histological Classification of CNS Tumors

What is the Syncytial pattern?

The Syncytial pattern refers to a histological arrangement where cells fuse together to form a multinucleated structure, often seen in certain types of tumors.

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Astrocytomas and Their Subtypes

What is a low-grade astrocytoma?

A low-grade astrocytoma is a type of brain tumor characterized by slow growth and a lower degree of malignancy, often found in the white matter of the brain.

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Neuronal Tumors and Their Types

What is Central neurocytoma?

A low-grade neoplasm located within and adjacent to the ventricular system, typically found in the lateral or third ventricles, characterized by evenly spaced, round, uniform nuclei and often islands of neuropil.

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Oligodendrogliomas and Their Characteristics

What is an Oligodendroglioma?

Oligodendroglioma is an infiltrative tumor characterized by gelatinous, gray masses that may show cysts, focal hemorrhage, and calcification.

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Astrocytomas and Their Subtypes

What is an Astrocytoma?

Astrocytoma is a type of brain tumor that arises from astrocytes, which are star-shaped glial cells in the brain. It is categorized into three groups based on histologic features: well-differentiated astrocytoma (grade II), anaplastic astrocytoma (grade III), and glioblastoma (grade IV).

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Astrocytomas and Their Subtypes

What age group is most commonly affected by Diffuse astrocytomas?

Diffuse astrocytomas typically affect individuals in their fourth through sixth decades of life.

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Primary CNS Tumors

In which population is Metastatic/Primary Central Nervous System Lymphoma most common?

It is the most common CNS neoplasm in immunosuppressed persons.

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Germ Cell Tumors in the CNS

What is the significance of early diagnosis in Germ Cell Tumors?

Early diagnosis of Germ Cell Tumors is crucial as it can lead to more effective treatment options and better prognosis for the patient.

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Oligodendrogliomas and Their Characteristics

What is Oligodendroglioma?

Oligodendroglioma is a type of brain tumor characterized by sheets of regular cells with spherical nuclei containing finely granular chromatin, surrounded by a clear halo of cytoplasm, and often associated with calcification in 90% of cases. Mitotic activity is usually difficult to detect.

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Primary CNS Tumors

What is brain metastasis?

Brain metastasis refers to the spread of cancer cells from a primary tumor located in another part of the body to the brain.

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Primary CNS Tumors

How do childhood CNS tumors differ from adult CNS tumors?

Childhood CNS tumors differ from adults in both histologic subtype and location, typically arising in the posterior fossa, whereas adult tumors are mostly supratentorial.

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Meningiomas and Their Histological Patterns

What is a meningioma with a whorled pattern of cell growth and psammoma bodies?

A meningioma characterized by a distinctive whorled pattern of cellular arrangement and the presence of psammoma bodies, which are calcified structures often found in certain tumors.

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Neuronal Tumors and Their Types

What is a Central neurocytoma?

A Central neurocytoma is a type of neuronal tumor that typically arises in the lateral ventricles of the brain and is characterized by a well-circumscribed mass of neurocytic cells.

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Meningiomas and Their Histological Patterns

What characterizes Atypical meningiomas?

Atypical meningiomas (WHO grade II) are characterized by prominent nucleoli, increased cellularity, pattern-less growth, and a higher mitotic rate.

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Genetic Mutations in CNS Tumors

What is the NF2 tumor suppressor gene?

A gene located on the long arm of chromosome 22 (22q) that, when mutated, is associated with about half of meningiomas not linked to NF2.

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Germ Cell Tumors in the CNS

What is the male predominance in Germ Cell Tumors?

There is a male predominance in the pineal region for Germ Cell Tumors.

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Astrocytomas and Their Subtypes

What percentage of adult gliomas are Diffuse astrocytomas?

Diffuse astrocytomas account for 80% of adult gliomas.

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Meningiomas and Their Histological Patterns

What factors influence the prognosis of meningiomas?

The prognosis of meningiomas depends on lesion size and location, surgical accessibility, and histologic grade.

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Meningiomas and Their Histological Patterns

What defines the Secretory pattern in Meningiomas?

Gland-like PAS-positive eosinophilic secretions (pseudopsammoma bodies).

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Primary CNS Tumors

What percentage of extranodal lymphomas does Metastatic/Primary Central Nervous System Lymphoma represent?

It represents 2% of extranodal lymphomas.

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Germ Cell Tumors in the CNS

Where can Germ Cell Tumors occur in the CNS?

Germ Cell Tumors can occur in the central nervous system, particularly in the pineal gland and the suprasellar region.

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Oligodendrogliomas and Their Characteristics

What are the characteristics of Oligodendroglioma?

Oligodendroglioma tumor cells have round nuclei with a cytoplasmic halo and thin blood vessels in the background that form an interlacing pattern.

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Astrocytomas and Their Subtypes

What are Anaplastic Astrocytomas?

Anaplastic astrocytomas are a type of malignant brain tumor that arises from astrocytes, characterized by increased cellularity, nuclear atypia, and a higher mitotic rate compared to lower-grade astrocytomas.

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Primary CNS Tumors

What is Glioblastoma?

A necrotic, hemorrhagic, infiltrating mass that is a highly aggressive type of brain tumor.

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Meningiomas and Their Histological Patterns

What is a parasagittal multilobular meningioma?

A parasagittal multilobular meningioma is a type of tumor that is attached to the dura mater and causes compression of the underlying brain tissue.

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Embryonal Neoplasms in Pediatric Patients

What is Medulloblastoma?

Medulloblastoma is a type of aggressive brain tumor that primarily occurs in the cerebellum, commonly affecting children and characterized by rapid growth and potential to spread to other parts of the central nervous system.

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Histological Classification of CNS Tumors

What is the characteristic microscopic feature of Central Nervous System Lymphoma Tumors?

Malignant cells accumulate around blood vessels and infiltrate the surrounding brain parenchyma.

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Meningiomas and Their Histological Patterns

What defines Anaplastic (malignant) meningiomas?

Anaplastic meningiomas (WHO grade III) are highly aggressive tumors that resemble high-grade sarcomas or carcinomas.

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Meningiomas and Their Histological Patterns

What is the typical age group for meningiomas?

Meningiomas mostly occur in adults.

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Ependymomas and Their Locations

What are Anaplastic ependymomas?

Anaplastic ependymomas are a type of ependymoma characterized by increased cell density, high mitotic rates, necrosis, and less evident ependymal differentiation.

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Meningiomas and Their Histological Patterns

What is the Transitional pattern?

The Transitional pattern is a histological classification observed in certain CNS tumors, characterized by a mixture of features from different tumor types, often seen in meningiomas.

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Histological Classification of CNS Tumors

What is the definition of Secretory?

Relating to the process of secretion, which is the release of substances from cells or glands.

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Neuronal Tumors and Their Types

What are Gangliogliomas?

Gangliogliomas are rare, slow-growing tumors that typically contain both neuronal and glial components, often found in the temporal lobe of the brain.

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Embryonal Neoplasms in Pediatric Patients

What is Medulloblastoma?

Medulloblastoma is a highly cellular brain tumor characterized by sheets of anaplastic ('small blue') cells, which have little cytoplasm and hyperchromatic nuclei, along with abundant mitoses and often focal neuronal differentiation such as Homer Wright or neuroblastic rosettes.

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Embryonal Neoplasms in Pediatric Patients

What is the most common type of Embryonal Neoplasm?

The most common type of embryonal neoplasm is medulloblastoma, which accounts for 20% of pediatric brain tumors.

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Germ Cell Tumors in the CNS

Where do Germ Cell Tumors most commonly occur?

Most commonly in the pineal and suprasellar regions along the midline.

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Astrocytomas and Their Subtypes

What age group is most affected by pilocytic astrocytomas?

Children and young adults.

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Meningiomas and Their Histological Patterns

How do meningiomas typically interact with the underlying brain?

Most meningiomas are easily separable from the underlying brain, although some infiltrate the brain, which is associated with an increased risk of recurrence.

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Ependymomas and Their Locations

What are Ependymomas?

Ependymomas are a type of glioma that resemble ependymal cells, which line the ventricles of the brain and the central canal of the spinal cord.

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Germ Cell Tumors in the CNS

What are Germ Cell Tumors?

Germ Cell Tumors are a type of tumor that originates from germ cells, which are the cells that develop into sperm and eggs. They can occur in various locations, including the gonads and the central nervous system.

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Primary CNS Tumors

How do Metastatic Tumors typically present in the brain?

Metastatic tumors typically present as sharply demarcated masses, often located at the gray-white junction, and can elicit edema.

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Germ Cell Tumors in the CNS

What are the treatment options for Germ Cell Tumors?

Treatment options for Germ Cell Tumors typically include surgery, chemotherapy, and radiation therapy, depending on the tumor type and location.

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Oligodendrogliomas and Their Characteristics

Where are Oligodendrogliomas commonly located?

Oligodendrogliomas are mainly located in the cerebral hemispheres, particularly in the frontal or temporal lobes.

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Primary CNS Tumors

What are the unique characteristics of tumors of the nervous system?

Tumors of the nervous system do not have detectable premalignant or in situ stages, even low-grade lesions may infiltrate large regions of the brain, the anatomic site of the neoplasm can influence outcome, they are independent of histologic classification due to local effects, and they rarely spread outside of the CNS.

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Astrocytomas and Their Subtypes

What is an Astrocytoma?

Astrocytoma is a type of poorly defined, gray, infiltrative tumor that can vary in consistency from firm to soft and gelatinous, often exhibiting cystic degeneration and variations in gross appearance, particularly in glioblastoma, which may appear yellow due to tissue necrosis.

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Embryonal Neoplasms in Pediatric Patients

What is an Embryonal Neoplasm?

Embryonal neoplasms are tumors of neuroectodermal origin that exhibit a primitive 'small round cell' appearance, similar to normal progenitor cells in the developing CNS, with limited differentiation that may progress along multiple lineages.

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Astrocytomas and Their Subtypes

What are Rosenthal fibers?

Rosenthal fibers are elongated, eosinophilic structures found in pilocytic astrocytomas, indicative of the tumor's astrocytic origin.

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Embryonal Neoplasms in Pediatric Patients

What are primitive neuroectodermal tumors (PNETs)?

Tumors of similar histologic type and poor differentiation that can be found elsewhere in the nervous system, related to Medulloblastoma.

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Meningiomas and Their Histological Patterns

What are meningiomas?

Meningiomas are tumors that arise from arachnoid meningothelial cells, primarily occurring in adults.

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Meningiomas and Their Histological Patterns

What types of growth patterns are associated with mutations in NF2?

Mutations in NF2 are more common in tumors with fibroblastic, transitional, and psammomatous growth patterns.

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Astrocytomas and Their Subtypes

What are Astrocytomas?

Astrocytomas are a type of glioma that resemble astrocytes, which are star-shaped glial cells in the brain.

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Primary CNS Tumors

What is Metastatic/Primary Central Nervous System Lymphoma?

An aggressive disease characterized by multiple tumor nodules within the brain parenchyma, often associated with immunosuppressed individuals and linked to the Epstein-Barr virus.

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Neuronal Tumors and Their Types

Where is the typical location of a Dysembryoplastic neuroepithelial tumor?

The superficial temporal lobe.

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Astrocytomas and Their Subtypes

What is Astrocytoma?

Astrocytoma is a type of brain tumor characterized by a mild to moderate increase in the number of glial cell nuclei, variable nuclear pleomorphism, a fibrillary appearance in the background, and an indistinct transition between neoplastic and normal tissue.

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Primary CNS Tumors

What are Primary CNS tumors classified as?

Primary CNS tumors are classified as Gliomas, Neuronal Tumors, Embryonal (Primitive) Neoplasms, Germ Cell Tumors, Meningiomas, and Lymphoma.

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Astrocytomas and Their Subtypes

What is an Anaplastic astrocytoma?

Anaplastic astrocytomas are characterized by regions that are more densely cellular, greater nuclear pleomorphism, and the presence of mitotic figures.

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Ependymomas and Their Locations

What is Ependymoma?

Ependymoma is a type of tumor that can present as solid or papillary masses extending from the ventricular floor, commonly found in the fourth ventricle.

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Primary CNS Tumors

What are Metastatic/Primary Central Nervous System Lymphoma Tumors?

Aggressive large B-cell lymphomas that often occur in deep gray structures, white matter, and the cortex, with common periventricular spread and extensive areas of necrosis associated with EBV.

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Meningiomas and Their Histological Patterns

What are Meningiomas associated with NF2?

Multiple meningiomas that occur in association with eighth-nerve schwannomas or glial tumors.

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Histological Classification of CNS Tumors

What is a perivascular pseudorosette in Ependymoma?

A perivascular pseudorosette is a histological feature of Ependymoma where tumor cells are arranged around blood vessels, with an intervening zone containing thin ependymal processes.

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Astrocytomas and Their Subtypes

Where are Diffuse astrocytomas commonly located?

Diffuse astrocytomas are commonly located in the cerebral hemispheres.

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Primary CNS Tumors

What are Metastatic Tumors?

Metastatic tumors are secondary tumors that originate from primary cancers, mostly carcinomas, and account for one fourth to one half of intracranial tumors.

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Astrocytomas and Their Subtypes

What are Pilocytic astrocytomas?

Pilocytic astrocytomas are typically cystic tumors characterized by a mural nodule in the wall of the cyst, and if solid, they are usually well circumscribed.

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Neuronal Tumors and Their Types

What are Gangliogliomas?

Gangliogliomas are tumors that manifest with seizures and are characterized by a mixture of glial elements, usually a low-grade astrocytoma, and mature appearing neurons. The glial component can occasionally become frankly anaplastic, but most of these tumors are slow-growing.

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Astrocytomas and Their Subtypes

What are Pilocytic astrocytomas?

Pilocytic astrocytomas are a type of brain tumor characterized by the presence of hair-like cells and Rosenthal fibers.

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Astrocytomas and Their Subtypes

What are hair-like cells?

Hair-like cells are a distinctive feature of pilocytic astrocytomas, contributing to their unique histological appearance.

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Genetic Mutations in CNS Tumors

What genetic mutations are associated with Glioblastoma?

Glioblastoma is associated with loss-of-function mutations in the p53 pathway, mutations in the Rb tumor suppressor pathways, and gain-of-function mutations in the oncogenic PI3K pathways.

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Meningiomas and Their Histological Patterns

What is the Syncytial pattern in Meningiomas?

Whorled clusters of cells without visible cell membranes that sit in tight groups.

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Meningiomas and Their Histological Patterns

What characterizes the Fibroblastic pattern in Meningiomas?

Elongated cells and abundant collagen deposition between.

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Oligodendrogliomas and Their Characteristics

What are Oligodendrogliomas?

Oligodendrogliomas are a type of glioma that resemble oligodendrocytes, which are glial cells that produce myelin in the central nervous system.

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Neuronal Tumors and Their Types

What are the microscopic features of a Dysembryoplastic neuroepithelial tumor?

Small round neuronal cells arranged in columns, forming multiple discrete intracortical nodules with a myxoid background and well-differentiated floating neurons within pools of mucopolysaccharide-rich myxoid fluid.

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Primary CNS Tumors

What are the most common primary sites for Metastatic Tumors?

The most common primary sites for metastatic tumors are the lung, breast, skin (melanoma), kidney, and gastrointestinal tract, accounting for about 80% of cases.

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Oligodendrogliomas and Their Characteristics

What is an Oligodendroglioma?

A type of glioma that accounts for 5% to 15% of gliomas, typically found in the cerebral hemispheres, mainly in the frontal or temporal lobes, and has a better prognosis than astrocytomas of similar grade.

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Genetic Mutations in CNS Tumors

What genetic mutations are associated with Oligodendrogliomas?

Oligodendrogliomas are associated with deletions of chromosomes 1p and 19q, which make them highly responsive to chemotherapy and radiotherapy.

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Neuronal Tumors and Their Types

What is a Dysembryoplastic neuroepithelial tumor?

A Dysembryoplastic neuroepithelial tumor is a rare, benign brain tumor typically found in children and young adults, characterized by a mixture of glial and neuronal elements, often associated with epilepsy.

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Meningiomas and Their Histological Patterns

What are Meningiomas?

Meningiomas are well-defined dura-based masses that do not invade the brain, although they may extend into the overlying bone.

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Embryonal Neoplasms in Pediatric Patients

What is Medulloblastoma?

A type of brain tumor located in the midline of the cerebellum, commonly found in children, with lateral tumors occurring in adults. It is characterized by a well-circumscribed, gray, and friable appearance.

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Neuronal Tumors and Their Types

What are Gangliogliomas?

Gangliogliomas are mixed neuronal-glial tumors that often occur in the temporal lobe and are composed of both ganglion cells and glial cells.

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Primary CNS Tumors

How do Central Nervous System Lymphoma Tumors compare to glial neoplasms and metastases?

They are relatively well defined compared to glial neoplasms but not as discrete as metastases.

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Meningiomas and Their Histological Patterns

What features are shared in the Transitional pattern of Meningiomas?

Shares features of the syncytial and fibroblastic types.

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Astrocytomas and Their Subtypes

What are common presentations of Diffuse astrocytomas?

Common presentations of Diffuse astrocytomas include seizures, headaches, and focal neurologic deficits.

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Primary CNS Tumors

What do well-demarcated margins indicate in metastatic melanoma?

Well-demarcated margins suggest a clear boundary between the tumor and surrounding tissue, which can be associated with a better prognosis in metastatic melanoma.

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Embryonal Neoplasms in Pediatric Patients

What is Medulloblastoma?

A type of brain tumor that predominantly occurs in children and is exclusively located in the cerebellum, characterized by the expression of neuronal and glial markers.

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Ependymomas and Their Locations

What is Ependymoma?

Ependymoma is a type of tumor that arises from ependymal cells, characterized by cells with regular, round to oval nuclei, abundant granular chromatin, and a fibrillary background. It may show rosettes and canals resembling the embryologic ependymal canal.

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Histological Classification of CNS Tumors

What are the microscopic features of Ependymoma?

Microscopically, Ependymoma features cells with regular, round to oval nuclei, abundant granular chromatin, a fibrillary background, and may exhibit rosettes and perivascular pseudorosettes, where tumor cells are arranged around vessels with thin ependymal processes in between.

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Neuronal Tumors and Their Types

What is a Dysembryoplastic neuroepithelial tumor?

A Dysembryoplastic neuroepithelial tumor is a benign, slow-growing tumor commonly found in children and young adults, characterized by a unique histological appearance and often associated with epilepsy.

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Astrocytomas and Their Subtypes

Where are pilocytic astrocytomas commonly located?

In the cerebellum, third ventricle, optic pathways, spinal cord, and occasionally in the cerebral hemispheres.

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Genetic Mutations in CNS Tumors

What genetic mutation is associated with pilocytic astrocytomas?

Activating mutations in the serine-threonine kinase BRAF.

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Neuronal Tumors and Their Types

What is a Dysembryoplastic neuroepithelial tumor?

A low-grade childhood tumor that grows slowly and has a good prognosis after resection, often manifesting as a seizure disorder.

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Astrocytomas and Their Subtypes

What are the three histologic groups of astrocytomas?

The three histologic groups of astrocytomas are well-differentiated astrocytoma (grade II), anaplastic astrocytoma (grade III), and glioblastoma (grade IV).

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Germ Cell Tumors in the CNS

What are the common types of Germ Cell Tumors?

The common types of Germ Cell Tumors include teratomas, seminomas, and non-seminomatous germ cell tumors, each with distinct characteristics and treatment approaches.

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Oligodendrogliomas and Their Characteristics

What age group is most affected by Oligodendroglioma?

Oligodendrogliomas primarily affect individuals in their fourth and fifth decades of life.

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Astrocytomas and Their Subtypes

What mutations are found in lower-grade astrocytomas?

Lower-grade astrocytomas are characterized by mutations of IDH1 and IDH2.

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Germ Cell Tumors in the CNS

What is the most common primary CNS germ cell tumor?

The most common primary CNS germ cell tumor is germinoma.

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Germ Cell Tumors in the CNS

What percentage of brain tumors do Germ Cell Tumors represent?

Germ Cell Tumors represent 0.2% to 1% of brain tumors.

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Primary CNS Tumors

What is the response rate of Metastatic/Primary Central Nervous System Lymphoma?

It has a relatively poor response rate to treatment.

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Primary CNS Tumors

What is the age spectrum for nonimmunosuppressed individuals with Metastatic/Primary Central Nervous System Lymphoma?

The age spectrum is relatively wide, with more cases occurring after age 60.

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Primary CNS Tumors

What percentage of intracranial tumors is Metastatic/Primary Central Nervous System Lymphoma?

It accounts for 1% of intracranial tumors.

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Primary CNS Tumors

What is the microscopic characteristic of the boundary between Metastatic Tumors and brain parenchyma?

At the microscopic level, the boundary between metastatic tumors and brain parenchyma is sharp, often accompanied by surrounding reactive gliosis.

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Oligodendrogliomas and Their Characteristics

What is the WHO grade of anaplastic oligodendroglioma?
A) Grade I
B) Grade II
C) Grade III/IV
D) Grade V
E) Grade 0

C) Grade III/IV
Explanation: Anaplastic oligodendroglioma is classified as a WHO grade III/IV tumor, indicating its aggressive nature and higher potential for malignancy compared to lower-grade oligodendrogliomas.

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Astrocytomas and Their Subtypes

What is a notable feature of glioblastoma in terms of gross appearance?
A) Uniform appearance
B) Variation in gross appearance
C) Always yellow in color
D) Always encapsulated
E) Consistently soft

B) Variation in gross appearance
Explanation: Glioblastoma, a subtype of astrocytoma, is noted for its variation in gross appearance, which can complicate diagnosis and treatment.

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Astrocytomas and Their Subtypes

What causes the yellow appearance in astrocytomas?
A) Presence of blood
B) Tissue necrosis
C) High fat content
D) Inflammation
E) Calcification

B) Tissue necrosis
Explanation: The yellow color observed in some astrocytomas is a result of tissue necrosis, indicating areas of dead or dying cells within the tumor.

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Astrocytomas and Their Subtypes

What distinguishes glioblastoma from anaplastic astrocytoma?
A) Presence of necrosis
B) Lower cellularity
C) Absence of mitotic figures
D) Lack of vascular proliferation
E) Uniform nuclear morphology

A) Presence of necrosis
Explanation: Glioblastoma is distinguished from anaplastic astrocytoma by the presence of necrosis, often accompanied by pseudopalisading nuclei, as well as vascular proliferation, making it a more aggressive tumor.

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Histological Classification of CNS Tumors

Where are secretory cells commonly found?
A) In muscle tissue
B) In connective tissue
C) In epithelial tissue
D) In nervous tissue
E) In adipose tissue

C) In epithelial tissue
Explanation: Secretory cells are primarily found in epithelial tissue, where they are involved in the secretion of various substances necessary for bodily functions.

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Astrocytomas and Their Subtypes

What is a key histological feature of glioblastoma?
A) Low cellularity
B) Necrosis and pseudopalisading of tumor cell nuclei
C) Presence of lymphocytes
D) Mitosis in a low percentage of cells
E) Abundant extracellular matrix

B) Necrosis and pseudopalisading of tumor cell nuclei
Explanation: Glioblastoma is characterized by densely cellular tumors that exhibit necrosis and pseudopalisading of tumor cell nuclei, which are distinctive histological features that help in its identification.

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Meningiomas and Their Histological Patterns

What is a characteristic feature of meningiomas associated with NF2?
A) They are always benign
B) They are associated with eighth-nerve schwannomas or glial tumors
C) They only occur in children
D) They are located in the spinal cord
E) They are exclusively found in the brainstem

B) They are associated with eighth-nerve schwannomas or glial tumors
Explanation: Meningiomas associated with NF2 are characterized by the presence of multiple meningiomas along with eighth-nerve schwannomas or glial tumors, indicating a specific relationship between these tumor types.

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Astrocytomas and Their Subtypes

What is a key characteristic of astrocytomas in terms of their appearance?
A) Well-defined, white tumors
B) Poorly defined, gray, infiltrative tumors
C) Brightly colored, encapsulated tumors
D) Smooth, red tumors
E) Transparent, fluid-filled tumors

B) Poorly defined, gray, infiltrative tumors
Explanation: Astrocytomas are characterized by their poorly defined, gray, infiltrative appearance, which distinguishes them from other types of tumors.

p.48
Histological Classification of CNS Tumors

What is a syncytial pattern characterized by?
A) Individual cell structures
B) Multiple nuclei within a single cell
C) A single nucleus in each cell
D) Absence of cellular organization
E) Only prokaryotic cells

B) Multiple nuclei within a single cell
Explanation: A syncytial pattern is characterized by the presence of multiple nuclei within a single cell, which occurs when cells fuse together, forming a multinucleated structure.

p.18
Astrocytomas and Their Subtypes

What type of cells are characteristic of pilocytic astrocytomas?
A) Squamous cells
B) Hair-like cells
C) Cuboidal cells
D) Columnar cells
E) Ciliated cells

B) Hair-like cells
Explanation: Pilocytic astrocytomas are characterized by the presence of hair-like cells, which are a distinctive feature of this type of tumor.

p.45
Meningiomas and Their Histological Patterns

What is a key characteristic of a parasagittal multilobular meningioma?
A) It is located in the cerebellum
B) It is attached to the dura with compression of underlying brain
C) It is a type of glioma
D) It is always benign
E) It originates from neuronal tissue

B) It is attached to the dura with compression of underlying brain
Explanation: A parasagittal multilobular meningioma is specifically characterized by its attachment to the dura mater and the compression it exerts on the underlying brain tissue, which is crucial for understanding its clinical implications.

p.20
Oligodendrogliomas and Their Characteristics

What is a key macroscopic characteristic of oligodendrogliomas?
A) Hard, bony masses
B) Gelatinous, gray masses
C) Fluid-filled sacs
D) Dense, fibrous tissue
E) Transparent, watery lesions

B) Gelatinous, gray masses
Explanation: Oligodendrogliomas are characterized by their infiltrative nature and appear as gelatinous, gray masses, which is a distinctive feature observed during macroscopic examination.

p.31
Neuronal Tumors and Their Types

What type of tumor is a central neurocytoma?
A) A type of meningioma
B) A type of astrocytoma
C) A neuronal tumor
D) A type of oligodendroglioma
E) A type of ependymoma

C) A neuronal tumor
Explanation: Central neurocytoma is classified as a neuronal tumor, which arises from neurocytes, typically found in the central nervous system, particularly in the lateral ventricles.

p.40
Embryonal Neoplasms in Pediatric Patients

What is a key microscopic feature of medulloblastoma?
A) Low cellularity
B) Sheets of anaplastic cells
C) Presence of large, mature neurons
D) Abundant cytoplasm
E) Lack of mitotic activity

B) Sheets of anaplastic cells
Explanation: Medulloblastoma is characterized by extremely cellular structures, specifically featuring sheets of anaplastic ('small blue') cells, which are indicative of this type of tumor.

p.48
Histological Classification of CNS Tumors

What is a common example of a syncytial structure in the human body?
A) Neurons
B) Cardiac muscle cells
C) Skeletal muscle fibers
D) Epithelial cells
E) Adipocytes

C) Skeletal muscle fibers
Explanation: Skeletal muscle fibers are a common example of a syncytial structure, as they are formed by the fusion of multiple myoblasts, resulting in long, multinucleated cells.

p.9
Astrocytomas and Their Subtypes

What is a key characteristic of glioblastoma?
A) Non-invasive growth
B) Necrotic, hemorrhagic, infiltrating mass
C) Well-defined borders
D) Slow-growing tumor
E) Primarily affects children

B) Necrotic, hemorrhagic, infiltrating mass
Explanation: Glioblastoma is characterized as a necrotic, hemorrhagic, infiltrating mass, indicating its aggressive nature and tendency to invade surrounding brain tissue.

p.18
Astrocytomas and Their Subtypes

What are Rosenthal fibers associated with?
A) Oligodendrogliomas
B) Pilocytic astrocytomas
C) Ependymomas
D) Meningiomas
E) Germ cell tumors

B) Pilocytic astrocytomas
Explanation: Rosenthal fibers are a hallmark of pilocytic astrocytomas, indicating the presence of these specific structures within the tumor.

p.16
Astrocytomas and Their Subtypes

What is a characteristic macroscopic feature of pilocytic astrocytomas?
A) Solid and poorly circumscribed
B) Cystic with a mural nodule
C) Completely solid with no cystic component
D) Highly infiltrative and irregular
E) Small and non-palpable

B) Cystic with a mural nodule
Explanation: Pilocytic astrocytomas are typically cystic in nature, often featuring a mural nodule within the wall of the cyst, which is a key characteristic in their macroscopic appearance.

p.12
Astrocytomas and Their Subtypes

What is a key characteristic of anaplastic astrocytomas?
A) Low cellularity
B) Greater nuclear pleomorphism
C) Absence of mitotic figures
D) Presence of necrosis
E) Lack of vascular proliferation

B) Greater nuclear pleomorphism
Explanation: Anaplastic astrocytomas are characterized by regions that are more densely cellular and exhibit greater nuclear pleomorphism, indicating a higher degree of cellular abnormality compared to lower-grade tumors.

p.11
Astrocytomas and Their Subtypes

What is a characteristic feature of low-grade astrocytomas?
A) They are highly aggressive tumors
B) They have a slow growth rate
C) They are always located in the brainstem
D) They are exclusively found in children
E) They are associated with high levels of necrosis

B) They have a slow growth rate
Explanation: Low-grade astrocytomas are characterized by their slow growth rate, which distinguishes them from higher-grade tumors that tend to grow more aggressively.

p.60
Primary CNS Tumors

What is a typical symptom of brain metastasis?
A) Increased appetite
B) Severe headaches
C) Improved memory
D) Weight gain
E) Enhanced vision

B) Severe headaches
Explanation: Severe headaches are a common symptom of brain metastasis, often resulting from increased intracranial pressure or irritation of the brain tissue.

p.20
Oligodendrogliomas and Their Characteristics

Which of the following may be observed in oligodendrogliomas?
A) Only solid tumors
B) Cysts and focal hemorrhage
C) Purely calcified structures
D) No visible abnormalities
E) Only necrotic tissue

B) Cysts and focal hemorrhage
Explanation: Oligodendrogliomas may show the presence of cysts and focal hemorrhage, indicating their infiltrative nature and complexity in structure.

p.22
Oligodendrogliomas and Their Characteristics

What is a characteristic feature of oligodendroglioma tumor cells?
A) Elongated nuclei with no cytoplasmic halo
B) Round nuclei with a cytoplasmic halo
C) Irregular nuclei with a dense cytoplasm
D) Flat nuclei with a thick cytoplasmic border
E) Large nuclei with multiple nucleoli

B) Round nuclei with a cytoplasmic halo
Explanation: Oligodendroglioma tumor cells are characterized by having round nuclei surrounded by a distinct cytoplasmic halo, which is a key histological feature used for diagnosis.

p.22
Oligodendrogliomas and Their Characteristics

What type of blood vessels are typically found in the background of oligodendrogliomas?
A) Thick-walled arteries
B) Thin blood vessels
C) Large veins
D) Capillaries with irregular shapes
E) No blood vessels present

B) Thin blood vessels
Explanation: Oligodendrogliomas are noted for having thin blood vessels in the background, which form an interlacing pattern, contributing to the tumor's histological appearance.

p.23
Oligodendrogliomas and Their Characteristics

Which characteristic is associated with anaplastic oligodendroglioma?
A) Low cell density
B) Nuclear anaplasia
C) Absence of mitotic activity
D) High differentiation
E) Benign behavior

B) Nuclear anaplasia
Explanation: Anaplastic oligodendroglioma is characterized by nuclear anaplasia, which refers to the abnormal appearance of nuclei in tumor cells, indicating a higher grade and more aggressive behavior.

p.15
Astrocytomas and Their Subtypes

What type of tumors are pilocytic astrocytomas classified as?
A) Malignant tumors
B) Relatively benign tumors
C) Highly aggressive tumors
D) Metastatic tumors
E) Neuroblastomas

B) Relatively benign tumors
Explanation: Pilocytic astrocytomas are classified as relatively benign tumors, indicating that they generally have a better prognosis compared to malignant tumors.

p.26
Ependymomas and Their Locations

What type of background is typically seen in ependymomas?
A) Necrotic background
B) Fibrillary background
C) Mucinous background
D) Hemorrhagic background
E) Fibrotic background

B) Fibrillary background
Explanation: Ependymomas are noted for having a fibrillary background, which is a distinctive histological feature that aids in their diagnosis.

p.58
Primary CNS Tumors

Which of the following is NOT a common primary site for metastatic tumors?
A) Lung
B) Breast
C) Skin (melanoma)
D) Kidney
E) Pancreas

E) Pancreas
Explanation: The most common primary sites for metastatic tumors include the lung, breast, skin (melanoma), kidney, and gastrointestinal tract, with the pancreas not being listed among them.

p.60
Primary CNS Tumors

What is the primary treatment approach for brain metastasis?
A) Surgery only
B) Radiation therapy
C) Chemotherapy only
D) A combination of treatments
E) No treatment is necessary

D) A combination of treatments
Explanation: The treatment for brain metastasis often involves a combination of therapies, including surgery, radiation therapy, and chemotherapy, tailored to the individual patient's condition.

p.2
Primary CNS Tumors

What factor can influence the outcome of a nervous system tumor?
A) The patient's age
B) The anatomic site of the neoplasm
C) The histologic classification
D) The size of the tumor
E) The presence of symptoms

B) The anatomic site of the neoplasm
Explanation: The location of the neoplasm within the nervous system can significantly influence the outcome, as different sites may have varying impacts on function and treatment options.

p.56
Primary CNS Tumors

What is a common characteristic of the spread of metastatic/primary CNS lymphoma tumors?
A) They spread through the bloodstream
B) They show periventricular spread
C) They do not spread at all
D) They spread only to the spinal cord
E) They spread through the lymphatic system

B) They show periventricular spread
Explanation: Periventricular spread is a common characteristic of these tumors, indicating their tendency to infiltrate areas surrounding the ventricles of the brain.

p.8
Astrocytomas and Their Subtypes

What is a characteristic feature of a low-grade astrocytoma?
A) High-grade malignancy
B) Expanded white matter of the left cerebral hemisphere
C) Presence of necrosis
D) Rapid growth rate
E) Involvement of the spinal cord

B) Expanded white matter of the left cerebral hemisphere
Explanation: A low-grade astrocytoma is characterized by the expansion of white matter, particularly noted in the left cerebral hemisphere, indicating its location and the nature of the tumor.

p.14
Astrocytomas and Their Subtypes

Which of the following best describes the cellularity of glioblastoma?
A) Sparse and scattered
B) Moderately cellular
C) Densely cellular
D) Acellular
E) Low cellularity

C) Densely cellular
Explanation: Glioblastoma is described as a densely cellular tumor, which contributes to its aggressive behavior and poor prognosis.

p.26
Ependymomas and Their Locations

What is a key microscopic feature of ependymomas?
A) Irregular nuclei with sparse chromatin
B) Cells with regular, round to oval nuclei and abundant granular chromatin
C) Presence of necrotic tissue
D) Large multinucleated giant cells
E) High mitotic activity

B) Cells with regular, round to oval nuclei and abundant granular chromatin
Explanation: Ependymomas are characterized by cells that have regular, round to oval nuclei and abundant granular chromatin, which are important features for their identification under a microscope.

p.60
Primary CNS Tumors

How is brain metastasis typically diagnosed?
A) Blood tests
B) MRI or CT scans
C) X-rays
D) Ultrasound
E) Biopsy of the skin

B) MRI or CT scans
Explanation: Brain metastasis is usually diagnosed using imaging techniques such as MRI or CT scans, which can reveal the presence of tumors in the brain.

p.4
Astrocytomas and Their Subtypes

Which type of glioma is characterized by its resemblance to astrocytes?
A) Oligodendrogliomas
B) Ependymomas
C) Astrocytomas
D) Meningiomas
E) Germ cell tumors

C) Astrocytomas
Explanation: Astrocytomas are a type of glioma that resemble astrocytes, which are a specific type of glial cell in the central nervous system.

p.55
Primary CNS Tumors

What is a characteristic of metastatic/primary central nervous system lymphoma tumors?
A) They are benign tumors
B) They are aggressive with relatively poor response
C) They are always single tumors
D) They are primarily found in children
E) They have a high survival rate

B) They are aggressive with relatively poor response
Explanation: Metastatic/primary CNS lymphoma tumors are known for being aggressive and typically show a poor response to treatment, which is a significant characteristic of this disease.

p.58
Primary CNS Tumors

Where do metastatic tumors typically form in the brain?
A) In the brainstem
B) At the gray-white junction
C) In the cerebellum
D) In the ventricles
E) In the spinal cord

B) At the gray-white junction
Explanation: Metastatic tumors often form sharply demarcated masses at the gray-white junction of the brain, which is a characteristic location for these tumors.

p.40
Embryonal Neoplasms in Pediatric Patients

What type of nuclei are found in the anaplastic cells of medulloblastoma?
A) Hypochromatic nuclei
B) Normal nuclei
C) Hyperchromatic nuclei
D) Multinucleated cells
E) Pyknotic nuclei

C) Hyperchromatic nuclei
Explanation: The anaplastic cells in medulloblastoma exhibit hyperchromatic nuclei, which are a hallmark of malignancy and indicate increased DNA content.

p.47
Meningiomas and Their Histological Patterns

What are psammoma bodies associated with in meningiomas?
A) Syncytial pattern
B) Transitional pattern
C) Secretory pattern
D) Psammomatous pattern
E) Fibroblastic pattern

D) Psammomatous pattern
Explanation: The psammomatous pattern of meningiomas is specifically characterized by the presence of numerous psammoma bodies, which are calcified structures.

p.16
Astrocytomas and Their Subtypes

If a pilocytic astrocytoma is solid, how is it usually described?
A) Poorly circumscribed
B) Well circumscribed
C) Highly infiltrative
D) Irregular in shape
E) Diffuse and non-localized

B) Well circumscribed
Explanation: When pilocytic astrocytomas are solid, they are usually well circumscribed, indicating a clear boundary that distinguishes them from surrounding tissues.

p.1
Primary CNS Tumors

What percentage of all pediatric tumors are primary CNS tumors?
A) 5%
B) 10%
C) 20%
D) 30%
E) 50%

C) 20%
Explanation: Primary CNS tumors represent 20% of all pediatric tumors, highlighting their importance in childhood oncology.

p.17
Astrocytomas and Their Subtypes

What type of cells are primarily found in pilocytic astrocytomas?
A) Squamous cells
B) Bipolar cells
C) Cuboidal cells
D) Columnar cells
E) Transitional cells

B) Bipolar cells
Explanation: Pilocytic astrocytomas are characterized by the presence of bipolar cells, which have long, thin 'hairlike' processes, indicating their specific cellular structure.

p.23
Oligodendrogliomas and Their Characteristics

What does higher cell density in anaplastic oligodendroglioma indicate?
A) Lower aggressiveness
B) Increased malignancy potential
C) Benign nature
D) Lack of tumor growth
E) Normal cell function

B) Increased malignancy potential
Explanation: Higher cell density in anaplastic oligodendroglioma suggests a more aggressive tumor with increased malignancy potential, which is a key feature of this subtype.

p.43
Germ Cell Tumors in the CNS

What are germ cell tumors primarily derived from?
A) Epithelial cells
B) Mesenchymal cells
C) Germ cells
D) Neuronal cells
E) Endothelial cells

C) Germ cells
Explanation: Germ cell tumors originate from germ cells, which are the reproductive cells in the body, responsible for producing sperm and eggs.

p.47
Meningiomas and Their Histological Patterns

What is a defining feature of the transitional pattern in meningiomas?
A) Whorled clusters of cells
B) Numerous psammoma bodies
C) Elongated cells with collagen
D) Features of both syncytial and fibroblastic types
E) Gland-like PAS-positive eosinophilic secretions

D) Features of both syncytial and fibroblastic types
Explanation: The transitional pattern in meningiomas exhibits characteristics of both the syncytial and fibroblastic types, making it a hybrid pattern.

p.55
Primary CNS Tumors

In which population are CNS lymphoma tumors most commonly found?
A) Healthy individuals
B) Immunosuppressed persons
C) Pregnant women
D) Athletes
E) Children under 10

B) Immunosuppressed persons
Explanation: CNS lymphoma tumors are the most common neoplasm in immunosuppressed individuals, and they are nearly always positive for the oncogenic Epstein-Barr virus.

p.43
Germ Cell Tumors in the CNS

Where are germ cell tumors most commonly found in pediatric patients?
A) Brain
B) Lungs
C) Liver
D) Testes and ovaries
E) Skin

D) Testes and ovaries
Explanation: In pediatric patients, germ cell tumors are most commonly found in the testes in boys and the ovaries in girls, although they can also occur in other locations.

p.59
Primary CNS Tumors

What is a characteristic feature of metastatic melanoma?
A) Poorly defined margins
B) Multicentricity and well-demarcated margins
C) Uniform color
D) Absence of pigmentation
E) Rapid growth without spread

B) Multicentricity and well-demarcated margins
Explanation: Metastatic melanoma is characterized by multicentricity and well-demarcated margins, which helps in distinguishing it from other types of skin lesions.

p.1
Primary CNS Tumors

What percentage of all CNS tumors are primary tumors?
A) 10%
B) 25%
C) 50%
D) 50% to 75%
E) 90%

D) 50% to 75%
Explanation: Primary tumors account for half to three quarters of all CNS tumors, indicating their significant prevalence in the overall classification of CNS tumors.

p.60
Primary CNS Tumors

Which of the following is a common source of brain metastasis?
A) Skin cancer
B) Lung cancer
C) Breast cancer
D) All of the above
E) None of the above

D) All of the above
Explanation: Brain metastasis can arise from various types of cancer, including lung cancer, breast cancer, and skin cancer, making it a common complication in advanced stages of these diseases.

p.4
Histological Classification of CNS Tumors

Which of the following is NOT a type of glioma?
A) Astrocytomas
B) Oligodendrogliomas
C) Ependymomas
D) Neuronal tumors
E) All of the above are types of gliomas

D) Neuronal tumors
Explanation: Neuronal tumors are not classified as gliomas. The three types of gliomas mentioned are astrocytomas, oligodendrogliomas, and ependymomas, which are all derived from glial cells.

p.47
Meningiomas and Their Histological Patterns

Which pattern of meningiomas is characterized by elongated cells and abundant collagen deposition?
A) Syncytial pattern
B) Transitional pattern
C) Psammomatous pattern
D) Secretory pattern
E) Fibroblastic pattern

E) Fibroblastic pattern
Explanation: The fibroblastic pattern of meningiomas is characterized by elongated cells and significant collagen deposition, distinguishing it from other patterns.

p.20
Oligodendrogliomas and Their Characteristics

What type of calcification is associated with oligodendrogliomas?
A) No calcification
B) Diffuse calcification
C) Focal calcification
D) Complete calcification
E) Irregular calcification

C) Focal calcification
Explanation: Oligodendrogliomas may exhibit focal calcification, which is a notable feature that can be observed during imaging or pathological examination.

p.4
Oligodendrogliomas and Their Characteristics

What type of glioma resembles oligodendrocytes?
A) Ependymomas
B) Astrocytomas
C) Oligodendrogliomas
D) Medulloblastomas
E) Schwannomas

C) Oligodendrogliomas
Explanation: Oligodendrogliomas are gliomas that resemble oligodendrocytes, which are another type of glial cell responsible for myelination in the central nervous system.

p.52
Histological Classification of CNS Tumors

What is a common example of a secretory cell?
A) Neuron
B) Adipocyte
C) Goblet cell
D) Osteocyte
E) Myocyte

C) Goblet cell
Explanation: Goblet cells are a well-known example of secretory cells, as they produce and secrete mucus in various epithelial tissues, particularly in the respiratory and digestive tracts.

p.31
Neuronal Tumors and Their Types

Which age group is most commonly affected by central neurocytomas?
A) Infants
B) Young adults
C) Elderly individuals
D) Children
E) Middle-aged adults

B) Young adults
Explanation: Central neurocytomas most commonly affect young adults, typically in their 20s to 40s, making this demographic particularly relevant for diagnosis and treatment.

p.20
Oligodendrogliomas and Their Characteristics

What is a common appearance of oligodendrogliomas on imaging studies?
A) Solid white masses
B) Cystic lesions without enhancement
C) Gelatinous, gray masses with possible calcification
D) Hyperdense areas with no surrounding edema
E) Completely clear areas with no visible mass

C) Gelatinous, gray masses with possible calcification
Explanation: On imaging studies, oligodendrogliomas typically appear as gelatinous, gray masses that may also show calcification, which is a characteristic feature of these tumors.

p.52
Histological Classification of CNS Tumors

What triggers the secretion process in secretory cells?
A) Electrical impulses
B) Hormonal signals
C) Nutrient availability
D) Temperature changes
E) All of the above

E) All of the above
Explanation: The secretion process in secretory cells can be triggered by various factors, including electrical impulses, hormonal signals, nutrient availability, and temperature changes, reflecting the complexity of their regulation.

p.60
Primary CNS Tumors

What is brain metastasis?
A) A primary brain tumor
B) Cancer that originates in the brain
C) Cancer that spreads to the brain from another part of the body
D) A benign brain tumor
E) A type of stroke

C) Cancer that spreads to the brain from another part of the body
Explanation: Brain metastasis refers to cancer that has spread to the brain from a primary tumor located elsewhere in the body, making it a secondary brain tumor.

p.7
Astrocytomas and Their Subtypes

What texture can astrocytomas exhibit?
A) Only firm
B) Only soft
C) Firm or soft and gelatinous
D) Only hard
E) Only liquid

C) Firm or soft and gelatinous
Explanation: Astrocytomas can have a range of textures, being described as either firm or soft and gelatinous, which can vary based on the specific tumor characteristics.

p.52
Histological Classification of CNS Tumors

What is the primary function of secretory cells?
A) To store nutrients
B) To produce and release substances
C) To provide structural support
D) To transport oxygen
E) To protect against pathogens

B) To produce and release substances
Explanation: Secretory cells are specialized for the production and release of various substances, such as hormones, enzymes, and mucus, playing a crucial role in various physiological processes.

p.12
Astrocytomas and Their Subtypes

What histologic feature is commonly seen in glioblastoma?
A) Low cellularity
B) Absence of necrosis
C) Pseudopalisading nuclei
D) Uniform nuclear appearance
E) Lack of vascular proliferation

C) Pseudopalisading nuclei
Explanation: Glioblastoma often presents with necrosis that features pseudopalisading nuclei, which is a distinctive histological finding that helps differentiate it from other types of astrocytomas.

p.2
Primary CNS Tumors

How do low-grade lesions behave in the context of nervous system tumors?
A) They remain localized and do not infiltrate
B) They may infiltrate large regions of the brain
C) They are always benign
D) They are easily removable
E) They do not affect surrounding tissues

B) They may infiltrate large regions of the brain
Explanation: Even low-grade lesions in the nervous system can infiltrate extensive areas of the brain, which complicates treatment and prognosis.

p.17
Astrocytomas and Their Subtypes

Which of the following is true regarding necrosis in pilocytic astrocytomas?
A) Necrosis is common
B) Necrosis is rare
C) Necrosis is always present
D) Necrosis is moderate
E) Necrosis is extensive

B) Necrosis is rare
Explanation: In pilocytic astrocytomas, necrosis and mitoses are rare, which is an important characteristic that differentiates them from more aggressive tumors.

p.31
Neuronal Tumors and Their Types

What is a common characteristic of central neurocytomas?
A) They are highly aggressive
B) They are typically benign
C) They are always malignant
D) They originate from glial cells
E) They are associated with genetic mutations

B) They are typically benign
Explanation: Central neurocytomas are generally considered to be benign tumors, meaning they tend to grow slowly and have a better prognosis compared to malignant tumors.

p.17
Astrocytomas and Their Subtypes

What type of positivity do the cells in pilocytic astrocytomas exhibit?
A) CD20-positive
B) GFAP-positive
C) Ki-67-positive
D) S100-negative
E) EMA-positive

B) GFAP-positive
Explanation: The cells in pilocytic astrocytomas are GFAP-positive, indicating their astrocytic origin and helping in the diagnosis of this tumor type.

p.58
Histological Classification of CNS Tumors

What is a notable microscopic feature of the boundary between metastatic tumors and brain parenchyma?
A) Blurred boundary
B) Sharp boundary with reactive gliosis
C) No boundary
D) Thickened boundary
E) Infiltrative boundary

B) Sharp boundary with reactive gliosis
Explanation: The boundary between metastatic tumors and brain parenchyma is sharp at the microscopic level, often accompanied by surrounding reactive gliosis, indicating a clear distinction between the tumor and normal brain tissue.

p.41
Embryonal Neoplasms in Pediatric Patients

In which part of the brain does medulloblastoma typically originate?
A) Cerebrum
B) Brainstem
C) Cerebellum
D) Thalamus
E) Hippocampus

C) Cerebellum
Explanation: Medulloblastoma typically originates in the cerebellum, which is the part of the brain responsible for coordination and balance, making it particularly impactful on motor functions.

p.46
Genetic Mutations in CNS Tumors

What genetic mutation is commonly found in meningiomas not associated with NF2?
A) TP53 mutation
B) NF2 tumor suppressor gene mutation
C) EGFR mutation
D) KRAS mutation
E) BRCA1 mutation

B) NF2 tumor suppressor gene mutation
Explanation: About half of meningiomas that are not associated with NF2 exhibit acquired loss-of-function mutations in the NF2 tumor suppressor gene located on chromosome 22, highlighting its role in meningioma development.

p.4
Histological Classification of CNS Tumors

What are gliomas classified based on?
A) Their location in the brain
B) Their resemblance to different types of glial cells
C) Their size and shape
D) Their age of onset
E) Their response to treatment

B) Their resemblance to different types of glial cells
Explanation: Gliomas are classified histologically based on their resemblance to different types of glial cells, which include astrocytes, oligodendrocytes, and ependymal cells.

p.48
Histological Classification of CNS Tumors

In which type of tissue is a syncytial pattern most commonly observed?
A) Epithelial tissue
B) Muscle tissue
C) Nervous tissue
D) Connective tissue
E) Adipose tissue

B) Muscle tissue
Explanation: A syncytial pattern is most commonly observed in muscle tissue, particularly in skeletal muscle, where muscle fibers are formed by the fusion of myoblasts, resulting in multinucleated cells.

p.17
Histological Classification of CNS Tumors

What is a key histological feature of pilocytic astrocytomas?
A) Presence of necrosis
B) Presence of mitoses
C) Rosenthal fibers
D) High cellularity
E) Calcifications

C) Rosenthal fibers
Explanation: Rosenthal fibers are a distinctive histological feature of pilocytic astrocytomas, along with eosinophilic granular bodies and microcysts, which help in their identification under microscopy.

p.31
Neuronal Tumors and Their Types

Where are central neurocytomas most commonly located?
A) In the spinal cord
B) In the cerebellum
C) In the lateral ventricles
D) In the brainstem
E) In the meninges

C) In the lateral ventricles
Explanation: Central neurocytomas are most commonly found in the lateral ventricles of the brain, which is a characteristic location for this type of tumor.

p.43
Germ Cell Tumors in the CNS

Which of the following is a common type of germ cell tumor?
A) Glioblastoma
B) Teratoma
C) Meningioma
D) Astrocytoma
E) Oligodendroglioma

B) Teratoma
Explanation: Teratomas are a common type of germ cell tumor that can contain various types of tissues, such as hair, muscle, and bone, and are often found in the gonads or midline structures.

p.12
Astrocytomas and Their Subtypes

What is a common histological feature of both anaplastic astrocytomas and glioblastomas?
A) Low mitotic figures
B) High cellularity
C) Absence of pleomorphism
D) Lack of necrosis
E) Uniform nuclear structure

B) High cellularity
Explanation: Both anaplastic astrocytomas and glioblastomas exhibit high cellularity, which is indicative of their aggressive nature and reflects the increased number of abnormal cells present in these tumors.

p.5
Astrocytomas and Their Subtypes

In which age group are diffuse astrocytomas most commonly diagnosed?
A) Infants
B) Adolescents
C) Young adults
D) Fourth through sixth decades of life
E) Elderly over 80 years

D) Fourth through sixth decades of life
Explanation: Diffuse astrocytomas are most commonly diagnosed in individuals during their fourth through sixth decades of life, highlighting the age-related incidence of this tumor type.

p.43
Germ Cell Tumors in the CNS

What is a characteristic feature of germ cell tumors?
A) They are always benign
B) They can produce hormones
C) They are exclusively found in adults
D) They do not metastasize
E) They are derived from glial cells

B) They can produce hormones
Explanation: Some germ cell tumors can produce hormones, such as alpha-fetoprotein (AFP) and human chorionic gonadotropin (hCG), which can be used as tumor markers in diagnosis.

p.10
Astrocytomas and Their Subtypes

What is the appearance of the background in astrocytomas?
A) Smooth and homogeneous
B) Fibrillary appearance
C) Granular texture
D) Solid and opaque
E) Transparent and clear

B) Fibrillary appearance
Explanation: The background of astrocytomas exhibits a fibrillary appearance, which is a distinctive histological feature that helps in identifying this type of tumor.

p.50
Histological Classification of CNS Tumors

What does the term 'psammomatous' refer to in a medical context?
A) A type of benign tumor
B) A characteristic of certain tumors with calcified structures
C) A type of viral infection
D) A method of imaging
E) A form of inflammation

B) A characteristic of certain tumors with calcified structures
Explanation: 'Psammomatous' refers to a specific histological feature seen in certain tumors, characterized by the presence of psammoma bodies, which are calcified structures often found in various types of neoplasms.

p.14
Astrocytomas and Their Subtypes

What does the term 'pseudopalisading' refer to in glioblastoma?
A) A type of necrosis
B) Arrangement of tumor cell nuclei around necrotic areas
C) A form of cell division
D) A type of blood vessel formation
E) Presence of inflammatory cells

B) Arrangement of tumor cell nuclei around necrotic areas
Explanation: Pseudopalisading refers to the arrangement of tumor cell nuclei that align around areas of necrosis, which is a hallmark feature of glioblastoma, indicating the aggressive nature of the tumor.

p.12
Astrocytomas and Their Subtypes

Which feature is NOT typically associated with glioblastoma?
A) Necrosis
B) Pseudopalisading nuclei
C) Vascular proliferation
D) Low mitotic activity
E) Histologic similarity to anaplastic astrocytoma

D) Low mitotic activity
Explanation: Glioblastoma is characterized by high mitotic activity, along with features such as necrosis and vascular proliferation, making it one of the most aggressive forms of astrocytoma.

p.47
Meningiomas and Their Histological Patterns

What characterizes the syncytial pattern of meningiomas?
A) Elongated cells with abundant collagen
B) Whorled clusters of cells without visible cell membranes
C) Numerous psammoma bodies
D) Gland-like PAS-positive eosinophilic secretions
E) Features of both syncytial and fibroblastic types

B) Whorled clusters of cells without visible cell membranes
Explanation: The syncytial pattern in meningiomas is defined by whorled clusters of cells that lack visible cell membranes, indicating a specific cellular arrangement.

p.48
Histological Classification of CNS Tumors

Which of the following is NOT a characteristic of syncytial patterns?
A) Presence of multiple nuclei
B) Fusion of cells
C) Homogeneous cytoplasm
D) Individual cell membranes
E) Multinucleated structure

D) Individual cell membranes
Explanation: Syncytial patterns do not have individual cell membranes due to the fusion of cells, which leads to a multinucleated structure with a shared cytoplasm.

p.26
Ependymomas and Their Locations

What structure do ependymomas resemble in their rosettes?
A) Blood vessels
B) Embryologic ependymal canal
C) Neuronal synapses
D) Meningeal layers
E) Cerebral cortex

B) Embryologic ependymal canal
Explanation: The rosettes and canals in ependymomas resemble the embryologic ependymal canal, indicating their origin and developmental characteristics.

p.5
Astrocytomas and Their Subtypes

What percentage of adult gliomas are diffuse astrocytomas?
A) 50%
B) 60%
C) 70%
D) 80%
E) 90%

D) 80%
Explanation: Diffuse astrocytomas account for 80% of adult gliomas, indicating their prevalence among glioma types in adults.

p.4
Ependymomas and Their Locations

Which glioma type is associated with ependymal cells?
A) Astrocytomas
B) Oligodendrogliomas
C) Ependymomas
D) Glioblastomas
E) Neurocytomas

C) Ependymomas
Explanation: Ependymomas are gliomas that are characterized by their resemblance to ependymal cells, which line the ventricles of the brain and the central canal of the spinal cord.

p.40
Embryonal Neoplasms in Pediatric Patients

What is often observed in medulloblastoma regarding neuronal differentiation?
A) Complete absence of differentiation
B) Focal neuronal differentiation
C) Extensive differentiation into mature neurons
D) Differentiation into glial cells
E) Differentiation into epithelial cells

B) Focal neuronal differentiation
Explanation: Medulloblastoma often shows focal neuronal differentiation, which can manifest as Homer Wright or neuroblastic rosettes, indicating some degree of neuronal maturation.

p.5
Astrocytomas and Their Subtypes

Where are diffuse astrocytomas typically located?
A) Brainstem
B) Cerebellum
C) Cerebral hemispheres
D) Spinal cord
E) Ventricles

C) Cerebral hemispheres
Explanation: Diffuse astrocytomas are typically located in the cerebral hemispheres, which is a common site for these tumors.

p.40
Embryonal Neoplasms in Pediatric Patients

What is a common feature of mitotic activity in medulloblastoma?
A) Rare mitoses
B) Abundant mitoses
C) No mitotic figures
D) Only apoptotic cells
E) Mitotic figures only in mature neurons

B) Abundant mitoses
Explanation: Medulloblastoma is characterized by abundant mitoses, reflecting its aggressive nature and high proliferation rate of the tumor cells.

p.43
Germ Cell Tumors in the CNS

Which imaging technique is commonly used to diagnose germ cell tumors?
A) X-ray
B) Ultrasound
C) MRI
D) CT scan
E) PET scan

C) MRI
Explanation: MRI is commonly used to diagnose germ cell tumors, particularly in the brain and spinal cord, due to its ability to provide detailed images of soft tissues.

p.46
Histological Classification of CNS Tumors

In which growth patterns are mutations in the NF2 gene more commonly found?
A) Papillary and anaplastic
B) Fibroblastic, transitional, and psammomatous
C) Medullary and squamous
D) Adenomatous and cystic
E) Neuroendocrine and small cell

B) Fibroblastic, transitional, and psammomatous
Explanation: Mutations in the NF2 gene are more frequently observed in meningiomas exhibiting specific growth patterns, particularly fibroblastic, transitional, and psammomatous types, indicating a correlation between growth pattern and genetic mutation.

p.22
Oligodendrogliomas and Their Characteristics

What pattern do the blood vessels form in oligodendrogliomas?
A) A radial pattern
B) A linear pattern
C) An interlacing pattern
D) A spiral pattern
E) A clustered pattern

C) An interlacing pattern
Explanation: The thin blood vessels in oligodendrogliomas form an interlacing pattern, which is a distinctive histological feature that helps in identifying this type of tumor.

p.58
Primary CNS Tumors

What type of tumors are mostly found in metastatic cases?
A) Sarcomas
B) Lymphomas
C) Carcinomas
D) Neuronal tumors
E) Germ cell tumors

C) Carcinomas
Explanation: Metastatic tumors are mostly carcinomas, accounting for one fourth to one half of intracranial tumors, indicating their prevalence in metastatic cases.

p.11
Astrocytomas and Their Subtypes

Which age group is most commonly affected by low-grade astrocytomas?
A) Infants
B) Young adults
C) Middle-aged adults
D) Elderly individuals
E) They affect all age groups equally

B) Young adults
Explanation: Low-grade astrocytomas are most commonly diagnosed in young adults, although they can occur in individuals of various ages.

p.52
Histological Classification of CNS Tumors

Which of the following substances can secretory cells produce?
A) Only hormones
B) Only enzymes
C) Hormones, enzymes, and mucus
D) Only neurotransmitters
E) Only antibodies

C) Hormones, enzymes, and mucus
Explanation: Secretory cells can produce a variety of substances, including hormones, enzymes, and mucus, which are essential for various bodily functions.

p.1
Primary CNS Tumors

In adults, where do most CNS tumors arise?
A) In the spinal cord
B) In the posterior fossa
C) In the supratentorial region
D) In the brainstem
E) In the cerebellum

C) In the supratentorial region
Explanation: In adults, CNS tumors predominantly arise in the supratentorial region, contrasting with the posterior fossa location typical of childhood CNS tumors.

p.23
Oligodendrogliomas and Their Characteristics

What is a notable feature of mitotic activity in anaplastic oligodendroglioma?
A) It is absent
B) It is low
C) It is high
D) It is normal
E) It is irregular

C) It is high
Explanation: Anaplastic oligodendroglioma exhibits high mitotic activity, which is indicative of rapid cell division and tumor growth, further emphasizing its aggressive nature.

p.11
Astrocytomas and Their Subtypes

What is the typical treatment approach for low-grade astrocytomas?
A) Chemotherapy only
B) Radiation therapy only
C) Surgical resection
D) No treatment is necessary
E) Immediate palliative care

C) Surgical resection
Explanation: The typical treatment for low-grade astrocytomas often involves surgical resection to remove as much of the tumor as possible, which can help alleviate symptoms and improve outcomes.

p.7
Astrocytomas and Their Subtypes

What type of degeneration is commonly observed in astrocytomas?
A) Cystic degeneration
B) Fibrous degeneration
C) Calcific degeneration
D) Lipid degeneration
E) Hemorrhagic degeneration

A) Cystic degeneration
Explanation: Astrocytomas can exhibit cystic degeneration, which is a common feature that can affect the tumor's overall structure and appearance.

p.15
Astrocytomas and Their Subtypes

Where are pilocytic astrocytomas commonly located?
A) Only in the brainstem
B) Cerebellum, third ventricle, optic pathways, spinal cord, and occasionally cerebral hemispheres
C) Exclusively in the cerebral hemispheres
D) Only in the spinal cord
E) In the peripheral nervous system

B) Cerebellum, third ventricle, optic pathways, spinal cord, and occasionally cerebral hemispheres
Explanation: Pilocytic astrocytomas can be found in various locations including the cerebellum, third ventricle, optic pathways, spinal cord, and occasionally in the cerebral hemispheres.

p.20
Oligodendrogliomas and Their Characteristics

How would you describe the growth pattern of oligodendrogliomas?
A) Rapidly growing and non-invasive
B) Infiltrative and diffuse
C) Well-circumscribed and encapsulated
D) Completely benign and non-invasive
E) Only occurring in children

B) Infiltrative and diffuse
Explanation: Oligodendrogliomas are known for their infiltrative growth pattern, which allows them to spread into surrounding brain tissue, making them challenging to treat.

p.48
Histological Classification of CNS Tumors

Which of the following processes can lead to the formation of a syncytial pattern?
A) Apoptosis
B) Cell division
C) Cell fusion
D) Cell differentiation
E) Cell migration

C) Cell fusion
Explanation: The formation of a syncytial pattern occurs through the process of cell fusion, where individual cells merge to form a larger cell with multiple nuclei.

p.1
Primary CNS Tumors

How do childhood CNS tumors differ from adult CNS tumors?
A) They are always benign
B) They arise in the posterior fossa
C) They are more common in females
D) They are larger in size
E) They are always malignant

B) They arise in the posterior fossa
Explanation: Childhood CNS tumors typically arise in the posterior fossa, whereas in adults, they are mostly found in the supratentorial region, indicating a significant difference in location between the two age groups.

p.2
Histological Classification of CNS Tumors

What is a unique characteristic of nervous system tumors regarding premalignant stages?
A) They have well-defined premalignant stages
B) They do not have detectable premalignant or in situ stages
C) They always present as in situ lesions
D) They can be easily diagnosed in early stages
E) They have multiple premalignant stages

B) They do not have detectable premalignant or in situ stages
Explanation: Nervous system tumors are characterized by the absence of detectable premalignant or in situ stages, making their early detection challenging.

p.15
Astrocytomas and Their Subtypes

In which age group are pilocytic astrocytomas most commonly found?
A) Infants
B) Middle-aged adults
C) Elderly individuals
D) Children and young adults
E) Newborns

D) Children and young adults
Explanation: Pilocytic astrocytomas are more prevalent in children and young adults, making age a significant factor in their occurrence.

p.49
Histological Classification of CNS Tumors

What is a fibroblastic pattern commonly associated with?
A) Muscle tissue
B) Nervous tissue
C) Connective tissue
D) Epithelial tissue
E) Adipose tissue

C) Connective tissue
Explanation: The fibroblastic pattern is primarily associated with connective tissue, where fibroblasts play a crucial role in the formation and maintenance of the extracellular matrix.

p.56
Primary CNS Tumors

Where are metastatic/primary central nervous system lymphoma tumors often located?
A) In the brainstem
B) In the cerebellum
C) In deep gray structures, white matter, and the cortex
D) In the spinal cord
E) In the peripheral nervous system

C) In deep gray structures, white matter, and the cortex
Explanation: These tumors are commonly found in deep gray structures, white matter, and the cortex of the brain, indicating their typical locations within the central nervous system.

p.33
Neuronal Tumors and Their Types

What type of tumor is a ganglioglioma?
A) A type of astrocytoma
B) A neuronal-glial tumor
C) A type of meningioma
D) A type of ependymoma
E) A germ cell tumor

B) A neuronal-glial tumor
Explanation: Gangliogliomas are classified as neuronal-glial tumors, which means they contain both neuronal and glial components, distinguishing them from other tumor types.

p.11
Astrocytomas and Their Subtypes

What is the typical prognosis for patients with low-grade astrocytomas?
A) Poor prognosis with a short survival time
B) Excellent prognosis with long-term survival
C) Variable prognosis depending on tumor location
D) Prognosis is always fatal
E) Prognosis is the same as high-grade tumors

C) Variable prognosis depending on tumor location
Explanation: The prognosis for patients with low-grade astrocytomas can vary significantly depending on factors such as the tumor's location, size, and the extent of surgical resection.

p.49
Histological Classification of CNS Tumors

What role do fibroblasts play in tissue repair?
A) They transmit signals between cells.
B) They produce enzymes for digestion.
C) They synthesize extracellular matrix components.
D) They facilitate muscle contraction.
E) They form protective barriers.

C) They synthesize extracellular matrix components.
Explanation: Fibroblasts are crucial in tissue repair as they synthesize extracellular matrix components, which help in healing and restoring tissue integrity.

p.5
Astrocytomas and Their Subtypes

Which of the following symptoms is NOT commonly associated with diffuse astrocytomas?
A) Seizures
B) Headaches
C) Focal neurologic deficits
D) Nausea
E) Cognitive changes

D) Nausea
Explanation: While seizures, headaches, and focal neurologic deficits are common presentations of diffuse astrocytomas, nausea is not typically associated with these tumors.

p.21
Oligodendrogliomas and Their Characteristics

What surrounds the nuclei in oligodendrogliomas?
A) Dense connective tissue
B) A clear halo of cytoplasm
C) A thick layer of myelin
D) A network of neurons
E) A layer of inflammatory cells

B) A clear halo of cytoplasm
Explanation: In oligodendrogliomas, the spherical nuclei are surrounded by a clear halo of cytoplasm, which is a distinctive feature observed under microscopy.

p.32
Astrocytomas and Their Subtypes

What is a common symptom of gangliogliomas?
A) Headaches
B) Seizures
C) Nausea
D) Vision problems
E) Memory loss

B) Seizures
Explanation: Gangliogliomas commonly manifest with seizures, making this symptom a key characteristic of the tumor.

p.30
Neuronal Tumors and Their Types

What type of tumor is a central neurocytoma?
A) High-grade neoplasm
B) Low-grade neoplasm
C) Malignant tumor
D) Benign tumor
E) Metastatic tumor

B) Low-grade neoplasm
Explanation: Central neurocytoma is classified as a low-grade neoplasm, indicating that it typically has a better prognosis and slower growth compared to high-grade tumors.

p.56
Primary CNS Tumors

How do metastatic/primary CNS lymphoma tumors compare to glial neoplasms?
A) They are less aggressive
B) They are more discrete than metastases
C) They are relatively well defined compared to glial neoplasms
D) They are indistinguishable from glial neoplasms
E) They are always benign

C) They are relatively well defined compared to glial neoplasms
Explanation: These tumors are noted to be relatively well defined when compared to glial neoplasms, although they are not as discrete as metastases.

p.30
Neuronal Tumors and Their Types

Where is central neurocytoma typically located?
A) In the spinal cord
B) Within and adjacent to the ventricular system
C) In the cerebellum
D) In the brainstem
E) In the peripheral nervous system

B) Within and adjacent to the ventricular system
Explanation: Central neurocytoma is primarily found within and adjacent to the ventricular system, particularly in the lateral or third ventricles, which is crucial for its identification.

p.37
Embryonal Neoplasms in Pediatric Patients

In which age group is medulloblastoma predominantly found?
A) Infants
B) Adults
C) Elderly
D) Children
E) Teenagers

D) Children
Explanation: Medulloblastoma is predominantly found in children, making it a significant concern in pediatric oncology.

p.37
Embryonal Neoplasms in Pediatric Patients

Where in the body does medulloblastoma exclusively occur?
A) Cerebrum
B) Brainstem
C) Cerebellum
D) Spinal cord
E) Peripheral nervous system

C) Cerebellum
Explanation: Medulloblastoma is exclusively located in the cerebellum, which is a critical area of the brain responsible for coordination and balance.

p.56
Primary CNS Tumors

Microscopically, where do malignant cells accumulate in CNS lymphoma tumors?
A) In the cerebrospinal fluid
B) Around blood vessels
C) In the ventricles
D) In the peripheral nerves
E) In the skull

B) Around blood vessels
Explanation: Microscopically, malignant cells in CNS lymphoma tumors accumulate around blood vessels and infiltrate the surrounding brain parenchyma, which is a key feature of their pathology.

p.6
Genetic Mutations in CNS Tumors

Which tumor suppressor pathway is affected by mutations in glioblastoma?
A) PI3K pathway
B) Rb pathway
C) p53 pathway
D) IDH pathway
E) APC pathway

C) p53 pathway
Explanation: Glioblastoma is associated with loss-of-function mutations in the p53 tumor suppressor pathway, which is crucial for maintaining genomic stability and regulating the cell cycle.

p.11
Astrocytomas and Their Subtypes

Which of the following is a common symptom of low-grade astrocytomas?
A) Severe headaches
B) Sudden vision loss
C) Seizures
D) Rapid weight loss
E) High fever

C) Seizures
Explanation: Seizures are a common symptom associated with low-grade astrocytomas due to their location in the brain and the effect they have on surrounding neural tissue.

p.10
Astrocytomas and Their Subtypes

What is a key microscopic feature of astrocytomas?
A) Decreased number of glial cell nuclei
B) Mild to moderate increase in the number of glial cell nuclei
C) Uniform nuclear appearance
D) Clear transition between neoplastic and normal tissue
E) Absence of glial cells

B) Mild to moderate increase in the number of glial cell nuclei
Explanation: Astrocytomas are characterized by a mild to moderate increase in the number of glial cell nuclei, which is a significant feature observed under microscopy.

p.49
Histological Classification of CNS Tumors

In which type of tissue would you most likely find a fibroblastic pattern?
A) Nervous tissue
B) Epithelial tissue
C) Muscle tissue
D) Connective tissue
E) Lymphatic tissue

D) Connective tissue
Explanation: A fibroblastic pattern is typically found in connective tissue, where fibroblasts are abundant and contribute to the structural framework of the tissue.

p.33
Neuronal Tumors and Their Types

Where are gangliogliomas most commonly found?
A) In the spinal cord
B) In the cerebellum
C) In the cerebral hemispheres
D) In the brainstem
E) In the pituitary gland

C) In the cerebral hemispheres
Explanation: Gangliogliomas are most commonly found in the cerebral hemispheres, particularly in the temporal lobe, which is significant for their clinical presentation and management.

p.2
Primary CNS Tumors

What is a common characteristic of the spread of nervous system tumors?
A) They frequently metastasize to other organs
B) They rarely spread outside of the CNS
C) They always spread to the lymphatic system
D) They spread through the bloodstream
E) They can easily invade surrounding tissues

B) They rarely spread outside of the CNS
Explanation: Nervous system tumors typically remain confined to the central nervous system and rarely metastasize outside of this area, which is a distinctive feature of these tumors.

p.56
Primary CNS Tumors

What is a common feature of EBV-associated tumors in the context of CNS lymphoma?
A) They are always benign
B) They show extensive areas of necrosis
C) They are small cell lymphomas
D) They do not infiltrate surrounding tissue
E) They are easily removable by surgery

B) They show extensive areas of necrosis
Explanation: EBV-associated tumors often exhibit extensive areas of necrosis, which is a significant pathological feature of these aggressive lymphomas.

p.6
Genetic Mutations in CNS Tumors

What type of mutation is commonly associated with glioblastoma?
A) Gain-of-function mutations in the Rb pathway
B) Loss-of-function mutations in the p53 pathway
C) Mutations in the BRCA1 gene
D) Gain-of-function mutations in the p53 pathway
E) Loss-of-function mutations in the PI3K pathway

B) Loss-of-function mutations in the p53 pathway
Explanation: Glioblastoma is characterized by loss-of-function mutations in the p53 tumor suppressor pathway, which plays a critical role in regulating the cell cycle and preventing tumor formation.

p.27
Ependymomas and Their Locations

Where do ependymomas typically arise in the body?
A) In the lungs
B) In the liver
C) In the spinal cord and brain
D) In the skin
E) In the stomach

C) In the spinal cord and brain
Explanation: Ependymomas commonly arise in the spinal cord and brain, particularly in areas surrounding the ventricles of the brain and the central canal of the spinal cord.

p.21
Oligodendrogliomas and Their Characteristics

What is a common finding in 90% of oligodendrogliomas?
A) Necrosis
B) Hemorrhage
C) Calcification
D) Cyst formation
E) Inflammation

C) Calcification
Explanation: Calcification is found in 90% of oligodendrogliomas, making it a significant characteristic of these tumors.

p.32
Histological Classification of CNS Tumors

What is the primary histological feature of gangliogliomas?
A) Only glial cells
B) Mixture of glial elements and mature neurons
C) Only mature neurons
D) High-grade glioma cells
E) Necrotic tissue

B) Mixture of glial elements and mature neurons
Explanation: Gangliogliomas are characterized by a mixture of glial elements, typically a low-grade astrocytoma, and mature appearing neurons, which is crucial for their identification under microscopy.

p.34
Neuronal Tumors and Their Types

What type of tumor is a dysembryoplastic neuroepithelial tumor?
A) High-grade adult tumor
B) Low-grade childhood tumor
C) Benign skin tumor
D) Malignant brain tumor
E) Neuroendocrine tumor

B) Low-grade childhood tumor
Explanation: The dysembryoplastic neuroepithelial tumor is characterized as a low-grade tumor that primarily affects children, indicating a generally favorable prognosis after surgical resection.

p.49
Histological Classification of CNS Tumors

Which of the following best describes fibroblasts?
A) They are responsible for transmitting nerve impulses.
B) They produce collagen and other fibers.
C) They are involved in the absorption of nutrients.
D) They are the primary cells in muscle contraction.
E) They form the outer layer of skin.

B) They produce collagen and other fibers.
Explanation: Fibroblasts are specialized cells that produce collagen and other fibers, which are essential components of the extracellular matrix in connective tissue.

p.41
Embryonal Neoplasms in Pediatric Patients

What type of tumor is medulloblastoma?
A) A type of skin cancer
B) A type of brain tumor
C) A type of lung cancer
D) A type of liver tumor
E) A type of bone cancer

B) A type of brain tumor
Explanation: Medulloblastoma is classified as a type of brain tumor, specifically a malignant neoplasm that primarily affects children and arises in the cerebellum.

p.17
Histological Classification of CNS Tumors

What is a common feature found in the microscopy of pilocytic astrocytomas?
A) High mitotic activity
B) Microcysts
C) Extensive necrosis
D) Abundant calcifications
E) Large necrotic areas

B) Microcysts
Explanation: The presence of microcysts is a common feature in the microscopy of pilocytic astrocytomas, along with other features like Rosenthal fibers and eosinophilic granular bodies.

p.47
Meningiomas and Their Histological Patterns

What type of secretion is associated with the secretory pattern of meningiomas?
A) Whorled clusters of cells
B) Numerous psammoma bodies
C) Gland-like PAS-positive eosinophilic secretions
D) Elongated cells with collagen
E) Features of both syncytial and fibroblastic types

C) Gland-like PAS-positive eosinophilic secretions
Explanation: The secretory pattern of meningiomas is characterized by gland-like PAS-positive eosinophilic secretions, which may resemble pseudopsammoma bodies.

p.29
Neuronal Tumors and Their Types

What is a dysembryoplastic neuroepithelial tumor?
A) A type of astrocytoma
B) A benign tumor associated with epilepsy
C) A malignant tumor of the meninges
D) A type of ependymoma
E) A rare form of glioblastoma

B) A benign tumor associated with epilepsy
Explanation: Dysembryoplastic neuroepithelial tumors are typically benign and are often associated with epilepsy, making them significant in the context of neurological disorders.

p.33
Neuronal Tumors and Their Types

What is the typical treatment approach for gangliogliomas?
A) Chemotherapy only
B) Radiation therapy only
C) Surgical resection
D) Observation only
E) Immunotherapy

C) Surgical resection
Explanation: The typical treatment approach for gangliogliomas is surgical resection, as this is often the most effective way to remove the tumor and alleviate symptoms.

p.54
Meningiomas and Their Histological Patterns

What distinguishes atypical meningiomas (WHO grade II) from grade I meningiomas?
A) They are well-defined
B) They have a lower mitotic rate
C) They exhibit brain invasion
D) They do not have prominent nucleoli
E) They are less cellular

C) They exhibit brain invasion
Explanation: Atypical meningiomas (WHO grade II) are characterized by features such as brain invasion, increased cellularity, and prominent nucleoli, distinguishing them from grade I meningiomas.

p.26
Ependymomas and Their Locations

What is a perivascular pseudorosette in ependymomas?
A) Tumor cells arranged randomly
B) Tumor cells arranged around vessels with thin ependymal processes in between
C) A type of necrotic tissue
D) A structure found only in high-grade tumors
E) A feature of meningiomas

B) Tumor cells arranged around vessels with thin ependymal processes in between
Explanation: A perivascular pseudorosette is characterized by tumor cells arranged around blood vessels, with an intervening zone containing thin ependymal processes, which is a typical feature of ependymomas.

p.15
Genetic Mutations in CNS Tumors

What genetic mutation is commonly associated with pilocytic astrocytomas?
A) TP53 mutation
B) Activating mutations in the serine-threonine kinase BRAF
C) EGFR amplification
D) NF1 mutation
E) CDKN2A deletion

B) Activating mutations in the serine-threonine kinase BRAF
Explanation: Pilocytic astrocytomas are associated with activating mutations in the BRAF gene, which plays a role in cell signaling and growth.

p.31
Neuronal Tumors and Their Types

What is the typical treatment approach for central neurocytomas?
A) Chemotherapy
B) Radiation therapy
C) Surgical resection
D) Immunotherapy
E) Observation only

C) Surgical resection
Explanation: The typical treatment for central neurocytomas involves surgical resection, as this approach aims to remove the tumor and alleviate symptoms, given their generally benign nature.

p.21
Oligodendrogliomas and Their Characteristics

What is a key microscopic feature of oligodendrogliomas?
A) Sheets of irregular cells with large nuclei
B) Sheets of regular cells with spherical nuclei
C) Clusters of small, round cells
D) Single-layered flat cells
E) Dense fibrous tissue

B) Sheets of regular cells with spherical nuclei
Explanation: Oligodendrogliomas are characterized by sheets of regular cells that have spherical nuclei containing finely granular chromatin, which is similar to that found in normal oligodendrocytes.

p.33
Neuronal Tumors and Their Types

Which of the following symptoms is commonly associated with gangliogliomas?
A) Severe headaches
B) Visual disturbances
C) Seizures
D) Memory loss
E) Nausea

C) Seizures
Explanation: Seizures are a common symptom associated with gangliogliomas due to their location in the brain and the irritation they cause to surrounding neural tissue.

p.10
Astrocytomas and Their Subtypes

How is the transition between neoplastic and normal tissue described in astrocytomas?
A) Distinct and clear
B) Indistinct
C) Abrupt
D) Gradual and smooth
E) Non-existent

B) Indistinct
Explanation: In astrocytomas, the transition between neoplastic (tumor) and normal tissue is described as indistinct, making it challenging to delineate the boundaries of the tumor.

p.25
Ependymomas and Their Locations

What is a characteristic feature of ependymomas?
A) They are always cystic
B) They form in the brainstem
C) They present as solid or papillary masses
D) They are exclusively found in adults
E) They originate from neurons

C) They present as solid or papillary masses
Explanation: Ependymomas are characterized by their appearance as solid or papillary masses, particularly in the fourth ventricle, which is a key aspect of their macroscopic presentation.

p.27
Ependymomas and Their Locations

Which age group is most commonly affected by ependymomas?
A) Infants and young children
B) Adolescents
C) Adults aged 30-50
D) Elderly individuals
E) All age groups equally

A) Infants and young children
Explanation: Ependymomas are most commonly diagnosed in infants and young children, making them a significant concern in pediatric neuro-oncology.

p.21
Oligodendrogliomas and Their Characteristics

How is mitotic activity typically observed in oligodendrogliomas?
A) High mitotic activity
B) Moderate mitotic activity
C) Mitotic activity usually is difficult to detect
D) Frequent mitotic figures
E) Absent mitotic activity

C) Mitotic activity usually is difficult to detect
Explanation: In oligodendrogliomas, mitotic activity is typically difficult to detect, which is an important aspect of their histological evaluation.

p.55
Primary CNS Tumors

What is the typical age range for nonimmunosuppressed individuals diagnosed with CNS lymphoma?
A) Primarily under 20
B) Primarily between 20 and 40
C) More after 60
D) Primarily between 40 and 60
E) All ages equally

C) More after 60
Explanation: In nonimmunosuppressed individuals, the age spectrum for CNS lymphoma is relatively wide, but it is more commonly diagnosed in individuals over the age of 60.

p.10
Astrocytomas and Their Subtypes

What does variable nuclear pleomorphism indicate in astrocytomas?
A) Consistent nuclear size
B) Variation in nuclear size and shape
C) Complete absence of nuclei
D) Only one type of nuclear morphology
E) Increased apoptosis

B) Variation in nuclear size and shape
Explanation: Variable nuclear pleomorphism in astrocytomas indicates that there is a variation in the size and shape of the nuclei, which is a common feature in neoplastic tissues.

p.55
Primary CNS Tumors

What percentage of extranodal lymphomas do CNS lymphoma tumors represent?
A) 10%
B) 5%
C) 2%
D) 1%
E) 15%

C) 2%
Explanation: CNS lymphoma tumors account for 2% of extranodal lymphomas, indicating their relative rarity compared to other types of lymphomas.

p.44
Meningiomas and Their Histological Patterns

From which cells do meningiomas arise?
A) Astrocytes
B) Oligodendrocytes
C) Arachnoid meningothelial cells
D) Ependymal cells
E) Neurons

C) Arachnoid meningothelial cells
Explanation: Meningiomas arise specifically from arachnoid meningothelial cells, which are part of the protective layers surrounding the brain and spinal cord.

p.44
Meningiomas and Their Histological Patterns

What age group is most commonly affected by meningiomas?
A) Children
B) Adolescents
C) Young adults
D) Mostly adults
E) Elderly only

D) Mostly adults
Explanation: Meningiomas predominantly occur in adults, indicating a higher prevalence in this age group compared to children or the elderly.

p.13
Histological Classification of CNS Tumors

Which grade is an anaplastic astrocytoma classified as?
A) Grade I
B) Grade II
C) Grade III
D) Grade IV
E) Grade V

C) Grade III
Explanation: Anaplastic astrocytomas are classified as Grade III tumors, indicating a higher level of malignancy compared to lower-grade astrocytomas, which are less aggressive.

p.37
Embryonal Neoplasms in Pediatric Patients

What are tumors of similar histologic type and poor differentiation found elsewhere in the nervous system called?
A) Gliomas
B) Medulloblastomas
C) Primitive neuroectodermal tumors (PNETs)
D) Ependymomas
E) Meningiomas

C) Primitive neuroectodermal tumors (PNETs)
Explanation: Tumors that share a similar histologic type and poor degree of differentiation to medulloblastoma are referred to as primitive neuroectodermal tumors (PNETs) when found in other areas of the nervous system.

p.34
Neuronal Tumors and Their Types

What is a common manifestation of dysembryoplastic neuroepithelial tumors?
A) Memory loss
B) Seizure disorder
C) Visual disturbances
D) Motor paralysis
E) Speech difficulties

B) Seizure disorder
Explanation: Dysembryoplastic neuroepithelial tumors commonly manifest as seizure disorders, which is a significant clinical feature associated with this type of tumor.

p.32
Astrocytomas and Their Subtypes

What can occasionally happen to the glial component of gangliogliomas?
A) It remains benign
B) It becomes anaplastic
C) It disappears completely
D) It turns into a different tumor type
E) It becomes calcified

B) It becomes anaplastic
Explanation: The glial component of gangliogliomas can occasionally become frankly anaplastic, indicating a change in the tumor's behavior and potential aggressiveness.

p.2
Histological Classification of CNS Tumors

How does the histologic classification relate to the behavior of nervous system tumors?
A) It is the only factor determining tumor behavior
B) It is independent of local effects
C) It directly correlates with the tumor's spread
D) It has no relevance to the tumor's outcome
E) It can influence local effects but is not the sole factor

E) It can influence local effects but is not the sole factor
Explanation: The behavior of nervous system tumors is often independent of histologic classification due to local effects, indicating that other factors also play a crucial role.

p.58
Primary CNS Tumors

What effect do metastatic tumors have on surrounding brain tissue?
A) They cause necrosis
B) They elicit edema
C) They promote regeneration
D) They reduce blood flow
E) They increase neuronal activity

B) They elicit edema
Explanation: Metastatic tumors often elicit edema in the surrounding brain tissue, which is a common response to the presence of these tumors and contributes to the clinical symptoms observed.

p.56
Primary CNS Tumors

What type of lymphoma are metastatic/primary CNS lymphoma tumors nearly always classified as?
A) Small cell lymphomas
B) T-cell lymphomas
C) Large B-cell lymphomas
D) Follicular lymphomas
E) Hodgkin lymphomas

C) Large B-cell lymphomas
Explanation: These tumors are nearly always classified as aggressive large B-cell lymphomas, indicating their aggressive nature and specific type within the lymphoma classification.

p.6
Astrocytomas and Their Subtypes

Which mutation is associated with lower-grade astrocytomas?
A) Mutation of Rb
B) Gain-of-function mutations in PI3K
C) Mutation of IDH1 and IDH2
D) Loss-of-function mutations in p53
E) Mutation of BRCA2

C) Mutation of IDH1 and IDH2
Explanation: Lower-grade astrocytomas are commonly associated with mutations in the IDH1 and IDH2 genes, which are important for cellular metabolism and have implications for tumor progression.

p.57
Primary CNS Tumors

What is the primary characteristic of Primary CNS Lymphoma?
A) It originates in the lungs
B) It is a type of brain tumor
C) It affects the skin
D) It is a benign tumor
E) It is a type of leukemia

B) It is a type of brain tumor
Explanation: Primary CNS Lymphoma is specifically classified as a type of brain tumor that originates in the central nervous system, distinguishing it from other types of lymphomas that may affect different parts of the body.

p.13
Astrocytomas and Their Subtypes

What is the typical treatment approach for anaplastic astrocytomas?
A) Surgery only
B) Radiation therapy only
C) Chemotherapy only
D) A combination of surgery, radiation, and chemotherapy
E) No treatment necessary

D) A combination of surgery, radiation, and chemotherapy
Explanation: The treatment for anaplastic astrocytomas typically involves a multimodal approach, including surgery to remove the tumor, followed by radiation therapy and chemotherapy to target any remaining cancer cells.

p.36
Embryonal Neoplasms in Pediatric Patients

What is a characteristic appearance of embryonal neoplasms?
A) Large, irregular cells
B) Small round cell appearance
C) Flat, elongated cells
D) Multi-nucleated giant cells
E) Spindle-shaped cells

B) Small round cell appearance
Explanation: Embryonal neoplasms, particularly those of neuroectodermal origin, exhibit a primitive 'small round cell' appearance that resembles normal progenitor cells in the developing central nervous system (CNS).

p.29
Neuronal Tumors and Their Types

What type of tumor is a central neurocytoma?
A) A type of glioma
B) A neuronal tumor
C) A type of meningioma
D) A type of ependymoma
E) A type of astrocytoma

B) A neuronal tumor
Explanation: Central neurocytoma is classified as a neuronal tumor, specifically arising from neurocytes, which are neurons in the central nervous system.

p.29
Neuronal Tumors and Their Types

Which of the following is a characteristic of gangliogliomas?
A) They are exclusively found in children
B) They are composed of both neuronal and glial components
C) They are always benign
D) They originate from ependymal cells
E) They are a type of embryonal tumor

B) They are composed of both neuronal and glial components
Explanation: Gangliogliomas are unique tumors that consist of both neuronal and glial cells, making them distinct within the category of neuronal tumors.

p.27
Ependymomas and Their Locations

What type of tumor is an ependymoma?
A) A type of glioma
B) A type of sarcoma
C) A type of carcinoma
D) A type of lymphoma
E) A type of melanoma

A) A type of glioma
Explanation: Ependymomas are classified as a type of glioma, which are tumors that arise from glial cells in the central nervous system.

p.49
Histological Classification of CNS Tumors

Which of the following is NOT a characteristic of fibroblasts?
A) They are star-shaped cells.
B) They can divide and proliferate.
C) They produce collagen.
D) They are primarily involved in nerve signaling.
E) They are found in connective tissue.

D) They are primarily involved in nerve signaling.
Explanation: Fibroblasts are not involved in nerve signaling; instead, they are primarily associated with the production of collagen and the maintenance of connective tissue.

p.6
Genetic Mutations in CNS Tumors

What type of mutations are involved in the oncogenic PI3K pathways?
A) Loss-of-function mutations
B) Gain-of-function mutations
C) Silent mutations
D) Frameshift mutations
E) Nonsense mutations

B) Gain-of-function mutations
Explanation: The oncogenic PI3K pathways are characterized by gain-of-function mutations, which can lead to increased cell growth and survival, contributing to tumorigenesis.

p.44
Meningiomas and Their Histological Patterns

What factors influence the prognosis of meningiomas?
A) Patient's age and gender
B) Lesion size and location, surgical accessibility, and histologic grade
C) Tumor color and texture
D) Family history of tumors
E) Presence of headaches

B) Lesion size and location, surgical accessibility, and histologic grade
Explanation: The prognosis for meningiomas is dependent on several factors, including the size and location of the lesion, how accessible it is for surgery, and the histologic grade of the tumor.

p.33
Neuronal Tumors and Their Types

What age group is most commonly affected by gangliogliomas?
A) Infants
B) Young adults
C) Middle-aged adults
D) Elderly individuals
E) All age groups equally

B) Young adults
Explanation: Gangliogliomas are most commonly diagnosed in young adults, making this demographic particularly relevant for awareness and diagnosis of this tumor type.

p.13
Astrocytomas and Their Subtypes

What is an anaplastic astrocytoma?
A) A benign tumor of the brain
B) A type of low-grade glioma
C) A malignant tumor of astrocytic origin
D) A type of meningioma
E) A non-cancerous brain lesion

C) A malignant tumor of astrocytic origin
Explanation: Anaplastic astrocytomas are classified as malignant tumors that arise from astrocytes, which are star-shaped glial cells in the brain, indicating their aggressive nature and potential for rapid growth.

p.5
Histological Classification of CNS Tumors

What are the three histologic groups of astrocytomas?
A) Grade I, Grade II, Grade III
B) Well-differentiated astrocytoma, Anaplastic astrocytoma, Glioblastoma
C) Low-grade, Intermediate-grade, High-grade
D) Benign, Malignant, Metastatic
E) Diffuse, Focal, Mixed

B) Well-differentiated astrocytoma, Anaplastic astrocytoma, Glioblastoma
Explanation: The three histologic groups of astrocytomas are well-differentiated astrocytoma (grade II), anaplastic astrocytoma (grade III), and glioblastoma (grade IV), which reflect increasing grades of malignancy.

p.41
Embryonal Neoplasms in Pediatric Patients

What is the typical treatment approach for medulloblastoma?
A) Only surgery
B) Chemotherapy and radiation therapy
C) Herbal medicine
D) Physical therapy
E) No treatment is necessary

B) Chemotherapy and radiation therapy
Explanation: The typical treatment for medulloblastoma involves a combination of surgery, chemotherapy, and radiation therapy to effectively manage and eliminate the tumor.

p.54
Meningiomas and Their Histological Patterns

What is a characteristic of WHO grade I meningiomas?
A) Highly aggressive tumors
B) Well-defined dura-based masses
C) Prominent nucleoli
D) Brain invasion
E) Pattern-less growth

B) Well-defined dura-based masses
Explanation: WHO grade I meningiomas are characterized as well-defined dura-based masses that do not invade the brain, making them less aggressive compared to higher-grade tumors.

p.39
Embryonal Neoplasms in Pediatric Patients

What type of tumor is medulloblastoma?
A) A type of glioma
B) A type of neuronal tumor
C) A type of embryonal neoplasm
D) A type of meningioma
E) A type of ependymoma

C) A type of embryonal neoplasm
Explanation: Medulloblastoma is classified as an embryonal neoplasm, primarily affecting the cerebellum and commonly occurring in children.

p.57
Primary CNS Tumors

Which demographic is most commonly affected by Primary CNS Lymphoma?
A) Children under 10
B) Young adults
C) Elderly individuals
D) Middle-aged adults
E) Pregnant women

C) Elderly individuals
Explanation: Primary CNS Lymphoma predominantly affects elderly individuals, particularly those who are immunocompromised, making age a significant risk factor for this type of tumor.

p.51
Histological Classification of CNS Tumors

What is a transitional pattern in the context of histology?
A) A pattern that shows no change over time
B) A pattern that indicates a shift between two types of tissues
C) A pattern that is only found in embryonic tissues
D) A pattern that is exclusively associated with malignant tumors
E) A pattern that is uniform across all tissue types

B) A pattern that indicates a shift between two types of tissues
Explanation: A transitional pattern refers to a histological pattern that demonstrates a transition or shift between two different types of tissues, often seen in certain types of tumors or tissue responses.

p.24
Ependymomas and Their Locations

Where are ependymomas commonly located in children?
A) Near the brainstem
B) Near the fourth ventricle
C) In the cerebellum
D) In the frontal lobe
E) In the temporal lobe

B) Near the fourth ventricle
Explanation: In the first two decades of life, ependymomas are commonly found near the fourth ventricle, accounting for 5% to 10% of primary brain tumors in this age group.

p.41
Embryonal Neoplasms in Pediatric Patients

What is a common symptom of medulloblastoma?
A) Skin rash
B) Hearing loss
C) Headaches and vomiting
D) Joint pain
E) Weight gain

C) Headaches and vomiting
Explanation: Common symptoms of medulloblastoma include headaches and vomiting, which can occur due to increased intracranial pressure caused by the tumor.

p.38
Primary CNS Tumors

What is a common characteristic of medulloblastoma in adults?
A) It is always benign
B) It occurs in the brainstem
C) Lateral tumors occur
D) It is located in the frontal lobe
E) It is always asymptomatic

C) Lateral tumors occur
Explanation: In adults, medulloblastoma is noted for the occurrence of lateral tumors, which differs from the typical midline location seen in children.

p.34
Histological Classification of CNS Tumors

What is a key microscopic feature of dysembryoplastic neuroepithelial tumors?
A) Large atypical cells
B) Small round neuronal cells arranged in columns
C) Presence of necrosis
D) High mitotic activity
E) Abundant lymphocytic infiltration

B) Small round neuronal cells arranged in columns
Explanation: Microscopic examination of dysembryoplastic neuroepithelial tumors reveals small round neuronal cells arranged in columns, which is a distinctive histological feature.

p.53
Meningiomas and Their Histological Patterns

What type of tumor is a meningioma?
A) Neuronal tumor
B) Embryonal neoplasm
C) Glial tumor
D) Tumor of the meninges
E) Germ cell tumor

D) Tumor of the meninges
Explanation: Meningiomas are tumors that arise from the meninges, the protective membranes covering the brain and spinal cord, making them distinct from other types of CNS tumors.

p.41
Embryonal Neoplasms in Pediatric Patients

What age group is most commonly affected by medulloblastoma?
A) Infants
B) Adolescents
C) Adults
D) Elderly
E) Children

E) Children
Explanation: Medulloblastoma primarily affects children, making it one of the most common types of brain tumors found in pediatric patients.

p.55
Primary CNS Tumors

What percentage of intracranial tumors are CNS lymphoma tumors?
A) 5%
B) 10%
C) 1%
D) 3%
E) 15%

C) 1%
Explanation: CNS lymphoma tumors represent 1% of all intracranial tumors, highlighting their specific classification within the broader category of brain tumors.

p.13
Astrocytomas and Their Subtypes

What is a common characteristic of anaplastic astrocytomas?
A) Slow growth rate
B) Well-defined borders
C) High cellularity and atypical cells
D) Presence of calcifications
E) Absence of necrosis

C) High cellularity and atypical cells
Explanation: Anaplastic astrocytomas are characterized by high cellularity and the presence of atypical cells, which contribute to their aggressive behavior and poor prognosis.

p.32
Astrocytomas and Their Subtypes

What is the growth rate of most gangliogliomas?
A) Rapidly growing
B) Slow-growing
C) Aggressive
D) Variable
E) Extremely fast

B) Slow-growing
Explanation: Most gangliogliomas are classified as slow-growing tumors, which is an important aspect of their clinical behavior.

p.21
Oligodendrogliomas and Their Characteristics

What type of vascular structure is commonly seen in oligodendrogliomas?
A) Thick-walled arteries
B) Delicate network of anastomosing capillaries
C) Large veins
D) Lymphatic vessels
E) Avascular regions

B) Delicate network of anastomosing capillaries
Explanation: Oligodendrogliomas are characterized by a delicate network of anastomosing capillaries, which contributes to their unique histological appearance.

p.53
Meningiomas and Their Histological Patterns

What is a characteristic histological feature of meningiomas?
A) Solid sheets of cells
B) Whorled pattern of cell growth
C) Necrotic tissue
D) Infiltrative growth pattern
E) High mitotic activity

B) Whorled pattern of cell growth
Explanation: Meningiomas are often characterized by a whorled pattern of cell growth, which is a distinctive histological feature that helps in their identification under a microscope.

p.27
Ependymomas and Their Locations

What is a characteristic feature of ependymomas?
A) They are highly aggressive tumors
B) They arise from neurons
C) They can cause hydrocephalus
D) They are always benign
E) They are exclusively found in adults

C) They can cause hydrocephalus
Explanation: Ependymomas can obstruct the flow of cerebrospinal fluid, leading to hydrocephalus, which is an accumulation of fluid in the brain, a notable characteristic of these tumors.

p.13
Astrocytomas and Their Subtypes

What is the prognosis for patients diagnosed with anaplastic astrocytomas?
A) Excellent
B) Good
C) Fair
D) Poor
E) Variable

D) Poor
Explanation: The prognosis for patients with anaplastic astrocytomas is generally poor due to the aggressive nature of the tumor and its tendency to recur, making early diagnosis and treatment critical.

p.42
Germ Cell Tumors in the CNS

What is the typical age range for the occurrence of germ cell tumors?
A) 0-5 years
B) 6-10 years
C) 11-20 years
D) 21-30 years
E) 31-40 years

C) 11-20 years
Explanation: Germ cell tumors predominantly occur in young individuals, with 90% of cases arising during the first two decades of life, indicating a strong age-related prevalence.

p.30
Histological Classification of CNS Tumors

What is a notable microscopic feature of central neurocytoma?
A) Irregular nuclei
B) Evenly spaced, round, uniform nuclei
C) Presence of necrosis
D) High mitotic activity
E) Abundant calcifications

B) Evenly spaced, round, uniform nuclei
Explanation: Microscopic examination of central neurocytoma reveals evenly spaced, round, uniform nuclei, which is a characteristic feature that helps in its diagnosis.

p.25
Ependymomas and Their Locations

Where do ependymomas typically form in the brain?
A) In the frontal lobe
B) In the fourth ventricle
C) In the spinal cord
D) In the temporal lobe
E) In the cerebellum

B) In the fourth ventricle
Explanation: Ependymomas are commonly found in the fourth ventricle, where they can present as solid or papillary masses extending from the ventricular floor, indicating their specific anatomical location.

p.30
Histological Classification of CNS Tumors

What additional structure is often found in central neurocytoma?
A) Large cysts
B) Islands of neuropil
C) Areas of hemorrhage
D) Dense fibrous tissue
E) Calcified deposits

B) Islands of neuropil
Explanation: Central neurocytoma often contains islands of neuropil, which are networks of nerve fibers and supportive tissue, contributing to its histological appearance.

p.24
Ependymomas and Their Locations

What is the most common location for ependymomas in adults?
A) Near the fourth ventricle
B) In the cerebellum
C) In the spinal cord
D) In the brainstem
E) In the frontal lobe

C) In the spinal cord
Explanation: In adults, the most common location for ependymomas is the spinal cord, particularly in individuals with Neurofibromatosis type 2 (NF2).

p.3
Primary CNS Tumors

Which of the following is NOT a classification of primary CNS tumors?
A) Gliomas
B) Neuronal Tumors
C) Embryonal Neoplasms
D) Germ Cell Tumors
E) Cardiac Tumors

E) Cardiac Tumors
Explanation: Cardiac tumors are not classified as primary CNS tumors. The primary classifications include Gliomas, Neuronal Tumors, Embryonal Neoplasms, Germ Cell Tumors, Meningiomas, and Lymphoma.

p.53
Meningiomas and Their Histological Patterns

Which of the following best describes the growth pattern of meningiomas?
A) Infiltrative and aggressive
B) Whorled and well-defined
C) Diffuse and poorly defined
D) Solid and necrotic
E) Disorganized and chaotic

B) Whorled and well-defined
Explanation: Meningiomas typically exhibit a whorled and well-defined growth pattern, which distinguishes them from other types of brain tumors that may have more infiltrative characteristics.

p.38
Primary CNS Tumors

Where is medulloblastoma typically located in children?
A) Frontal lobe
B) Midline of the cerebellum
C) Temporal lobe
D) Brainstem
E) Occipital lobe

B) Midline of the cerebellum
Explanation: In children, medulloblastoma is typically located in the midline of the cerebellum, which is a key characteristic of this type of tumor.

p.37
Histological Classification of CNS Tumors

What type of markers are nearly always expressed in medulloblastoma?
A) Only glial markers
B) Only neuronal markers
C) Neuronal and glial markers
D) Vascular markers
E) Immune markers

C) Neuronal and glial markers
Explanation: Medulloblastoma typically expresses both neuronal and glial markers, indicating its origin from neuroectodermal tissue.

p.25
Ependymomas and Their Locations

What type of mass is associated with ependymomas in the fourth ventricle?
A) Cystic
B) Solid or papillary
C) Hemorrhagic
D) Necrotic
E) Fibrous

B) Solid or papillary
Explanation: Ependymomas are associated with solid or papillary masses that extend from the ventricular floor in the fourth ventricle, highlighting their distinct morphological characteristics.

p.38
Histological Classification of CNS Tumors

What is the macroscopic appearance of medulloblastoma?
A) Soft and yellow
B) Well circumscribed, gray, and friable
C) Hard and calcified
D) Transparent and gelatinous
E) Dark and necrotic

B) Well circumscribed, gray, and friable
Explanation: Medulloblastoma is characterized macroscopically as well circumscribed, gray, and friable, which helps in its identification during examination.

p.51
Histological Classification of CNS Tumors

What is the significance of identifying transitional patterns in tumors?
A) It helps in determining the age of the tumor
B) It indicates the tumor's response to treatment
C) It aids in the classification and diagnosis of the tumor
D) It shows the tumor's genetic mutations
E) It reveals the tumor's location in the body

C) It aids in the classification and diagnosis of the tumor
Explanation: Identifying transitional patterns in tumors is significant as it assists pathologists in classifying and diagnosing the tumor type, which is crucial for determining the appropriate treatment plan.

p.19
Oligodendrogliomas and Their Characteristics

What percentage of gliomas are oligodendrogliomas?
A) 1% to 5%
B) 5% to 15%
C) 15% to 25%
D) 25% to 35%
E) 35% to 45%

B) 5% to 15%
Explanation: Oligodendrogliomas account for 5% to 15% of all gliomas, indicating their relative prevalence among brain tumors.

p.51
Histological Classification of CNS Tumors

Transitional patterns can be indicative of which of the following?
A) A stable tumor
B) A benign condition
C) A malignant transformation
D) A viral infection
E) A genetic disorder

C) A malignant transformation
Explanation: Transitional patterns can indicate a malignant transformation, as they often reflect changes in tissue that may lead to cancerous growth, making them important for diagnosis and treatment planning.

p.44
Meningiomas and Their Histological Patterns

What is a characteristic feature of most meningiomas?
A) They are always malignant
B) They are easily separable from the underlying brain
C) They always infiltrate the brain
D) They are located only in the spinal cord
E) They are always asymptomatic

B) They are easily separable from the underlying brain
Explanation: Most meningiomas can be easily separated from the underlying brain tissue, although some may infiltrate the brain, which is associated with a higher risk of recurrence.

p.39
Embryonal Neoplasms in Pediatric Patients

In which part of the brain does medulloblastoma primarily occur?
A) Cerebrum
B) Brainstem
C) Cerebellum
D) Spinal cord
E) Thalamus

C) Cerebellum
Explanation: Medulloblastoma primarily occurs in the cerebellum, which is responsible for coordination and balance, making it a significant concern in pediatric neuro-oncology.

p.51
Astrocytomas and Their Subtypes

In which type of tumors might you commonly observe transitional patterns?
A) Oligodendrogliomas
B) Meningiomas
C) Astrocytomas
D) Germ Cell Tumors
E) Neuronal Tumors

C) Astrocytomas
Explanation: Transitional patterns are often observed in astrocytomas, where the tumor may exhibit characteristics of both normal and abnormal tissue, indicating a transition in cellular morphology.

p.57
Primary CNS Tumors

What is the typical treatment approach for Primary CNS Lymphoma?
A) Surgery only
B) Radiation therapy only
C) Chemotherapy and radiation therapy
D) Herbal remedies
E) No treatment is necessary

C) Chemotherapy and radiation therapy
Explanation: The typical treatment for Primary CNS Lymphoma involves a combination of chemotherapy and radiation therapy, as this approach has been shown to be effective in managing the disease.

p.42
Germ Cell Tumors in the CNS

What percentage of brain tumors do germ cell tumors represent?
A) 0.1% to 0.5%
B) 0.2% to 1%
C) 1% to 5%
D) 5% to 10%
E) 10% to 15%

B) 0.2% to 1%
Explanation: Germ cell tumors account for a small percentage of brain tumors, specifically between 0.2% and 1%, highlighting their relative rarity in the context of CNS tumors.

p.27
Ependymomas and Their Locations

What is a common treatment option for ependymomas?
A) Chemotherapy only
B) Radiation therapy only
C) Surgical resection
D) Herbal medicine
E) Physical therapy

C) Surgical resection
Explanation: Surgical resection is a common treatment option for ependymomas, aiming to remove as much of the tumor as possible, often followed by radiation therapy to target any remaining cancerous cells.

p.54
Meningiomas and Their Histological Patterns

What is a key feature of anaplastic (malignant) meningiomas (WHO grade III)?
A) They are well-defined
B) They resemble low-grade tumors
C) They are highly aggressive
D) They have a low mitotic rate
E) They do not invade surrounding tissues

C) They are highly aggressive
Explanation: Anaplastic (malignant) meningiomas (WHO grade III) are known for their highly aggressive nature, resembling high-grade sarcomas or carcinomas, which makes them significantly more dangerous than lower-grade meningiomas.

p.34
Neuronal Tumors and Their Types

What type of neurons are found within the pools of myxoid fluid in dysembryoplastic neuroepithelial tumors?
A) Immature neurons
B) Well-differentiated floating neurons
C) Atypical neurons
D) Neuroblasts
E) Giant cells

B) Well-differentiated floating neurons
Explanation: The presence of well-differentiated floating neurons within pools of mucopolysaccharide-rich myxoid fluid is a characteristic feature of dysembryoplastic neuroepithelial tumors.

p.19
Genetic Mutations in CNS Tumors

What genetic deletions are commonly associated with oligodendrogliomas?
A) Deletions of chromosomes 3p and 10q
B) Deletions of chromosomes 1p and 19q
C) Deletions of chromosomes 7q and 22q
D) Deletions of chromosomes 5p and 17q
E) No genetic deletions are associated

B) Deletions of chromosomes 1p and 19q
Explanation: Oligodendrogliomas are characterized by deletions of chromosomes 1p and 19q, which are associated with a high responsiveness to chemotherapy and radiotherapy, making them significant in treatment planning.

p.24
Ependymomas and Their Locations

What is the relationship between ependymomas and the ependymal-lined ventricular system?
A) Ependymomas originate in the cerebellum
B) Ependymomas are located next to the ependymal-lined ventricular system
C) Ependymomas are unrelated to the ventricular system
D) Ependymomas only occur in the brain
E) Ependymomas are found only in the spinal cord

B) Ependymomas are located next to the ependymal-lined ventricular system
Explanation: Ependymomas are tumors that are located next to the ependymal-lined ventricular system, including the central canal of the spinal cord, indicating their association with this anatomical structure.

p.57
Primary CNS Tumors

What is a common symptom of Primary CNS Lymphoma?
A) Skin rash
B) Severe headaches
C) Joint pain
D) Nausea
E) Fever

B) Severe headaches
Explanation: Severe headaches are a common symptom of Primary CNS Lymphoma, along with other neurological symptoms, due to the tumor's location in the central nervous system.

p.36
Embryonal Neoplasms in Pediatric Patients

What is the most common type of embryonal neoplasm in pediatric patients?
A) Ependymoma
B) Neuroblastoma
C) Medulloblastoma
D) Glioblastoma
E) Oligodendroglioma

C) Medulloblastoma
Explanation: Medulloblastoma is the most common embryonal neoplasm, accounting for 20% of pediatric brain tumors, highlighting its significance in childhood CNS tumors.

p.54
Meningiomas and Their Histological Patterns

Which of the following features is associated with atypical meningiomas?
A) Low cellularity
B) Pattern-less growth
C) Well-defined margins
D) No brain invasion
E) Low mitotic rate

B) Pattern-less growth
Explanation: Atypical meningiomas (WHO grade II) are characterized by features such as pattern-less growth and a higher mitotic rate, which differentiate them from lower-grade meningiomas.

p.44
Meningiomas and Their Histological Patterns

What is a feature associated with meningiomas that infiltrate the brain?
A) Decreased risk of recurrence
B) Increased risk of recurrence
C) No effect on prognosis
D) Always benign
E) Always symptomatic

B) Increased risk of recurrence
Explanation: Meningiomas that infiltrate the brain are associated with an increased risk of recurrence, making their management more complex and challenging.

p.34
Neuronal Tumors and Their Types

Where is the dysembryoplastic neuroepithelial tumor typically located?
A) Frontal lobe
B) Occipital lobe
C) Superficial temporal lobe
D) Cerebellum
E) Brainstem

C) Superficial temporal lobe
Explanation: The dysembryoplastic neuroepithelial tumor is typically located in the superficial temporal lobe, which is important for diagnosis and treatment planning.

p.39
Embryonal Neoplasms in Pediatric Patients

What age group is most commonly affected by medulloblastoma?
A) Infants
B) Adolescents
C) Adults
D) Elderly
E) Children

E) Children
Explanation: Medulloblastoma predominantly affects children, making it one of the most common malignant brain tumors in pediatric patients.

p.34
Histological Classification of CNS Tumors

What is the background composition of the nodules formed by dysembryoplastic neuroepithelial tumors?
A) Fibrous tissue
B) Myxoid background
C) Calcified deposits
D) Hemorrhagic fluid
E) Necrotic tissue

B) Myxoid background
Explanation: The tumor forms multiple discrete intracortical nodules that have a myxoid background, which is significant for its histological identification.

p.3
Primary CNS Tumors

Which type of primary CNS tumor is known to arise from the meninges?
A) Lymphoma
B) Germ Cell Tumors
C) Meningiomas
D) Neuronal Tumors
E) Gliomas

C) Meningiomas
Explanation: Meningiomas are primary CNS tumors that originate from the meninges, the protective membranes covering the brain and spinal cord.

p.53
Meningiomas and Their Histological Patterns

What are psammoma bodies associated with in meningiomas?
A) Inflammation
B) Calcification
C) Necrosis
D) Vascular proliferation
E) High cellularity

B) Calcification
Explanation: Psammoma bodies are calcified structures that can be found in meningiomas, indicating areas of calcification within the tumor, which is a notable histological feature.

p.3
Primary CNS Tumors

What type of primary CNS tumor includes tumors derived from nerve cells?
A) Meningiomas
B) Neuronal Tumors
C) Germ Cell Tumors
D) Lymphoma
E) Embryonal Neoplasms

B) Neuronal Tumors
Explanation: Neuronal Tumors are classified as primary CNS tumors that originate from nerve cells, distinguishing them from other tumor types.

p.3
Primary CNS Tumors

Which classification of primary CNS tumors is associated with the development of tumors in the embryonic stage?
A) Germ Cell Tumors
B) Meningiomas
C) Embryonal (Primitive) Neoplasms
D) Lymphoma
E) Gliomas

C) Embryonal (Primitive) Neoplasms
Explanation: Embryonal (Primitive) Neoplasms are a classification of primary CNS tumors that arise during the embryonic stage of development.

p.6
Genetic Mutations in CNS Tumors

What is the role of the Rb tumor suppressor pathway in astrocytomas?
A) It promotes cell division
B) It is unaffected by mutations
C) It is involved in cell cycle regulation
D) It only affects lower-grade tumors
E) It is a type of oncogene

C) It is involved in cell cycle regulation
Explanation: The Rb tumor suppressor pathway plays a critical role in regulating the cell cycle, and mutations in this pathway can contribute to tumorigenesis in various types of tumors, including astrocytomas.

p.24
Ependymomas and Their Locations

What percentage of primary brain tumors do ependymomas account for in the first two decades of life?
A) 1% to 2%
B) 5% to 10%
C) 15% to 20%
D) 25% to 30%
E) 50% to 60%

B) 5% to 10%
Explanation: Ependymomas account for 5% to 10% of primary brain tumors in the first two decades of life, highlighting their prevalence in this age group.

p.42
Germ Cell Tumors in the CNS

Where are germ cell tumors most commonly located?
A) In the cerebellum
B) Along the midline, particularly in the pineal and suprasellar regions
C) In the temporal lobe
D) In the brainstem
E) In the occipital lobe

B) Along the midline, particularly in the pineal and suprasellar regions
Explanation: Germ cell tumors are most frequently found along the midline of the brain, with the pineal and suprasellar regions being the most common sites.

p.35
Neuronal Tumors and Their Types

Which of the following is a characteristic feature of dysembryoplastic neuroepithelial tumors?
A) They are highly aggressive
B) They are often found in children
C) They are primarily located in the spinal cord
D) They have a high rate of metastasis
E) They are associated with high levels of calcification

B) They are often found in children
Explanation: Dysembryoplastic neuroepithelial tumors are most commonly diagnosed in children and young adults, making their age demographic a significant characteristic.

p.51
Histological Classification of CNS Tumors

Which of the following is NOT a characteristic of transitional patterns?
A) Presence of both normal and abnormal cells
B) Uniformity across all cells
C) Indication of tissue change
D) Variability in cell morphology
E) Potential for malignancy

B) Uniformity across all cells
Explanation: Transitional patterns are characterized by variability in cell morphology and the presence of both normal and abnormal cells, rather than uniformity, which would indicate a different type of tissue response.

p.36
Embryonal Neoplasms in Pediatric Patients

What is the origin of embryonal neoplasms?
A) Mesodermal
B) Endodermal
C) Neuroectodermal
D) Ectodermal
E) Hematopoietic

C) Neuroectodermal
Explanation: Embryonal neoplasms arise from neuroectodermal tissue, which is the origin of the central nervous system, leading to their characteristic features and behaviors.

p.42
Germ Cell Tumors in the CNS

What is the most common primary CNS germ cell tumor?
A) Teratoma
B) Embryonal carcinoma
C) Choriocarcinoma
D) Germinoma
E) Yolk sac tumor

D) Germinoma
Explanation: The most common primary CNS germ cell tumor is the germinoma, which is a specific type of germ cell tumor that occurs in the central nervous system.

p.28
Ependymomas and Their Locations

What is a key characteristic of anaplastic ependymomas?
A) Low cell density
B) High mitotic rates
C) No necrosis
D) High ependymal differentiation
E) Presence of lymphocytes

B) High mitotic rates
Explanation: Anaplastic ependymomas are characterized by high mitotic rates, indicating aggressive cell division, which is a significant feature distinguishing them from other types of ependymomas.

p.3
Primary CNS Tumors

Which type of primary CNS tumor is characterized by the presence of glial cells?
A) Neuronal Tumors
B) Meningiomas
C) Lymphoma
D) Gliomas
E) Germ Cell Tumors

D) Gliomas
Explanation: Gliomas are a type of primary CNS tumor that arise from glial cells, which support and protect neurons in the brain.

p.24
Ependymomas and Their Locations

In which condition are spinal cord ependymomas particularly frequent?
A) Neurofibromatosis type 1
B) Neurofibromatosis type 2
C) Tuberous sclerosis
D) Li-Fraumeni syndrome
E) Von Hippel-Lindau disease

B) Neurofibromatosis type 2
Explanation: Spinal cord ependymomas are particularly frequent in the setting of Neurofibromatosis type 2 (NF2), indicating a specific association between this genetic condition and the occurrence of these tumors.

p.54
Meningiomas and Their Histological Patterns

What is the primary difference between meningiomas and anaplastic meningiomas?
A) Meningiomas are always benign
B) Anaplastic meningiomas do not invade the brain
C) Meningiomas have a higher mitotic rate
D) Anaplastic meningiomas are less aggressive
E) Meningiomas do not resemble sarcomas or carcinomas

E) Meningiomas do not resemble sarcomas or carcinomas
Explanation: Meningiomas, particularly lower-grade ones, do not resemble high-grade sarcomas or carcinomas, which is a key characteristic that differentiates them from anaplastic meningiomas, known for their aggressive behavior.

p.53
Meningiomas and Their Histological Patterns

Which of the following is NOT a common feature of meningiomas?
A) Whorled pattern
B) Psammoma bodies
C) High-grade malignancy
D) Extra-axial location
E) Slow growth

C) High-grade malignancy
Explanation: Meningiomas are typically benign and exhibit slow growth, unlike high-grade malignancies, which are more aggressive and infiltrative.

p.19
Oligodendrogliomas and Their Characteristics

In which age group are oligodendrogliomas most commonly diagnosed?
A) Infants
B) Adolescents
C) Young adults
D) Fourth and fifth decades of life
E) Elderly individuals

D) Fourth and fifth decades of life
Explanation: Oligodendrogliomas are most commonly diagnosed in individuals during their fourth and fifth decades of life, highlighting the age-related incidence of this tumor type.

p.19
Oligodendrogliomas and Their Characteristics

How does the prognosis of oligodendrogliomas compare to that of astrocytomas of similar grade?
A) Worse prognosis
B) Similar prognosis
C) Better prognosis
D) No prognosis available
E) Prognosis varies widely

C) Better prognosis
Explanation: Oligodendrogliomas generally have a better prognosis than patients with astrocytomas of similar grade, indicating a more favorable outcome for those diagnosed with oligodendrogliomas.

p.36
Embryonal Neoplasms in Pediatric Patients

How does differentiation in embryonal neoplasms typically progress?
A) It is fully differentiated
B) It is limited but may progress along multiple lineages
C) It does not occur at all
D) It only progresses in one lineage
E) It results in mature cell types immediately

B) It is limited but may progress along multiple lineages
Explanation: Differentiation in embryonal neoplasms is often limited, but there is potential for progression along multiple lineages, reflecting the complexity of these tumors.

p.39
Embryonal Neoplasms in Pediatric Patients

Which of the following is a common treatment for medulloblastoma?
A) Chemotherapy
B) Radiation therapy
C) Surgery
D) All of the above
E) None of the above

D) All of the above
Explanation: Treatment for medulloblastoma typically involves a combination of surgery, chemotherapy, and radiation therapy to effectively manage the tumor and prevent recurrence.

p.36
Embryonal Neoplasms in Pediatric Patients

What type of cells do embryonal neoplasms resemble?
A) Mature neurons
B) Progenitor cells
C) Astrocytes
D) Oligodendrocytes
E) Ependymal cells

B) Progenitor cells
Explanation: The small round cell appearance of embryonal neoplasms is reminiscent of normal progenitor cells encountered in the developing CNS, indicating their neuroectodermal origin.

p.39
Embryonal Neoplasms in Pediatric Patients

What is a potential long-term effect of treatment for medulloblastoma?
A) Improved cognitive function
B) Increased risk of secondary tumors
C) Enhanced motor skills
D) Decreased risk of infections
E) None of the above

B) Increased risk of secondary tumors
Explanation: One potential long-term effect of treatment for medulloblastoma is an increased risk of developing secondary tumors, particularly due to the effects of radiation therapy.

p.42
Germ Cell Tumors in the CNS

Which gender shows a predominance for germ cell tumors in the pineal region?
A) Female
B) Male
C) No gender predominance
D) Both genders equally
E) Transgender individuals

B) Male
Explanation: There is a male predominance for germ cell tumors occurring in the pineal region, indicating a gender-related risk factor associated with these tumors.

p.35
Neuronal Tumors and Their Types

What is the typical prognosis for patients with dysembryoplastic neuroepithelial tumors?
A) Poor prognosis with high mortality
B) Excellent prognosis with low recurrence
C) Variable prognosis depending on treatment
D) Moderate prognosis with frequent complications
E) Poor prognosis with aggressive treatment required

B) Excellent prognosis with low recurrence
Explanation: Patients with dysembryoplastic neuroepithelial tumors generally have an excellent prognosis, with low rates of recurrence after surgical removal, making them one of the more favorable types of brain tumors.

p.57
Primary CNS Tumors

Which imaging technique is commonly used to diagnose Primary CNS Lymphoma?
A) X-ray
B) Ultrasound
C) MRI (Magnetic Resonance Imaging)
D) CT (Computed Tomography)
E) PET (Positron Emission Tomography)

C) MRI (Magnetic Resonance Imaging)
Explanation: MRI is commonly used to diagnose Primary CNS Lymphoma due to its ability to provide detailed images of the brain and detect abnormalities associated with the tumor.

p.28
Ependymomas and Their Locations

What is a common feature of anaplastic ependymomas related to tissue structure?
A) High ependymal differentiation
B) Presence of necrosis
C) Low cell density
D) Abundant lymphocytes
E) Increased vascularization

B) Presence of necrosis
Explanation: Necrosis is a common feature in anaplastic ependymomas, indicating areas of dead tissue due to the aggressive nature of the tumor.

p.19
Oligodendrogliomas and Their Characteristics

Where are oligodendrogliomas primarily located in the brain?
A) Brainstem
B) Cerebellum
C) Cerebral hemispheres, mainly frontal or temporal lobes
D) Occipital lobe
E) Spinal cord

C) Cerebral hemispheres, mainly frontal or temporal lobes
Explanation: Oligodendrogliomas are primarily found in the cerebral hemispheres, particularly in the frontal or temporal lobes, which is significant for understanding their anatomical distribution.

p.28
Ependymomas and Their Locations

Which of the following is NOT a characteristic of anaplastic ependymomas?
A) Increased cell density
B) Necrosis
C) Less evident ependymal differentiation
D) Low mitotic rates
E) High mitotic rates

D) Low mitotic rates
Explanation: Anaplastic ependymomas are characterized by high mitotic rates, not low, making option D the correct answer as it does not align with the characteristics of this tumor type.

p.28
Ependymomas and Their Locations

How does ependymal differentiation appear in anaplastic ependymomas?
A) Highly evident
B) Moderately evident
C) Less evident
D) Absent
E) Uniformly evident

C) Less evident
Explanation: In anaplastic ependymomas, ependymal differentiation is less evident, which is a characteristic that distinguishes them from more differentiated ependymomas.

p.28
Ependymomas and Their Locations

What does increased cell density in anaplastic ependymomas indicate?
A) Decreased tumor aggressiveness
B) Increased tumor aggressiveness
C) Normal cell growth
D) Presence of necrosis
E) High differentiation

B) Increased tumor aggressiveness
Explanation: Increased cell density in anaplastic ependymomas is indicative of tumor aggressiveness, suggesting a more severe and potentially harmful growth pattern.

p.35
Neuronal Tumors and Their Types

Which imaging technique is commonly used to diagnose dysembryoplastic neuroepithelial tumors?
A) X-ray
B) Ultrasound
C) MRI (Magnetic Resonance Imaging)
D) CT (Computed Tomography)
E) PET (Positron Emission Tomography)

C) MRI (Magnetic Resonance Imaging)
Explanation: MRI is the preferred imaging technique for diagnosing dysembryoplastic neuroepithelial tumors, as it provides detailed images of brain structures and helps in identifying the tumor's characteristics.

p.35
Neuronal Tumors and Their Types

What type of tumor is a dysembryoplastic neuroepithelial tumor?
A) A type of germ cell tumor
B) A type of neuronal tumor
C) A type of meningioma
D) A type of ependymoma
E) A type of astrocytoma

B) A type of neuronal tumor
Explanation: Dysembryoplastic neuroepithelial tumors are classified as neuronal tumors, which are characterized by their origin from neuroepithelial tissue and are typically found in the brain.

p.35
Neuronal Tumors and Their Types

What histological feature is commonly associated with dysembryoplastic neuroepithelial tumors?
A) Necrosis
B) Calcification
C) High mitotic activity
D) Presence of necrotic tissue
E) Abnormal blood vessel formation

B) Calcification
Explanation: Dysembryoplastic neuroepithelial tumors often exhibit calcification on imaging and histological examination, which is a distinguishing feature of this tumor type.

Study Smarter, Not Harder
Study Smarter, Not Harder