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Neuromuscular 08

Topic: Pathology

Created on Saturday, February 14 2009 by gliageek

Last modified on Thursday, February 19 2009.


Courtesy of Dr. Mark Cohen
The concentric structures seen within this nerve biopsy indicate:

 
        A) Peripheral nerve involvement in a patient with adrenomyeloneuropathy
 
        B) Repeated demyelination and remyelination
 
        C) Repeated trauma with perineurial damage
 
        D) Hereditary neuropathy with liability to pressure palsies
 
        E) Plexiform neurofibroma
 

 


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This question was created on February 14, 2009 by gliageek.
This question was last modified on February 19, 2009.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ANSWERS AND EXPLANATIONS




A) Peripheral nerve involvement in a patient with adrenomyeloneuropathy

This answer is incorrect.


Ultrastructural inclusions may be seen, but light microscopy is non-specific   (See References)

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B) Repeated demyelination and remyelination

This answer is correct.


Repeated demyelination and remyelination, such as is seen in patients with CIDP and HSMN1, result in these concentric structures often referred to as "onion bulbs"   (See References)

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C) Repeated trauma with perineurial damage

This answer is incorrect.


Results in traumatic neuroma.   (See References)

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D) Hereditary neuropathy with liability to pressure palsies

This answer is incorrect.


Although rare onion-bulbs may accompany HNLPP, the characteristic findings are fibers with segmental myelin thickening resembling jelly rolls, called tomacules   (See References)

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E) Plexiform neurofibroma

This answer is incorrect.


Plexiform neurofibroma is characerized by accumulation of mucopolysacchride within plexiform nerve formations   (See References)

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References:

1. Graham, D.I., and Lantos, P.L. (2002). Greenfield's Neuropathology, 7th ed. Arnold Press, New York. (ISBN:0340742313) Advertising:
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pathology
Neuromuscular 08
Question ID: 021409131
Question written by gliageek. (C) FrontalCortex.com 2006-2009, all rights reserved. Created: 02/14/2009
Modified: 02/19/2009
Estimated Permutations: 120

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