Neuropathology: ependymoma: practice question

A Pathology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pathology · Neuropathology: ependymoma

Sample item

A 6-year-old child has morning headaches, vomiting and obstructive hydrocephalus. MRI shows a mass arising from the floor of the fourth ventricle. Which histological feature would favour ependymoma?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Perivascular pseudorosettes of tumour cells around vessels with a nucleus-free zone

Ependymomas arise from ependymal cells, often in the fourth ventricle in children. Tumour cells radiate their processes toward blood vessels, leaving an anuclear fibrillary zone that forms perivascular pseudorosettes, and true ependymal rosettes are less common. Blepharoplasts can be seen on special stains.

Option by option

  • A. Homer Wright rosettes around neuropil in sheets of small blue cells

    Homer Wright rosettes belong to medulloblastoma and other primitive neuroectodermal tumours.

  • B. Rosenthal fibres with a biphasic compact and microcystic pattern

    Rosenthal fibres and a biphasic pattern describe pilocytic astrocytoma.

  • C. Perivascular pseudorosettes of tumour cells around vessels with a nucleus-free zone (correct)

    Correct. Perivascular pseudorosettes characterise ependymoma.

  • D. Whorls of meningothelial cells with psammoma bodies

    Whorls with psammoma bodies describe meningioma.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Pathology question

What is the answer to this Pathology question?

The best answer is C, Perivascular pseudorosettes of tumour cells around vessels with a nucleus-free zone. Ependymomas arise from ependymal cells, often in the fourth ventricle in children.

Why is "Homer Wright rosettes around neuropil in sheets of small blue cells" not the answer?

Homer Wright rosettes belong to medulloblastoma and other primitive neuroectodermal tumours.

Why is "Rosenthal fibres with a biphasic compact and microcystic pattern" not the answer?

Rosenthal fibres and a biphasic pattern describe pilocytic astrocytoma.

Why is "Whorls of meningothelial cells with psammoma bodies" not the answer?

Whorls with psammoma bodies describe meningioma.

What concept does this question test?

It tests Neuropathology: ependymoma in Pathology. Tumour cells radiate their processes toward blood vessels, leaving an anuclear fibrillary zone that forms perivascular pseudorosettes, and true ependymal rosettes are less common. Blepharoplasts can be seen on special stains.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Neuropathology: ependymoma?

Learn each disease as a bundle: cause, key histology, markers, and the clinical hallmark. Then use the flashcards and the other Pathology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.