Question

A patient presents with hearing loss and balance problems. Histopathology of the lesion shows Antony A and Antony B areas and Verocay bodies. What is the most likely diagnosis?

• A. Schwannoma
• B. Ependymoma
• C. Meningioma
• D. Medulloblastoma

Hint:

Antoni A, Antoni B, and Verocay bodies = Schwannoma.

Answer 1

The Correct Option is A

Step 1: Understanding the Question:
Hearing loss and balance problems (Cranial Nerve VIII dysfunction) associated with specific histopathological markers point to a tumor of the nerve sheath.
Step 2: Detailed Explanation:

Schwannoma (Acoustic Neuroma): This is a benign tumor of the Schwann cells. When it occurs on the vestibular branch of CN VIII, it is called a Vestibular Schwannoma.

Histology - Antoni A: These are hypercellular areas with spindle cells arranged in interlacing fascicles.

Histology - Antoni B: These are hypocellular, loose, myxoid areas.

Verocay Bodies: These are pathognomonic features found in Antoni A areas. They consist of two rows of nuclei separated by an acellular zone of cell processes (nuclear palisading).

Genetics: Bilateral acoustic schwannomas are a hallmark of Neurofibromatosis Type 2 (NF2).

Differential - Meningioma: Shows psammoma bodies and whorled patterns, not Antoni areas.

Step 3: Final Answer:
The combination of Antoni A/B areas and Verocay bodies is definitively diagnostic of a Schwannoma.