Nephropathy in individuals with diabetes is the leading cause of:

Choice A reason: Most patients with CNS tumors do not develop metastatic disease. Central nervous system (CNS) tumors, including brain tumors, typically do not metastasize outside the CNS. Instead, they grow and exert pressure on adjacent brain structures, leading to neurological symptoms.

Choice B reason: While brain tumors can be very deadly, the TNM classification system is not avoided due to the lethality of the tumors. The main reason for not using the TNM system is because the classification criteria do not align well with the unique aspects of brain tumors.

Choice C reason: Tumor size is less relevant than the location and histology for brain tumors. The location of the tumor within the brain and its histological characteristics (e.g., type, grade, and molecular features) are more critical for prognosis and treatment planning. Brain tumors can cause significant clinical issues even when small, depending on their location.

Choice D reason: Brain tumors can have a poor prognosis, but this is not the reason the TNM classification is not used. The classification system's limitation is primarily due to the fact that brain tumors' behavior and treatment considerations depend more on their location and histological features than on tumor size, nodal involvement, and metastasis, which are the focus of the TNM system.

Choice A reason: Reversible deviant cells do not accurately describe neoplasia. Neoplasia involves the uncontrolled and irreversible growth of abnormal cells. While some deviant cell changes can be reversible, neoplasia specifically refers to irreversible changes that lead to tumor formation.

Choice B reason: Neoplasia does not adhere to the genetic controls placed on cellular proliferation and differentiation. In fact, the hallmark of neoplasia is the loss of these regulatory mechanisms, leading to uncontrolled cell growth and differentiation.

Choice C reason: Neoplasia indeed alters cellular proliferation and differentiation. This alteration is due to genetic mutations and other changes that lead to the loss of normal growth control. The result is the formation of tumors, which can be benign or malignant.

Choice D reason: Controlled and regulated cells do not describe neoplasia. Neoplastic cells grow and proliferate without the normal regulatory signals that control cell growth and differentiation. This uncontrolled growth is what characterizes neoplasia.