Bone and Soft Tissue Pathology Practice Questions

Q: Which of the following is characterized by large intracytoplasmic glycogen storage?

Ewing's sarcoma. **Explanation:** **Ewing’s Sarcoma** is the correct answer because it is a "Small Round Blue Cell Tumor" characterized by cells with scant cytoplasm that contains abundant **glycogen**. This glycogen can be histologically demonstrated using a **Periodic Acid-Schiff (PAS) stain**, which appears positive, and is sensitive to diastase digestion. This is a crucial diagnostic feature used to differentiate it from other small round cell tumors like neuroblastoma or lymphoma. **Analysis of Incorrect Options:** * **Fibrous Dysplasia:** Characterized by a "Chinese letter" pattern of trabeculae of woven bone without osteoblastic rimming, set in a fibroblastic stroma. It does not show significant glycogen storage. * **Adamantinoma:** A rare, slow-growing tumor typically found in the tibia. It shows epithelial differentiation (nests of cells) resembling ameloblastoma of the jaw, rather than glycogen-rich round cells. * **Osteoclastoma (Giant Cell Tumor):** Characterized by a "double cell population" consisting of mononuclear stromal cells (the neoplastic component) and numerous multinucleated giant cells (osteoclast-like). **NEET-PG High-Yield Pearls:** * **Genetics:** Associated with **t(11;22)(q24;q12)** translocation, resulting in the **EWS-FLI1** fusion gene. * **Radiology:** Classically presents with an **"onion-skin"** periosteal reaction. * **Marker:** **CD99 (MIC2)** is a highly sensitive membrane marker for Ewing’s sarcoma. * **Origin:** It is believed to arise from primitive neuroectodermal cells (mesenchymal origin).

Q: Glomus tumors are most commonly seen in which of the following locations?

Finger. **Explanation:** **Glomus tumors** (glomangiomas) are benign, exquisitely painful tumors arising from the modified smooth muscle cells of the **glomus body**. The glomus body is a specialized arteriovenous anastomosis involved in thermoregulation. 1. **Why the Finger is Correct:** Glomus bodies are most densely concentrated in the distal portions of the digits, particularly in the **subungual (under the nail) region** of the fingers. These tumors typically present as a small, firm, blue-red nodule. Clinically, they are characterized by a classic triad: **paroxysmal pain, localized tenderness, and sensitivity to cold.** 2. **Why Other Options are Incorrect:** * **Liver, Adrenals, and Pituitary:** These organs do not contain glomus bodies. While vascular tumors can occur in these sites (e.g., hepatic hemangiomas), glomus tumors are specifically cutaneous or subcutaneous lesions of the extremities. **High-Yield Clinical Pearls for NEET-PG:** * **Origin:** Derived from **Sucquet-Hoyer canals** (the arterial segment of the glomus body). * **Histology:** Characterized by nests of uniform, round "glomus cells" surrounding thin-walled vascular spaces. * **Immunohistochemistry (IHC):** Glomus cells are positive for **Alpha-Smooth Muscle Actin (α-SMA)** and Vimentin, reflecting their smooth muscle origin. They are negative for endothelial markers like CD31 (except in the vessel lining). * **Treatment:** Simple surgical excision is curative and provides immediate pain relief. * **Differential Diagnosis:** Must be distinguished from other painful skin tumors (mnemonic **LEND AN ARM**: Leiomyoma, Eccrine spiradenoma, Neuroma, Dermatofibroma, Angiolipoma, Neurilemmoma, **Glomus tumor**).

Question 1

Which of the following are characteristic features of cherubism?

Accepted Answer

Both premature exfoliation of primary teeth and progressive painless symmetric swelling of cheek bones

Answer

Premature exfoliation of primary teeth

Answer

Hypoplastic defects

Answer

Progressive painless symmetric swelling of cheek bones

Question 2

Malignant tumour of skeletal muscle is

Accepted Answer

Rhabdomyosarcoma

Answer

Rhabdomyoma

Answer

Leiomyoma

Answer

Leiomyosarcoma

Question 3

Which of the following is characterized by large intracytoplasmic glycogen storage?

Accepted Answer

Ewing's sarcoma

Answer

Fibrous dysplasia

Answer

Adamantinoma

Answer

Osteoclastoma

Question 4

What is the most common site of rhabdomyosarcoma?

Accepted Answer

Orbit

Answer

Nasopharynx

Answer

Extremities

Answer

Hypopharynx

Question 5

Mutation in the GNAS1 gene is associated with which of the following conditions?

Accepted Answer

Fibrous dysplasia

Answer

Ossifying fibroma

Answer

Focal cementoosseous dysplasia

Answer

Periapical cementoosseous dysplasia

Question 6

Which of the following radiographic findings is associated with Paget’s disease?

Accepted Answer

Paget’s disease

Answer

Fibrous dysplasia

Answer

Hyperparathyroidism

Answer

Osteoma

Question 7

Carcinoma with predilection for metastasis to bones of hands and feet?

Accepted Answer

Bronchus

Answer

Prostate

Answer

Pelvis

Answer

Breast

Question 8

Glomus tumors are most commonly seen in which of the following locations?

Accepted Answer

Finger

Answer

Liver

Answer

Adrenals

Answer

Pituitary

Question 9

Perifasicular atrophy of muscle fibres is seen in which condition?

Accepted Answer

Dermatomyositis

Answer

Steroid myopathy

Answer

Inclusion body myositis

Answer

Viral myositis

Question 10

Which lesion displays an ill-defined border?

Accepted Answer

Sclerosing osteitis

Answer

Periapical cyst

Answer

Soft tissue capsule

Answer

Multiple myeloma

Bone and Soft Tissue Pathology — MCQs

Bone and Soft Tissue Pathology — MCQs

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