Endocrine Pathology Practice Questions

Q: Which of the following endocrine glands is NOT involved in Multiple Endocrine Neoplasia Type I (MEN-1)?

Thyroid. Multiple Endocrine Neoplasia Type 1 (MEN-1), also known as **Wermer Syndrome**, is an autosomal dominant disorder caused by a mutation in the *MEN1* tumor suppressor gene (encoding the protein Menin) [1]. **Why Thyroid is the correct answer:** While thyroid abnormalities (like adenomas or goiter) can occasionally coexist in patients with MEN-1, the **Thyroid gland is not part of the classic diagnostic triad**. Medullary Thyroid Carcinoma (MTC) is a hallmark of MEN-2A and MEN-2B, but not MEN-1 [1]. **Analysis of Incorrect Options:** The classic MEN-1 syndrome is characterized by the **"3 Ps"**: * **Parathyroid (Option C):** This is the most common manifestation (95% of cases). It typically presents as multiglandular parathyroid hyperplasia leading to primary hyperparathyroidism [1]. * **Pancreas (Option B):** Pancreatic neuroendocrine tumors (PanNETs) are the leading cause of morbidity/mortality [1]. Common types include Gastrinomas (Zollinger-Ellison Syndrome) and Insulinomas. * **Pituitary (Option A):** Anterior pituitary adenomas occur in about 25% of patients [1], with **Prolactinoma** being the most frequent subtype. **High-Yield Clinical Pearls for NEET-PG:** * **Gene Locus:** Chromosome **11q13** [1]. * **Most common initial presentation:** Hypercalcemia (due to Parathyroid hyperplasia). * **Other associated tumors:** Adrenal cortical tumors, carcinoid tumors (thymic, bronchial, GI), and cutaneous lesions (angiofibromas, lipomas). * **Rule of 3s:** Remember **P**arathyroid, **P**ancreas, and **P**ituitary to distinguish MEN-1 from MEN-2 (which involves Medullary Thyroid Cancer and Pheochromocytoma) [1]. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Endocrine System, pp. 1079, 1104-1105, 1125, 1139-1140.

Question 1

Which of the following is NOT a true statement about pheochromocytoma?

Accepted Answer

90% are malignant

Answer

95% occur in the abdomen

Answer

They secrete catecholamines

Answer

They arise from sympathetic ganglia

Question 2

In Hashimoto's disease, serum antibodies are mainly against which of the following?

Accepted Answer

Thyroglobulins

Answer

Thyroid follicles

Answer

Thyroxine

Answer

Iodine

Question 3

Which cell type is most commonly involved in non-functioning pituitary adenoma?

Accepted Answer

Gonadotropin producing cell

Answer

Prolactin producing cell

Answer

GH producing cell

Answer

TSH producing cell

Question 4

Which of the following is a variant of papillary carcinoma of the thyroid?

Accepted Answer

Columnar cell

Answer

Medullary

Answer

Warthin

Answer

Insular

Question 5

All of the following are histological features of papillary carcinoma of the thyroid, except:

Accepted Answer

Amyloid deposits

Answer

Complex branching papillae with fibrovascular core

Answer

Orphan Annie eye nuclei and intranuclear grooves

Answer

Psammoma bodies

Question 6

Which of the following endocrine glands is NOT involved in Multiple Endocrine Neoplasia Type I (MEN-1)?

Accepted Answer

Thyroid

Answer

Pituitary

Answer

Pancreas

Answer

Parathyroid

Question 7

Which of the following statements is TRUE regarding papillary carcinoma of the thyroid?

Accepted Answer

The tumor is encapsulated.

Answer

Cells exhibit intranuclear vacuolation.

Answer

Amyloid deposition is observed.

Answer

It comprises 10-15% of all thyroid cancers.

Question 8

All of the following are associated with Multiple Endocrine Neoplasia type 2 (MEN-2) except?

Accepted Answer

Islet cell hyperplasia

Answer

Pheochromocytoma

Answer

Medullary carcinoma of the thyroid

Answer

Parathyroid adenoma

Question 9

Subcutaneous and visceral lipomas are associated with which type of multiple endocrine neoplasia (MEN) syndrome?

Accepted Answer

MEN 1

Answer

MEN 2A

Answer

MEN 2B

Answer

MEN 2C

Question 10

A 55-year-old man, who is on dialysis due to end-stage renal disease, complains of pain in his jaw and left arm for 6 months. An X-ray of the left arm reveals multiple, small bone cysts and pathologic fractures. What is the appropriate diagnosis for this patient's bone lesions?

Accepted Answer

Osteitis fibrosa cystica

Answer

Chronic osteomyelitis

Answer

Marble bone disease

Answer

Osteoid osteoma

Endocrine Pathology — MCQs

Endocrine Pathology — MCQs

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