Gastrointestinal Pathology Practice Questions

Q: All are true about Gastrointestinal Stromal Tumors (GIST) EXCEPT?

Majority are seen in the duodenum. **Explanation:** **Gastrointestinal Stromal Tumors (GIST)** are the most common mesenchymal neoplasms of the gastrointestinal tract. **1. Why Option D is the Correct Answer (The False Statement):** The majority of GISTs are found in the **stomach (60%)**, followed by the small intestine (30%). The duodenum is a relatively uncommon site for these tumors. Therefore, the statement that the majority are seen in the duodenum is incorrect. **2. Analysis of Other Options:** * **Option A:** GISTs are indeed the **most common mesenchymal tumors** of the GI tract, distinguishing them from more common epithelial tumors like adenocarcinomas. * **Option B:** Approximately 95% of GISTs are positive for **CD117 (c-kit)**, a tyrosine kinase receptor. This is the most specific diagnostic marker. They are also frequently positive for **DOG1** (Discovered On GIST 1). * **Option C:** These tumors originate from the **Interstitial Cells of Cajal (ICC)** [1], which are the "pacemaker cells" of the gut located in the muscularis propria. **3. High-Yield Clinical Pearls for NEET-PG:** * **Genetics:** Most GISTs have gain-of-function mutations in the **c-KIT gene** (80%) or the **PDGFRA gene** [1]. * **Morphology:** Histologically, they can show **spindle cell** (most common) or epithelioid patterns. * **Treatment:** The mainstay of medical treatment for unresectable or metastatic GIST is **Imatinib mesylate** [2], a tyrosine kinase inhibitor. * **Staining:** If CD117 is negative, **DOG1** is the most sensitive next step in immunohistochemistry. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Gastrointestinal Tract, pp. 782-783. [2] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Gastrointestinal Tract, pp. 783-784.

Question 1

Barrett's esophagus most commonly involves which part of the esophagus?

Accepted Answer

Lower 1/3rd

Answer

Upper 1/3rd

Answer

Middle 1/3rd

Answer

Diffuse

Question 2

A one-year-old boy presented with hepatosplenomegaly and delayed milestones. Liver biopsy and bone marrow biopsy revealed histiocytes with PAS-positive, diastase-resistant material in the cytoplasm. Electron-microscopic examination of these histiocytes is most likely to reveal the presence of?

Accepted Answer

Parallel arrays of tubular structures in lysosomes

Answer

Birbeck's granules in the cytoplasm

Answer

Myelin figures in the cytoplasm

Answer

Electron-dense deposits in the mitochondria

Question 3

MALToma is positive for:

Accepted Answer

CD 23

Answer

CD 3

Answer

CD 10

Answer

CD5

Question 4

Mucoepidermoid carcinoma of the parotid gland arises from which cell type?

Accepted Answer

Secretory cells

Answer

Excretory cells

Answer

Myoepithelial cells

Answer

Myofibril

Question 5

Anti-transglutaminase antibodies are typically seen in which condition?

Accepted Answer

Celiac sprue

Answer

Tropical sprue

Answer

Crohn's disease

Answer

Familial adenomatous polyposis

Question 6

What is the most common site of Mucosa-associated lymphoid tissue?

Accepted Answer

Ileum

Answer

Duodenum

Answer

Jejunum

Answer

Stomach

Question 7

What is the common term for peritoneal mice?

Accepted Answer

Appendices epiploicae

Answer

Pseudomyxoma peritonei

Answer

Peritoneal seedings of tumour

Answer

Endometriosis

Question 8

A 48-year-old female presents with epigastric pain which has worsened over the past week. The patient notes that the pain is exacerbated by food and is accompanied by nausea and vomiting. She also reports weight loss. Which of the following histopathological or gross findings cannot be held responsible for this clinical scenario?

Accepted Answer

None of the above

Answer

Gastric adenocarcinoma

Answer

Peptic ulcer disease

Answer

Chronic pancreatitis

Question 9

A female patient presents with diarrhea and abdominal distension. Small intestinal biopsy reveals villous atrophy and crypt hyperplasia. What is the most likely diagnosis?

Accepted Answer

Celiac sprue

Answer

Tropical sprue

Answer

Whipple's disease

Answer

Hirschsprung's disease

Question 10

All are true about Gastrointestinal Stromal Tumors (GIST) EXCEPT?

Accepted Answer

Majority are seen in the duodenum

Answer

Most common mesenchymal tumor of the gastrointestinal tract

Answer

C-kit (CD 117) positive

Answer

Originate from interstitial cells of Cajal

Gastrointestinal Pathology — MCQs

Gastrointestinal Pathology — MCQs

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