Hematopathology Practice Questions

Q: Which of the following is NOT a form of histiocytosis?

Chloroma. **Explanation:** The correct answer is **Chloroma** because it is a manifestation of myeloid leukemia, not a histiocytic disorder. **1. Why Chloroma is the correct answer:** A **Chloroma** (also known as **Granulocytic Sarcoma** or Myeloid Sarcoma) is an extramedullary solid tumor mass composed of primitive myeloid cells (myeloblasts). It is most commonly associated with **Acute Myeloid Leukemia (AML)**, particularly the M4 and M5 subtypes. The name "Chloroma" derives from its greenish appearance due to the presence of the enzyme **myeloperoxidase (MPO)**. **2. Why the other options are incorrect:** Options A, C, and D are the three classic clinical presentations of **Langerhans Cell Histiocytosis (LCH)**, a clonal proliferation of dendritic cells (histiocytes) [1]: * **Letterer-Siwe syndrome:** The acute disseminated form, typically seen in infants (<2 years). It involves multiple organs (skin, liver, spleen) and has a poor prognosis. * **Hand-Schüller-Christian triad:** The chronic disseminated form, characterized by the classic triad of **diabetes insipidus, exophthalmos, and lytic bone lesions** (skull). * **Eosinophilic granuloma:** The benign, localized form, usually presenting as solitary or few lytic bone lesions in older children or adults. **High-Yield Clinical Pearls for NEET-PG:** * **LCH Marker:** The pathognomonic electron microscopy finding in LCH is the **Birbeck granule** (tennis-racket shaped) [1]. * **Immunohistochemistry (IHC):** LCH cells are characteristically positive for **CD1a, S100, and CD207 (Langerin)** [1]. * **Chloroma Association:** Frequently associated with the chromosomal translocation **t(8;21)** in AML. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Diseases of White Blood Cells, Lymph Nodes, Spleen, and Thymus, pp. 629-630.

Question 1

Auer rods are characteristic findings in which of the following hematological conditions?

Accepted Answer

Acute myeloid leukemia

Answer

Chronic myeloid leukemia

Answer

Iron deficiency anemia

Answer

Hodgkin's disease

Question 2

Intravascular hemolysis occurs in which of the following conditions?

Accepted Answer

Paroxysmal nocturnal hemoglobinuria

Answer

Hereditary spherocytosis

Answer

Autoimmune hemolytic anemia

Answer

Thalassemia

Question 3

Which of the following statements regarding Chronic Myeloid Leukemia (CML) is true?

Accepted Answer

The size of splenomegaly is indicative of prognosis.

Answer

Phagocytic activity of white blood cells is reduced.

Answer

Sudan black stain is specific for myeloblasts.

Answer

All of the above.

Question 4

Lymph node biopsy of an AIDS patient shows what finding?

Accepted Answer

All of the above

Answer

Wahin-Finkeldey cells

Answer

Marked follicular hyperplasia

Answer

'Moth-eaten appearance'

Question 5

Microspherocytosis is seen in which of the following conditions?

Accepted Answer

All of the above

Answer

Congenital spherocytosis

Answer

Autoimmune acquired hemolytic anemia

Answer

Thalassemia

Question 6

Which of the following is NOT a form of histiocytosis?

Accepted Answer

Chloroma

Answer

Letterer-Siwe syndrome

Answer

Hand-Schüller-Christian triad

Answer

Eosinophilic granuloma

Question 7

Which of the following is NOT a minor diagnostic criterion for multiple myeloma?

Accepted Answer

Plasmacytoma on biopsy

Answer

Lytic bone lesions

Answer

Plasmacytosis greater than 20%

Answer

Monoclonal globulin spike on serum electrophoresis of > 2.5 g/dl for IgG, >1.5 g/dl for IgA

Question 8

What is the most characteristic finding in megaloblastic anemia?

Accepted Answer

Macroovalocyte

Answer

Target cell

Answer

Macrocyte

Answer

Microovalocyte

Question 9

The heme portion of the hemoglobin molecule consists of:

Accepted Answer

Four porphyrin rings, each containing a molecule of Fe in the center

Answer

Porphyrin ring with a molecule of Fe in the center

Answer

A polypeptide chain containing Fe

Answer

A pyrole ring with four molecules of Fe in the center

Question 10

Which of the following is seen in idiopathic thrombocytopenic purpura?

Accepted Answer

Increased bleeding time

Answer

Thrombocytosis

Answer

Increased prothrombin time

Answer

Increased clotting time

Hematopathology — MCQs

Hematopathology — MCQs

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