Hematopathology Practice Questions

Q: Castleman disease is associated with which of the following?

Human Herpesvirus 8 (HHV-8). **Explanation:** **Castleman Disease (CD)**, also known as angiofollicular lymph node hyperplasia, is a rare lymphoproliferative disorder. The association with **Human Herpesvirus 8 (HHV-8)** is the cornerstone of its pathogenesis, particularly in the **Multicentric** variant (MCD). **Why HHV-8 is the correct answer:** HHV-8 (also known as Kaposi Sarcoma-associated Herpesvirus) encodes a viral homolog of **Interleukin-6 (vIL-6)**. This viral cytokine mimics human IL-6, driving B-cell proliferation, plasma cell differentiation, and systemic inflammation. This is especially prevalent in HIV-positive patients with MCD, where HHV-8 is found in nearly 100% of cases. **Why other options are incorrect:** * **HSV (A) & CMV (B):** While these are common herpesviruses, they are not etiologically linked to the pathogenesis of Castleman disease. CMV is more commonly associated with infectious mononucleosis-like syndromes or retinitis in immunocompromised states. * **EBV (C):** EBV is strongly associated with other lymphoid malignancies like Burkitt lymphoma, Hodgkin lymphoma, and Nasopharyngeal carcinoma, but it is not the primary driver of Castleman disease. **High-Yield Clinical Pearls for NEET-PG:** * **Histological Variants:** 1. **Hyaline-Vascular (80-90%):** Characterized by "Lollipop lesions" (sclerotic vessels entering germinal centers) and "Onion-skinning" of the mantle zone. Usually unicentric. 2. **Plasma Cell Variant:** Associated with systemic symptoms (fever, anemia) and elevated ESR due to IL-6. * **Clinical Association:** HHV-8 positive MCD is a significant risk factor for developing **Kaposi Sarcoma** and **Primary Effusion Lymphoma (PEL)**. * **Key Cytokine:** **IL-6** is the "master regulator" of the disease symptoms and progression.

Question 1

All of the following genetic mutations are associated with an increased risk of deep venous thrombosis, EXCEPT:

Accepted Answer

Glycoprotein 1b platelet receptor defect

Answer

Factor V Leiden mutation

Answer

Heterozygous protein C deficiency

Answer

Prothrombin 20210G mutation

Question 2

Which of the following statements is NOT true about Immune Thrombocytopenic purpura (ITP)?

Accepted Answer

Increased megakaryocytes in bone marrow

Answer

Autoimmune mediated

Answer

Massive splenomegaly

Answer

Intravenous immunoglobulin is given

Question 3

A 41-year-old man presented with a 9-month history of cough, exertional dyspnea, nocturnal diaphoresis, and 10 kg weight loss. Physical examination revealed painless, massive, discrete, rubbery cervical, supraclavicular, and axillary lymphadenopathy. Chest radiography showed bilateral hilar lymphadenopathy. Serum calcium level was elevated at 16.2 mg/dL, with parathyroid hormone within the normal range. What is the most appropriate diagnostic investigation?

Accepted Answer

Excisional biopsy of the axillary node

Answer

Fine-needle aspiration cytology (FNAC) of the mediastinal lymph node

Answer

CT scan of the chest and abdomen

Answer

Core needle biopsy of the neck node

Question 4

What is the commonest site of lytic lesion in multiple myeloma?

Accepted Answer

Vertebral column

Answer

Femur

Answer

Clavicle

Answer

Pelvis

Question 5

Which congenital syndrome is associated with lymphoproliferative malignancy?

Accepted Answer

Chediak Higashi syndrome

Answer

Bloom syndrome

Answer

Fanconi's anemia

Answer

Turner syndrome

Question 6

Which of the following conditions is characterized by normal hemoglobin structure but reduced red blood cell volume?

Accepted Answer

Thalassemia

Answer

Chronic blood loss

Answer

Sickle cell anemia

Answer

Hemolytic anemia

Question 7

ADAMTS-13 is a metalloproteinase. It is produced by the:

Accepted Answer

Stellate cells in the liver

Answer

Alpha cells of the pancreas

Answer

Oligodendrocytes in the brain

Answer

Tubular epithelial cells of the kidney

Question 8

Giant platelets are seen in which of the following conditions?

Accepted Answer

Bernard-Soulier syndrome

Answer

Von Willebrand disease

Answer

Polycythemia rubra vera

Answer

Leukemia

Question 9

"Cabot" rings are characteristically seen in:

Accepted Answer

Post spleenectomy

Answer

Hemochromatosis

Answer

Thalassemia

Answer

Acquired hemolytic anemia

Question 10

Castleman disease is associated with which of the following?

Accepted Answer

Human Herpesvirus 8 (HHV-8)

Answer

Herpes Simplex Virus (HSV)

Answer

Cytomegalovirus (CMV)

Answer

Epstein-Barr Virus (EBV)

Hematopathology — MCQs

Hematopathology — MCQs

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