Neoplasia Practice Questions

Q: Psammoma bodies are seen in all the following conditions except?

Follicular carcinoma of thyroid. **Explanation:** Psammoma bodies are characteristic round, microscopic collections of calcium (dystrophic calcification) with a concentric, laminated "sand-like" appearance. **1. Why Follicular Carcinoma of Thyroid is the correct answer:** Psammoma bodies are a hallmark feature of **Papillary Thyroid Carcinoma (PTC)**, occurring in approximately 40-50% of cases [1]. In contrast, **Follicular Carcinoma of the Thyroid** typically lacks these structures [1]. This is a high-yield diagnostic distinction in pathology; the presence of psammoma bodies in a thyroid fine-needle aspiration (FNA) strongly points toward a papillary rather than a follicular neoplasm [1]. **2. Analysis of incorrect options (Conditions where Psammoma bodies ARE seen):** * **Malignant Mesothelioma:** These bodies are frequently found in the epithelial variant of mesothelioma. * **Somatostatinoma:** This is a rare neuroendocrine tumor (usually of the pancreas or duodenum) where psammoma bodies are a recognized histological feature. * **Prolactinoma:** While less common than in other tumors, "pituitary stones" or psammoma bodies can be seen in prolactin-secreting adenomas. **3. NEET-PG High-Yield Pearls:** To remember the common causes of Psammoma bodies, use the mnemonic **"PSaMMoma"**: * **P:** **P**apillary carcinoma of thyroid, **P**apillary renal cell carcinoma, **P**rolactinoma. * **S:** **S**erous cystadenocarcinoma of ovary, **S**omatostatinoma. * **M:** **M**eningioma, **M**esothelioma. **Key Concept:** Psammoma bodies represent a process of cell death where necrotic cells serve as a focus for calcium salt deposition in concentric layers. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Endocrine System, pp. 1099-1101.

Q: Molecular classification of breast cancer is based on which of the following?

Gene expression profiling. ### Explanation **Correct Answer: A. Gene Expression Profiling** The molecular classification of breast cancer (Perou-Sørlie classification) is fundamentally based on **Gene Expression Profiling** using DNA microarrays [1]. This technique measures the activity of thousands of genes simultaneously to categorize tumors into distinct biological subtypes: **Luminal A, Luminal B, HER2-enriched, and Basal-like.** [1] This classification is superior to traditional methods because it reflects the underlying biology, clinical behavior, and prognosis of the tumor. **Analysis of Incorrect Options:** * **B. Expression of hormone receptors (ER, PR, HER-2):** While these markers are used in daily clinical practice as **surrogates** (surrogate subtyping) to approximate the molecular class, the *true* molecular classification is defined by the genetic signature, not immunohistochemistry (IHC) alone [1]. * **C. Histology:** Histological classification (e.g., Invasive Ductal vs. Lobular carcinoma) is based on morphology and architecture under a microscope, which does not always correlate with the molecular driver of the tumor. * **D. Response to chemotherapy:** This is a clinical outcome or a criterion for choosing treatment, not a basis for the classification itself. **High-Yield Clinical Pearls for NEET-PG:** * **Luminal A:** Most common subtype; ER/PR positive, HER2 negative, low Ki-67. Has the **best prognosis**. * **Basal-like:** Usually "Triple Negative" (ER-/PR-/HER2-); expresses cytokeratins 5/6. Associated with **BRCA1 mutations** and has a poor prognosis [1]. * **HER2-enriched:** Characterized by *ERBB2* gene amplification; treated with Trastuzumab. * **Ki-67 Index:** A proliferation marker used to differentiate Luminal A (low Ki-67) from Luminal B (high Ki-67). **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Breast, pp. 1059-1068.

Question 1

Which of the following substances is produced by a carcinoid tumor?

Accepted Answer

Serotonin

Answer

GABA

Answer

Epinephrine

Answer

Norepinephrine

Question 2

Which of the following mutations in a tumor suppressor gene causes breast carcinoma?

Accepted Answer

p53

Answer

p43

Answer

p73

Answer

p83

Question 3

Erythropoietin is secreted by which of the following tumors?

Accepted Answer

Adrenocortical tumors

Answer

Hemangioblastoma

Answer

Hepatoma

Answer

Renal cell carcinoma

Question 4

Psammoma bodies are seen in all the following conditions except?

Accepted Answer

Follicular carcinoma of thyroid

Answer

Malignant mesothelioma

Answer

Somatostatinoma

Answer

Prolactinoma

Question 5

Which of the following tumors do not typically undergo spontaneous resolution?

Accepted Answer

Cholangiocarcinoma

Answer

Malignant melanoma

Answer

Osteogenic sarcoma

Answer

Retinoblastoma

Question 6

Which type of breast carcinoma is characterized by being bilateral and multicentric?

Accepted Answer

Lobular

Answer

Ductal

Answer

Medullary

Answer

Colloid

Question 7

Molecular classification of breast cancer is based on which of the following?

Accepted Answer

Gene expression profiling

Answer

Expression of hormone receptors like ER, PR, and HER-2 neu

Answer

Histology

Answer

Response to chemotherapy

Question 8

A 50-year-old woman undergoes screening colonoscopy. An isolated 1-cm pedunculated polyp is found in the sigmoid colon. The excised polyp histologically shows well-differentiated glands with no invasion of the stalk. Which of the following investigational research procedures can distinguish most clearly whether the polyp represents hyperplasia of the colonic mucosa or a tubular adenoma?

Accepted Answer

Molecular marker of clonality

Answer

Flow cytometry to quantitate cells in the S phase

Answer

Histochemical staining for mucin

Answer

Immunohistochemical staining for keratin

Question 9

What is the most common malignancy arising in a Marjolin's ulcer?

Accepted Answer

Squamous cell carcinoma

Answer

Adenocarcinoma

Answer

Basal cell carcinoma

Answer

Malignant fibrous histiocytoma

Question 10

Which of the following tumors is most similar to retinoblastoma?

Accepted Answer

Neuroblastoma

Answer

Fibroma

Answer

Phaeochromocytoma

Answer

Astrocytoma

Neoplasia — MCQs

Neoplasia — MCQs

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