Neoplasia Practice Questions

Q: Which of the following is NOT a specific tumor marker?

CEA. **Explanation:** The question asks for the marker that is **NOT** a specific tumor marker. In oncology, "specificity" refers to a marker's ability to pinpoint a particular cell type or malignancy. **Why CEA is the Correct Answer:** **Carcinoembryonic Antigen (CEA)** is a classic example of an **oncofetal antigen** [1]. It is highly **non-specific** because it can be elevated in a wide variety of conditions. While most commonly associated with colorectal carcinoma, it is also elevated in cancers of the pancreas, stomach, breast, and lung [2]. Crucially, it also rises in non-neoplastic conditions like heavy smoking, cirrhosis, and inflammatory bowel disease [1]. Therefore, CEA is primarily used for **monitoring treatment response and detecting recurrence**, rather than initial diagnosis [1]. **Analysis of Incorrect Options:** * **CD 99 (MIC2):** A highly specific marker for **Ewing’s Sarcoma** and Primitive Neuroectodermal Tumors (PNET). It shows a characteristic membranous staining pattern. * **HMB 45:** A specific monoclonal antibody used to identify **Melanoma**. It reacts against gp100, a protein found in melanosomes. * **Beta-globulin:** While broad, in the context of specific diagnostic pathology (like Beta-2 Microglobulin), it serves as a specific prognostic marker for **Multiple Myeloma** and certain lymphomas. **NEET-PG High-Yield Pearls:** * **Most specific marker for Prostate Cancer:** PSA (though it is organ-specific, not cancer-specific) [2]. * **Calretinin:** Most specific marker for **Mesothelioma**. * **Alpha-fetoprotein (AFP):** Elevated in Hepatocellular Carcinoma (HCC) and Yolk Sac Tumors [2]. * **S-100:** A sensitive but non-specific marker for melanoma, neural tumors, and chondroid tumors. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Neoplasia, pp. 319-320. [2] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Neoplasia, p. 346.

Q: On postmortem examination, in which organ are metastases usually found?

Liver. **Explanation:** In forensic and clinical pathology, the **liver** is the most common site for visceral metastases. This is primarily due to its dual blood supply and its role as a massive filtration system. The liver receives a significant volume of systemic blood via the hepatic artery and, more importantly, the entirety of the venous drainage from the gastrointestinal tract via the **portal venous system**. This makes it the primary "filter" for circulating tumor cells originating from the GI tract, pancreas, and gallbladder. Additionally, the fenestrated sinusoidal endothelium of the liver provides an ideal environment for tumor cell entrapment and growth. **Analysis of Options:** * **A. Liver (Correct):** It is the most frequent site of hematogenous metastasis, especially from primary tumors of the lung, breast, and the entire portal drainage area. * **B. Kidney:** While kidneys are highly vascular, they are relatively uncommon sites for clinically significant metastases compared to the liver or lungs. * **C. Brain:** Brain metastases are common in specific cancers (like lung or melanoma) but occur at a much lower overall frequency than hepatic involvement. * **D. Bones:** Bone is the third most common site for metastasis (after lung and liver). While frequent in prostate and breast cancer, it does not surpass the liver in overall postmortem frequency across all primary sites. **High-Yield Pearls for NEET-PG:** * **Most common site for metastasis overall:** Regional Lymph Nodes. * **Most common visceral organ for metastasis:** Liver (followed by Lungs). * **Organ least likely to have metastases:** Spleen, Heart, and Skeletal Muscle (due to high metabolic activity or physical barriers). * **Nutmeg Liver:** A classic postmortem finding in chronic passive congestion, often seen alongside metastatic deposits.

Question 1

Which of the following is NOT a specific tumor marker?

Accepted Answer

CEA

Answer

CD 99

Answer

HMB 45

Answer

beta-globulin

Question 2

Osseous metastasis is most common if the primary tumor is in which organ?

Accepted Answer

Bronchus

Answer

Colon

Answer

Pancreas

Answer

Adrenal

Question 3

On postmortem examination, in which organ are metastases usually found?

Accepted Answer

Liver

Answer

Kidney

Answer

Brain

Answer

Bones

Question 4

Which of the following is an example of transplacental carcinogenesis?

Accepted Answer

Vaginal carcinoma

Answer

Pancreatic carcinoma

Answer

Colon carcinoma

Answer

Breast cancer

Question 5

Maximum increase in alpha-fetoprotein is seen with which condition?

Accepted Answer

Hepatocellular carcinoma

Answer

Benign mature teratoma

Answer

Choriocarcinoma

Answer

Teratoma

Question 6

Which of the following is NOT a tumor suppressor gene?

Accepted Answer

RAS

Answer

WT-1

Answer

Rb

Answer

p53

Question 7

Carney triad consists of which of the following?

Accepted Answer

Gastric leiomyosarcoma, paraganglioma, and pulmonary chondroma

Answer

Gastric leiomyosarcoma, pulmonary hamartoma, and adrenal adenoma

Answer

Pancreatic apudoma, renal angiomyolipoma, and uterine leiomyoma

Answer

Hepatocellular carcinoma, hemangioblastoma, and renal cell carcinoma

Question 8

Smoking predisposes to all of the following cancers except?

Accepted Answer

Lymphoma

Answer

Carcinoma of the larynx

Answer

Carcinoma of the bladder

Answer

Carcinoma of the stomach

Question 9

Arsenic is associated with an increased risk of which of the following neoplasms?

Accepted Answer

Basal cell carcinoma

Answer

Mesothelioma

Answer

Melanoma

Answer

Squamous cell carcinoma

Question 10

Which of the following has a propensity to metastasize through lymph nodes?

Accepted Answer

Alveolar rhabdomyosarcoma

Answer

Osteosarcoma

Answer

Both

Answer

None

Neoplasia — MCQs

Neoplasia — MCQs

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