Neoplasia Practice Questions

Q: Kaposi's sarcoma is typically associated with which of the following viruses?

Human Herpesvirus 8 (HHV-8). **Explanation:** **Correct Answer: D. Human Herpesvirus 8 (HHV-8)** Kaposi’s Sarcoma (KS) is a low-grade vascular neoplasm derived from endothelial cells. The definitive etiological agent is **Human Herpesvirus 8 (HHV-8)**, also known as Kaposi Sarcoma-associated Herpesvirus (KSHV) [1]. HHV-8 encodes viral proteins (like v-cyclin and LANA) that interfere with host cell cycle checkpoints (p53 and Rb pathways), leading to uncontrolled endothelial proliferation. It is most commonly seen in the context of HIV/AIDS (Epidemic KS), but also occurs in elderly Mediterranean men (Classic KS), organ transplant recipients (Iatrogenic KS), and children in equatorial Africa (Endemic KS) [1]. **Incorrect Options:** * **A. Hepatitis C virus (HCV):** Primarily associated with Hepatocellular Carcinoma and Mixed Cryoglobulinemia; it does not cause vascular tumors. * **B. Human Papillomavirus (HPV):** High-risk strains (16, 18) are linked to squamous cell carcinomas of the cervix, anogenital region, and oropharynx via E6 and E7 oncoproteins [1]. * **C. Herpes Simplex virus (HSV):** HSV-1 and HSV-2 cause vesicular mucocutaneous lesions (cold sores and genital herpes) but are not oncogenic. **High-Yield Clinical Pearls for NEET-PG:** * **Histology:** Characterized by **spindle-shaped cells**, slit-like vascular spaces containing extravasated RBCs, and hyaline droplets. * **Marker:** **LANA-1** (Latent Nuclear Antigen) is the most specific immunohistochemical marker for HHV-8 in tissue sections. * **Clinical Presentation:** Presents as purple, red, or brown macules, plaques, or nodules, often on the skin but can involve the GI tract and lungs [1]. * **Association:** HHV-8 is also the causative agent for **Primary Effusion Lymphoma (PEL)** and a variant of **Multicentric Castleman Disease**. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Diseases of the Immune System, pp. 261-262.

Q: Which of the following is NOT a genetic syndrome associated with an increased incidence of neuroendocrine tumors?

Cri du chat syndrome. **Explanation:** The correct answer is **Cri du chat syndrome**. This condition is a chromosomal deletion syndrome caused by a partial deletion of the short arm of **chromosome 5 (5p-)**. It is characterized by a high-pitched "cat-like" cry, microcephaly, and intellectual disability, but it is **not** associated with a predisposition to neuroendocrine tumors (NETs). **Analysis of other options:** * **Multiple Endocrine Neoplasia 1 (MEN1):** Caused by mutations in the *MEN1* gene (Menin). It classically involves the "3 Ps": Parathyroid hyperplasia, **Pancreatic islet cell tumors** (e.g., gastrinomas, insulinomas), and Pituitary adenomas [1]. * **Von Hippel-Lindau (VHL) disease:** Caused by mutations in the *VHL* gene (Chr 3p). While famous for hemangioblastomas and Renal Cell Carcinoma, it is strongly associated with **Pancreatic Neuroendocrine Tumors (PanNETs)** and Pheochromocytomas [2]. * **Von Recklinghausen’s disease (Neurofibromatosis Type 1):** Caused by *NF1* gene mutations. It is associated with various neuroendocrine manifestations, most notably **Pheochromocytomas** [2] and **Somatostatinomas** (specifically in the duodenum). **Clinical Pearls for NEET-PG:** * **Zollinger-Ellison Syndrome** is the most common functional NET associated with MEN1 [1]. * **Carcinoid tumors** are the most common neuroendocrine tumors of the GI tract (most common site: Appendix/Ileum). * **High-yield marker:** **Chromogranin A** is the most specific serum biomarker for monitoring neuroendocrine tumors, while **Synaptophysin** is a highly reliable immunohistochemical marker. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Endocrine System, pp. 1139-1140. [2] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Endocrine System, p. 1137.

Q: Which of the following conditions is benign in nature?

Lymphangioma. **Explanation:** In medical nomenclature, the suffix **"-oma"** typically denotes a benign tumor (e.g., Adenoma, Lipoma) [2]. However, there are several critical exceptions where the suffix is used for malignant conditions [2]. **Correct Option: B. Lymphangioma** A lymphangioma is a **benign** malformation or tumor of the lymphatic vessels [1]. It is most commonly found in the neck or axilla of children (often referred to as a **Cystic Hygroma** when occurring in the neck). Unlike the other options, it does not metastasize and is characterized by endothelium-lined spaces filled with lymph. **Incorrect Options:** * **A. Lymphoma:** Despite the "-oma" suffix, this is always a **malignant** neoplasm of lymphoid tissue (e.g., Hodgkin and Non-Hodgkin Lymphoma). * **C. Melanoma:** This is a highly **malignant** tumor of melanocytes. It is one of the most aggressive skin cancers. * **D. Leukemia:** This is a **malignant** neoplasm of hematopoietic stem cells in the bone marrow, characterized by the replacement of normal marrow elements with abnormal white blood cells. **NEET-PG High-Yield Pearls:** * **The "Malignant -omas":** Always remember the classic exceptions—**Melanoma, Lymphoma, Mesothelioma, Seminoma, and Hepatoma** (Hepatocellular Carcinoma) are all **malignant** despite their names. * **Hamartomas:** These are non-neoplastic, disorganized masses of tissue indigenous to the site (e.g., Bile duct hamartoma) [1]. * **Choristoma:** A mass of histologically normal tissue in an abnormal location (ectopic rest), such as pancreatic tissue in the stomach wall. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Diseases of Infancy and Childhood, pp. 481-482. [2] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Neoplasia, pp. 276-278.

Question 1

Kaposi's sarcoma is typically associated with which of the following viruses?

Accepted Answer

Human Herpesvirus 8 (HHV-8)

Answer

Hepatitis C virus (HCV)

Answer

Human Papillomavirus (HPV)

Answer

Herpes Simplex virus (HSV)

Question 2

Kaposi's sarcoma is associated with which of the following?

Accepted Answer

HIV infection

Answer

Adenovirus

Answer

Picornavirus

Answer

All of the above

Question 3

Melanoma staging according to which classification?

Accepted Answer

Both Breslow and Clark

Answer

Breslow

Answer

Clark

Answer

Bethesda

Question 4

Which of the following is NOT a genetic syndrome associated with an increased incidence of neuroendocrine tumors?

Accepted Answer

Cri du chat syndrome

Answer

Multiple endocrine neoplasia 1

Answer

Von Hippel-Lindau disease

Answer

Von Recklinghausen's disease

Question 5

Which gene suppresses apoptosis?

Accepted Answer

BCL-2

Answer

BAK

Answer

BAX

Answer

BAD

Question 6

Which of the following carcinomas most frequently metastasizes to the brain?

Accepted Answer

Small cell carcinoma of the lung

Answer

Prostate cancer

Answer

Rectal carcinoma

Answer

Endometrial cancer

Question 7

Extragonadal germ cell tumors occur in all of the following locations except?

Accepted Answer

Testis

Answer

Sacrococcygeal region

Answer

Mediastinum

Answer

Brain

Question 8

A 32-year-old woman is found to have an adnexal mass during a pelvic examination. Resection reveals a malignant ovarian tumor. Which other organ or tissue is associated with cancers linked to the tumor suppressor gene implicated in this ovarian tumor?

Accepted Answer

Breast

Answer

Colon

Answer

Pancreas

Answer

Peripheral nerve

Question 9

Which of the following conditions is benign in nature?

Accepted Answer

Lymphangioma

Answer

Lymphoma

Answer

Melanoma

Answer

Leukemia

Question 10

Tumor suppressor genes BRCA1 and BRCA2 prevent tumorigenesis by acting as what?

Accepted Answer

DNA repair factors

Answer

Inhibitors of mitogenic signaling pathways

Answer

Inhibitors of cell cycle progression

Answer

Inhibitors of invasion and metastasis

Neoplasia — MCQs

Neoplasia — MCQs

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