Neoplasia Practice Questions

Q: Which type of breast cancer is characterized by the single file pattern?

Infiltrating lobular. **Explanation:** **Infiltrating Lobular Carcinoma (ILC)** is the correct answer because of its unique molecular pathology. The hallmark of ILC is the **loss of E-cadherin expression** (due to mutations in the *CDH1* gene). E-cadherin is a cell-surface glycoprotein responsible for calcium-dependent cell-to-cell adhesion. Without this "cellular glue," the malignant cells cannot form clusters or tubules. Instead, they migrate through the stroma in a linear, sequential fashion, creating the classic **"single file" (Indian file) pattern** [1]. **Analysis of Options:** * **Option A (Intraductal):** This refers to Ductal Carcinoma In Situ (DCIS). Cells are confined within the basement membrane of the ducts, often forming solid, cribriform, or papillary patterns, but not single files. * **Option C (Infiltrating Ductular):** Also known as Invasive Breast Carcinoma of No Special Type (NST). These cells retain E-cadherin, allowing them to adhere to one another and form cohesive nests, cords, or gland-like structures [1]. * **Option D:** Incorrect, as the single-file pattern is a specific diagnostic feature of the lobular subtype. **High-Yield Clinical Pearls for NEET-PG:** * **Target Lesion:** ILC often lacks a discrete central mass and may present as subtle thickening (difficult to detect on mammography) [1]. * **Bilateralism:** ILC has a higher frequency of being **bilateral and multicentric** compared to ductal carcinoma [1]. * **Metastasis:** It has a unique metastatic profile, often spreading to the **peritoneum, leptomeninges, and ovaries**. * **Staining:** Negative staining for **E-cadherin** is used immunohistochemically to confirm ILC and differentiate it from ductal variants. **References:** [1] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Liver And Biliary System Disease, pp. 454-455.

Q: All of the following are paraneoplastic syndromes of bronchogenic carcinoma except?

Myasthenia gravis. **Explanation:** Paraneoplastic syndromes (PNS) are systemic symptoms caused by substances (hormones, cytokines, or antibodies) secreted by tumor cells or as an immune response to the tumor, rather than by direct local effects or metastasis [1]. **Why Myasthenia Gravis (MG) is the correct answer:** While MG is a classic paraneoplastic syndrome, it is specifically associated with **Thymoma**, not bronchogenic carcinoma. In contrast, bronchogenic carcinoma (specifically Small Cell Lung Cancer) is associated with **Lambert-Eaton Myasthenic Syndrome (LEMS)**. While both involve neuromuscular junction dysfunction, LEMS is caused by antibodies against presynaptic voltage-gated calcium channels, whereas MG involves antibodies against postsynaptic acetylcholine receptors. **Analysis of Incorrect Options:** * **A. Hypercalcemia:** A common PNS of **Squamous Cell Carcinoma** of the lung, primarily due to the secretion of Parathyroid Hormone-related Protein (PTHrP) [1]. * **B. SIADH:** Syndrome of Inappropriate Antidiuretic Hormone secretion is a classic PNS associated with **Small Cell Lung Cancer (SCLC)**, leading to hyponatremia. * **C. Acanthosis Nigricans:** This dermatological manifestation (velvety hyperpigmentation in skin folds) is a recognized PNS for various visceral malignancies, including lung and gastric adenocarcinomas [1]. **High-Yield Clinical Pearls for NEET-PG:** * **Small Cell Carcinoma (SCLC):** Most common lung cancer to cause PNS. Associated with **ACTH** (Cushing syndrome), **ADH** (SIADH), and **Lambert-Eaton Syndrome**. * **Squamous Cell Carcinoma (SCC):** Think **"P"** for **P**THrP and **P**araneoplastic Hypercalcemia [1]. * **Hypertrophic Osteoarthropathy (HOA):** Often associated with Adenocarcinoma of the lung; presents with clubbing and periosteal new bone formation [1]. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Neoplasia, pp. 338-340.

Question 1

Which benign tumor is known to show metastasis?

Accepted Answer

Ameloblastoma

Answer

Warthin's tumor

Answer

Keratocanthoma

Answer

Neurofibroma

Question 2

What are the uses of a tumor marker?

Accepted Answer

Follow-up of a cancer patient, especially for detecting recurrence

Answer

Screening of a cancer

Answer

Confirmation of a diagnosed cancer

Answer

Monitoring the treatment of a cancer

Question 3

Which of the following hormones is elaborated by small cell carcinoma of the lung?

Accepted Answer

Adrenocorticotropic hormone (ACTH)

Answer

Parathyroid hormone (PTH)

Answer

Erythropoietin

Answer

Noradrenaline

Question 4

Which of the following tumors is most likely associated with either hyponatremia or diffuse pigmentation of the skin?

Accepted Answer

Small cell carcinoma of the lung

Answer

Renal adenocarcinoma

Answer

Hepatocellular carcinoma

Answer

Primary squamous cell carcinoma of the lung

Question 5

Which of the following is an antiapoptotic gene?

Accepted Answer

Bcl-X

Answer

Bax

Answer

Bad

Answer

Bim

Question 6

A patient's abdomen becomes distended with loculated masses of semi-translucent mucinous material produced by a mucinous cystadenoma. Which of the following are the most likely sites for the primary tumor?

Accepted Answer

Ovary or appendix

Answer

Colon or spleen

Answer

Liver or pancreas

Answer

Lung or bladder

Question 7

Cell arrest due to DNA damage is mediated by which of the following genes?

Accepted Answer

P53

Answer

Rb

Answer

P16

Answer

Notch signal

Question 8

Which type of breast cancer is characterized by the single file pattern?

Accepted Answer

Infiltrating lobular

Answer

Intraductal

Answer

Infiltrating ductular

Answer

All of the above

Question 9

Burkitt's lymphoma arises from which type of cell?

Accepted Answer

B cell

Answer

T cell

Answer

Pre B cell

Answer

NK cell

Question 10

All of the following are paraneoplastic syndromes of bronchogenic carcinoma except?

Accepted Answer

Myasthenia gravis

Answer

Hypercalcemia

Answer

SIADH

Answer

Acanthosis nigricans

Neoplasia — MCQs

Neoplasia — MCQs

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