Neoplasia Practice Questions

Q: Which of the following can be a complication of a dentigerous cyst?

All of the above. A **dentigerous cyst** (follicular cyst) is the most common developmental odontogenic cyst, arising from the follicle of an unerupted tooth (most commonly the mandibular third molar). It is characterized by a lining of non-keratinized stratified squamous epithelium derived from the reduced enamel epithelium [1]. **Explanation of the Correct Answer:** The correct answer is **D (All of the above)** because the epithelial lining of a dentigerous cyst possesses multipotentiality, meaning it can undergo neoplastic transformation into several types of tumors: 1. **Ameloblastoma:** This is the most common neoplastic complication. Approximately 15-17% of ameloblastomas arise within the wall of a pre-existing dentigerous cyst (unicystic ameloblastoma) [1]. 2. **Squamous Cell Carcinoma (SCC):** Chronic inflammation or unknown triggers can cause the epithelial lining to undergo malignant transformation into a primary intraosseous squamous cell carcinoma. 3. **Mucoepidermoid Carcinoma:** The lining of the cyst often contains mucous-secreting cells (prosoplasia). These cells can undergo malignant transformation into mucoepidermoid carcinoma, a salivary gland-type tumor occurring within the jaw. **Clinical Pearls for NEET-PG:** * **Radiological Hallmark:** Appears as a well-defined unilocular radiolucency attached to the **cemento-enamel junction (CEJ)** of an unerupted tooth. * **Most Common Site:** Mandibular 3rd molars > Maxillary canines. * **Histopathology:** Lining is typically 2–4 layers of flattened non-keratinized cells. The presence of **Rushton bodies** (linear/curved calcifications) is a characteristic finding. * **Management:** Enucleation is the treatment of choice; however, the specimen must be sent for histopathology to rule out the aforementioned neoplastic changes. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Head and Neck, pp. 741-742.

Q: What is CD 99 typically associated with?

Ewing's sarcoma. **Explanation:** **CD99 (MIC2 gene product)** is a 32-kDa transmembrane glycoprotein that is highly characteristic of the **Ewing Sarcoma Family of Tumors (ESFT)**. In Ewing’s sarcoma, CD99 typically shows a strong, diffuse, and continuous **membranous staining** pattern. While not 100% specific, it is a highly sensitive marker used to differentiate Ewing’s sarcoma from other small round blue cell tumors. **Analysis of Options:** * **Option A (Correct):** Ewing’s sarcoma is characterized by the translocation **t(11;22)(q24;q12)**, leading to the EWS-FLI1 fusion gene. CD99 expression is the gold standard immunohistochemical marker for its diagnosis. * **Option B (Incorrect):** Small Lymphocytic Lymphoma (SLL) is a B-cell neoplasm characterized by markers such as **CD5, CD19, CD20, and CD23**. It is typically CD99 negative. * **Option C (Incorrect):** Dermatofibroma is a benign fibrous histiocytoma of the skin. Its classic IHC marker is **Factor XIIIa**, and it is typically negative for CD34 (unlike Dermatofibrosarcoma Protuberans). * **Option D (Incorrect):** Malignant Fibrous Histiocytoma (now largely reclassified as Undifferentiated Pleomorphic Sarcoma) shows non-specific staining and is not associated with CD99. **High-Yield Clinical Pearls for NEET-PG:** * **CD99 Pattern:** Must be **membranous** to be significant for Ewing's. * **Other CD99+ conditions:** Lymphoblastic lymphoma, Synovial sarcoma, and Solitary Fibrous Tumor (SFT) can occasionally show positivity. * **Ewing’s Sarcoma Triad:** 1. Onion-skin periosteal reaction (X-ray); 2. Small round blue cells with Homer-Wright rosettes (Histology); 3. CD99 positivity (IHC).

Question 1

Which of the following childhood tumors most frequently metastasizes to the bone?

Accepted Answer

Neuroblastoma

Answer

Ganglioneuroma

Answer

Wilms' tumor

Answer

Ewing's sarcoma

Question 2

Thorium dioxide is known to cause which of the following malignancies?

Accepted Answer

Angiosarcoma

Answer

Lymphoma

Answer

Lymphangiosarcoma

Answer

Hemangioendothelioma

Question 3

Which of the following can be a complication of a dentigerous cyst?

Accepted Answer

All of the above

Answer

Ameloblastoma

Answer

Mucoepidermoid carcinoma

Answer

Squamous cell carcinoma

Question 4

Which of the following markers is not typically expressed by neuroendocrine tumors?

Accepted Answer

CK7

Answer

Synaptophysin

Answer

Chromogranin

Answer

CD56

Question 5

Which of the following neoplasms is generally considered radioresistant?

Accepted Answer

Osteosarcoma

Answer

Ewing's sarcoma

Answer

Lymphoma

Answer

Seminoma testis

Question 6

Gleason's classification is used for which of the following conditions?

Accepted Answer

Carcinoma of the prostate

Answer

Carcinoma of the breast

Answer

Carcinoma of the pancreas

Answer

Carcinoma of the rectum

Question 7

The retinoblastoma gene is located on which chromosome?

Accepted Answer

13

Answer

14

Answer

17

Answer

22

Question 8

What is CD 99 typically associated with?

Accepted Answer

Ewing's sarcoma

Answer

Small lymphocytic lymphoma (SLL)

Answer

Dermatofibroma

Answer

Malignant histiocytic fibroma

Question 9

The adenoma-carcinoma sequence was prototypically observed in which carcinoma?

Accepted Answer

Colon

Answer

Gastric

Answer

Salivary gland

Answer

Lacrimal gland

Question 10

What is the most common second malignancy in patients with familial retinoblastoma?

Accepted Answer

Osteosarcoma

Answer

Teratoma

Answer

Medullary carcinoma

Answer

Malignant melanoma

Neoplasia — MCQs

Neoplasia — MCQs

On this page

Practice by Chapter

Want unlimited practice?