Neoplasia Practice Questions

Q: Which of the following is a good prognostic factor in neuroblastomas?

Hyperdiploidy. ***Hyperdiploidy*** - An increased number of chromosomes (hyperdiploidy) (more than diploid, typically triploid or tetraploid) is associated with a **favorable outcome** in neuroblastoma, particularly in infants [1]. - This chromosomal characteristic indicates a less aggressive tumor biology and often correlates with better response to treatment and **higher survival rates** [1]. *N-myc amplification* - Amplification of the **N-myc oncogene** is a strong indicator of **poor prognosis** in neuroblastoma, leading to rapid tumor progression and resistance to therapy [1]. - It is associated with **advanced disease stage** and is a key factor in risk stratification for treatment intensity [1]. *RAS oncogene* - While mutations in the **RAS oncogene** are found in various cancers, their specific prognostic significance in neuroblastoma is less consistently favorable than hyperdiploidy. - RAS mutations can sometimes be associated with **tumor resistance** to certain therapies. *Translocations* - **Chromosomal translocations** in general are often associated with oncogenesis and can have variable prognostic implications depending on the specific genes involved. - In neuroblastoma, specific translocations are generally not considered a good prognostic factor; instead, they can sometimes be linked to **aggressive disease** [1]. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Diseases of Infancy and Childhood, pp. 486-487.

Q: Carcinoma originating from glands is called?

Adenocarcinoma. ***Adenocarcinoma*** - Carcinoma that arises from **glandular epithelium** is specifically classified as adenocarcinoma [1]. - It often presents in organs like the **breast**, **prostate**, and **gastrointestinal tract** [4,5]. *Fibrosarcoma* - This is a **malignant tumor** derived from **fibrous connective tissue**, not glands. - Typically occurs in **soft tissues**, and is distinct from epithelial tumors like adenocarcinoma. *Squamous cell carcinoma* - Originates from **squamous epithelial cells** and primarily affects areas such as the **skin** and **mucous membranes** [2]. - It is not associated with glandular structures, differing markedly from adenocarcinoma. *Basal cell carcinoma* - Arises from **basal cells** in the **epidermis** (skin), not from glandular tissue. - It is the most common type of skin cancer and is largely not relevant to glandular origin. **References:** [1] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Respiratory Tract Disease, pp. 335-336. [2] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Respiratory Tract Disease, pp. 336-337. [3] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Gastrointestinal Tract, pp. 777-778. [4] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Alimentary System Disease, pp. 348-349.

Q: Which of the following is an oncogene?

RAS. ***RAS*** - RAS is an **oncogene**, not a tumor suppressor gene; it promotes cell proliferation and survival [1]. - Mutations in RAS lead to uncontrolled cell division, contributing to various cancers. *p53* - p53 is a crucial **tumor suppressor gene** responsible for regulating the cell cycle and preventing tumor formation [1,2]. - It functions by inducing apoptosis in cells with damaged DNA, preventing their proliferation [2]. *WT-1* - WT-1 is a **tumor suppressor gene** associated with Wilms' tumor and regulates kidney and gonadal development. - It plays a role in cell growth and differentiation, preventing tumorigenesis when functioning correctly. *Rb* - The Rb gene encodes the **retinoblastoma protein**, a key tumor suppressor that regulates the cell cycle by inhibiting cell division [1,2]. - Loss of Rb function is primarily associated with retinoblastoma and other cancers, indicating its critical role in tumor suppression [1,2]. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Neoplasia, pp. 297-301. [2] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. (Basic Pathology) introduces the student to key general principles of pathology, both as a medical science and as a clinical activity with a vital role in patient care. Part 2 (Disease Mechanisms) provides fundamental knowledge about the cellular and molecular processes involved in diseases, providing the rationale for their treatment. Part 3 (Systematic Pathology) deals in detail with specific diseases, with emphasis on the clinically important aspects., pp. 227-228.

Q: Tyrosine kinase receptor is associated with proto-oncogene -

RET (REarranged during Transfection). ***RET*** - RET is a **tyrosine kinase receptor** that plays a crucial role in cell signaling and development [1][2]. - It is associated with several **neoplasms**, including medullary thyroid carcinoma and multiple endocrine neoplasia type 2 [1]. *RB* - RB (Retinoblastoma protein) is a **tumor suppressor gene**, not a proto-oncogene or receptor. - Its role is largely in regulating the **cell cycle**, particularly in preventing excessive cell growth. *RAS* - RAS is a family of **GTPase proteins** involved in transmitting signals within cells, but it is not a receptor itself [1]. - It is classified as an **oncogene**, but does not function as a tyrosine kinase receptor [2]. *MYC* - MYC is a **transcription factor** involved in cell cycle progression and growth, not a tyrosine kinase receptor [2]. - It is considered an **oncogene** that promotes cellular proliferation, but it doesn't have tyrosine kinase activity [3][4]. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Endocrine System, pp. 1097-1098. [2] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Neoplasia, pp. 291-292. [3] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. With Illustrations By, pp. 28-29. [4] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Neoplasia, pp. 293-294.

Q: Flexner-Wintersteiner rosette is seen in-

Retinoblastoma. ***Retinoblastoma*** - Flexner-Wintersteiner rosettes are **characteristic histological features** seen in retinoblastoma, indicating retinal differentiation [1]. - These rosettes reflect the **presence of photoreceptor-like structures**, which are specific to this type of tumor [1]. *Hepatoblastoma* - Histologically, hepatoblastoma shows **primitive epithelial cells** and **mixed patterns**, not Flexner-Wintersteiner rosettes. - It is primarily associated with **liver** and does not present with retinal differentiation. *Nephroblastoma* - Nephroblastoma, or Wilms tumor, typically exhibits **triphasic histology** (epithelial, stromal, and blastemal components) without rosette formation. - It primarily affects the **kidney** and does not involve the retina. *Neuroblastoma* - Neuroblastoma is characterized by **small round blue cells** and **neuroid differentiation** but lacks Flexner-Wintersteiner rosettes. - This tumor usually arises in the **adrenal glands** or sympathetic nervous system, not in retinal tissue. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Eye, p. 1342.

Q: Which of the following conditions is least associated with tumor suppressor genes?

Acute Myeloid Leukemia (AML). ***Multiple endocrine neoplasia*** - This syndrome involves mutations in **proto-oncogenes** like RET rather than tumor suppressor genes. - The condition is mainly characterized by the presence of **multiple endocrine tumors** rather than a failure of tumor suppression. *Retinoblastoma* - Associated with mutations in the **RB1 tumor suppressor gene**, leading to uncontrolled cell proliferation [1] [2]. - Classic example of **loss of function** in a tumor suppressor gene resulting in cancer, specifically in early childhood [1] [2]. *Neurofibromatosis* - Caused by mutations in **NF1** or **NF2 genes**, both of which function as tumor suppressors. - Leads to benign tumors such as **neurofibromas** and other neurogenic tumors due to malfunction in tumor suppression. *Breast cancers* - Often related to mutations in tumor suppressor genes such as **BRCA1** and **BRCA2**, which increase cancer risk [2]. - Implicated in the hereditary form of breast and ovarian cancers due to their roles in DNA repair and cell cycle regulation [2]. **References:** [1] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. (Basic Pathology) introduces the student to key general principles of pathology, both as a medical science and as a clinical activity with a vital role in patient care. Part 2 (Disease Mechanisms) provides fundamental knowledge about the cellular and molecular processes involved in diseases, providing the rationale for their treatment. Part 3 (Systematic Pathology) deals in detail with specific diseases, with emphasis on the clinically important aspects., pp. 227-228. [2] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Neoplasia, pp. 298-302.

Q: All are growth promoting oncogenes except ?

TGF-β. ***TGF-p*** - **TGF-p (Transforming Growth Factor beta)** is primarily known as a **growth inhibitory** factor rather than a promoting oncogene. - It plays a crucial role in **cell differentiation**, **apoptosis**, and inhibits cell proliferation, counteracting the effects of other oncogenes. *TGF-a* - **TGF-a (Transforming Growth Factor alpha)** is a **growth factor** that stimulates cell proliferation and is involved in various cancers [1][2]. - It binds to the **EGF receptor**, promoting growth and tumor development. *PDGF* - **PDGF (Platelet-Derived Growth Factor)** acts as a potent **mitogen** for connective tissue cells and is involved in wound healing and tumor growth [2][4]. - It plays a central role in promoting cell proliferation and migration, contributing to cancer progression [4]. *FGF* - **FGF (Fibroblast Growth Factor)** promotes mitosis and is crucial in **angiogenesis**, wound healing, and several developmental processes [2]. - Its overexpression is linked to various tumors, making it a significant oncogenic growth promoter [2][3]. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. With Illustrations By, pp. 30-31. [2] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Neoplasia, p. 292. [3] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Neoplasia, pp. 292-293. [4] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. With Illustrations By, pp. 31-32.

Q: Which of the following substances is not classified as a carcinogen for bladder cancer?

Isopropyl alcohol. ***Isopropyl alcohol*** - Research does not link **isopropyl alcohol** to an increased risk of bladder cancer, making it a non-carcinogenic substance in this context. - It is commonly used as a solvent and antiseptic, but has not shown **urogenic carcinogenicity** in studies. *Phenacetin* - **Phenacetin** is an analgesic that has been associated with an increased risk of bladder cancer, particularly due to its metabolite, which can be nephrotoxic. - Its use has significantly declined due to its carcinogenic effects on the urinary system. *Benzidine* - **Benzidine** is a well-known bladder carcinogen, primarily linked to the dye industry, where exposure has led to increased rates of bladder cancer [1]. - This substance has been implicated in **urothelial carcinoma** due to its mutagenic properties. *Acrolein* - **Acrolein** is a toxic compound that can cause bladder irritation and has been studied for its potential carcinogenic effects related to bladder cancer. - It is released during the combustion of materials and is known to contribute to **chemical injury** in the bladder. **References:** [1] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. (Basic Pathology) introduces the student to key general principles of pathology, both as a medical science and as a clinical activity with a vital role in patient care. Part 2 (Disease Mechanisms) provides fundamental knowledge about the cellular and molecular processes involved in diseases, providing the rationale for their treatment. Part 3 (Systematic Pathology) deals in detail with specific diseases, with emphasis on the clinically important aspects., pp. 217-218.

Q: What is a hamartoma?

Developmental malformation. ***Development malformation*** - A **hamartoma** is a type of **benign tumor** that consists of an overgrowth of mature cells, representing a **developmental malformation** [1]. - It is formed from tissues that are normally present in the affected organ but are disorganized, leading to a characteristic appearance. *Malignant tumor* - Hamartomas are classified as **benign tumors** [1], not malignant, as they do not invade surrounding tissues or metastasize. - Despite being a growth, they do not exhibit the aggressive characteristics of malignant tumors. *Hemorrhage in vessel* - Hemorrhage refers to bleeding within a vessel and is unrelated to the definition or nature of a **hamartoma**. - Hamartomas do not consist of blood or bleeding; instead, they involve disorganized tissue growth. *Metastatic tissue* - Metastatic tissue refers to cancerous cells that have spread from their original site, which contrasts with the **non-cancerous** nature of hamartomas [1]. - Hamartomas do not involve the spread of cancer cells, but rather a **local abnormality** in tissue arrangement. **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.

Question 1

Which of the following is a good prognostic factor in neuroblastomas?

Accepted Answer

Hyperdiploidy

Answer

N-myc amplification

Answer

RAS oncogene

Answer

Translocations

Question 2

Carcinoma originating from glands is called?

Accepted Answer

Adenocarcinoma

Answer

Basal cell carcinoma

Answer

Squamous cell carcinoma

Answer

Fibrosarcoma

Question 3

Which of the following is an oncogene?

Accepted Answer

RAS

Answer

WT-1

Answer

Rb

Answer

p53

Question 4

Tyrosine kinase receptor is associated with proto-oncogene -

Accepted Answer

RET (REarranged during Transfection)

Answer

RAS (RAt Sarcoma)

Answer

RB (Retinoblastoma gene)

Answer

MYC (Myelocytomatosis oncogene)

Question 5

Which substance plays a significant role in the tumor metastasis cascade?

Accepted Answer

MMP-2 (Matrix Metalloproteinase-2)

Answer

TNF-alpha

Answer

CD99

Answer

NM23

Question 6

Flexner-Wintersteiner rosette is seen in-

Accepted Answer

Retinoblastoma

Answer

Hepatoblastoma

Answer

Nephroblastoma

Answer

Neuroblastoma

Question 7

Which of the following conditions is least associated with tumor suppressor genes?

Accepted Answer

Acute Myeloid Leukemia (AML)

Answer

Neurofibromatosis

Answer

Retinoblastoma

Answer

Breast cancer

Question 8

All are growth promoting oncogenes except ?

Accepted Answer

TGF-β

Answer

FGF

Answer

PDGF

Answer

TGF-α

Question 9

Which of the following substances is not classified as a carcinogen for bladder cancer?

Accepted Answer

Isopropyl alcohol

Answer

Acrolein

Answer

Phenacetin

Answer

Benzidine

Question 10

What is a hamartoma?

Accepted Answer

Developmental malformation

Answer

Malignant tumor

Answer

Metastatic tissue

Answer

Hemorrhage in vessel

Neoplasia — MCQs

Neoplasia — MCQs

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