Neoplasia Practice Questions

Q: Choristoma is defined as:

Normal tissue in an abnormal site. **Explanation:** **Choristoma** is a developmental anomaly characterized by the presence of **microscopically normal cells or tissues in an abnormal anatomical location** [1]. It is a form of heterotopia or ectopia [1]. Although it presents as a mass and can mimic a neoplasm, it is not a true tumor but rather a congenital malformation. **Analysis of Options:** * **Option A (Correct):** This is the definition of Choristoma. A classic example is a nodule of well-organized pancreatic tissue found in the submucosa of the stomach or small intestine [1]. * **Option B (Incorrect):** This describes a **Hamartoma**. A hamartoma consists of an excessive, disorganized growth of mature cells and tissues indigenous to that particular site (e.g., a pulmonary hamartoma containing cartilage, bronchial epithelium, and connective tissue in the lung). * **Option C (Incorrect):** This is a vague description that could apply to various conditions, including dysplasia or neoplasia, but it does not define the specific developmental entity of choristoma. **High-Yield Clinical Pearls for NEET-PG:** * **Choristoma vs. Hamartoma:** Remember the mnemonic: **C**horistoma is **C**onfused (wrong place), **H**amartoma is **H**ome (right place, wrong organization). * **Common Examples of Choristoma:** 1. Pancreatic tissue in the stomach or Meckel’s diverticulum [1]. 2. Adrenal rest tissue in the kidney, ovary, or testis. 3. Gastric mucosa in the distal esophagus (Inlet patch) [1]. * **Key Feature:** Both choristomas and hamartomas are **benign** and grow at a rate similar to the surrounding tissues, unlike true neoplasms which exhibit autonomous growth. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Gastrointestinal Tract, pp. 757-759.

Q: A patient complains of difficulty breathing through his nose and bony pain in his cheeks, near his nose. Physical examination and CT of the head reveal mass lesions involving the nose, pharynx, and sinuses. CT-guided biopsy demonstrates a non-keratinizing, squamous cell carcinoma. Which of the following disorders is associated with the same oncogenic virus that is the likely cause of this patient's cancer?

Burkitt's lymphoma. **Explanation:** The patient presents with symptoms and biopsy findings (non-keratinizing squamous cell carcinoma of the nasopharynx) diagnostic of **Nasopharyngeal Carcinoma (NPC)**. NPC is strongly associated with the **Epstein-Barr Virus (EBV)**, particularly the undifferentiated (Type 3) and non-keratinizing (Type 2) subtypes. **Why Burkitt’s Lymphoma is correct:** Burkitt’s lymphoma is also etiologically linked to **EBV**. The virus infects B-cells via the CD21 receptor, leading to malignant transformation. In the endemic (African) form of Burkitt’s lymphoma, EBV is found in nearly 100% of cases. Therefore, it shares the same oncogenic driver as NPC. **Analysis of Incorrect Options:** * **A. Adult T-cell leukemia:** Caused by **HTLV-1** (Human T-lymphotropic virus 1). * **C. Cervical carcinoma:** Primarily caused by high-risk strains of **HPV** (Human Papillomavirus), specifically types 16 and 18. * **D. Hepatocellular carcinoma:** Associated with chronic infection by **Hepatitis B (HBV)** and **Hepatitis C (HCV)** viruses. **Clinical Pearls for NEET-PG:** * **NPC Triad (Trotter’s Triad):** Conductive hearing loss (due to Eustachian tube blockage), Palatal paralysis, and Trigeminal neuralgia. * **EBV Associations:** Infectious Mononucleosis, Nasopharyngeal Carcinoma, Burkitt’s Lymphoma, Hodgkin’s Lymphoma (Mixed cellularity), and Oral Hairy Leukoplakia (in HIV). * **Bimodal Age Distribution:** NPC often shows peaks in the 2nd and 6th decades of life. * **Tumor Marker:** Plasma EBV DNA levels are used for monitoring treatment response and recurrence in NPC.

Question 1

All of the following are examples of tumor markers, except?

Accepted Answer

Alpha-HCG (aHCG)

Answer

Alpha-Feto protein

Answer

Thyroglobulin

Answer

Beta-2-microglobulin

Question 2

All of the following are true regarding retinoblastoma, except:

Accepted Answer

Bilateral tumors are common in sporadic cases

Answer

Flexner-Wintersteiner rosettes

Answer

Rarely spreads to lungs

Answer

Dystrophic calcification

Question 3

Invasive squamous cell carcinoma is differentiated from carcinoma in situ by:

Accepted Answer

Penetration of basement membrane

Answer

Number of mitotic figures

Answer

Increased size of cell

Answer

Nuclear pleomorphism

Question 4

In a study comparing colonic polyps with malignant cells localized to the polyp versus those showing invasion of the stalk, molecular analysis revealed up-regulation of certain molecules in invasive malignant cells. Invasive lesions are more likely to exhibit lymphatic metastases. Which of the following markers is most likely to have increased expression in the invasive malignant epithelial cells?

Accepted Answer

CD44

Answer

BCL2

Answer

EGFR

Answer

RAS

Question 5

Malignant cells characteristically

Accepted Answer

Take at least 30 doubling times before they become clinically detectable

Answer

Have a shorter cell cycle than the normal cells in their parent tissue

Answer

Have the same DNA content as the normal cells in their parent tissue

Answer

Are contact inhibited in tissue culture

Question 6

Teratoma arises from which type of cells?

Accepted Answer

Totipotent cells

Answer

Mesodermal cells

Answer

Ectodermal cells

Answer

Endodermal cells

Question 7

Choristoma is defined as:

Accepted Answer

Normal tissue in an abnormal site

Answer

Normal tissue in excess at a normal site

Answer

Abnormal tissue at any site

Answer

None of the above

Question 8

Which of the following describes humoral hypercalcemia of malignancy (HHM)?

Accepted Answer

The rise in calcium levels due to parathyroid hormone-related peptide (PTH-rP)

Answer

Paraneoplastic calcitonin production

Answer

Vitamin D hypervitaminosis

Answer

Parafollicular C-cell proliferation of the thyroid gland

Question 9

In which of the following types of tumors can HPV-6 be detected?

Accepted Answer

Papilloma

Answer

CEOT

Answer

Sarcoma

Answer

Pyogenic Granuloma

Question 10

A patient complains of difficulty breathing through his nose and bony pain in his cheeks, near his nose. Physical examination and CT of the head reveal mass lesions involving the nose, pharynx, and sinuses. CT-guided biopsy demonstrates a non-keratinizing, squamous cell carcinoma. Which of the following disorders is associated with the same oncogenic virus that is the likely cause of this patient's cancer?

Accepted Answer

Burkitt's lymphoma

Answer

Adult T-cell leukemia

Answer

Cervical carcinoma

Answer

Hepatocellular carcinoma

Neoplasia — MCQs

Neoplasia — MCQs

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