Neoplasia Practice Questions

Q: Which tumors are associated with tuberous sclerosis?

All the above. **Explanation:** Tuberous Sclerosis Complex (TSC) is an autosomal dominant neurocutaneous syndrome caused by mutations in the **TSC1 (Hamartin)** or **TSC2 (Tuberin)** genes [1]. These genes normally inhibit the **mTOR pathway**; their mutation leads to constitutive activation of cell growth and the formation of hamartomas across multiple organ systems [1]. **Breakdown of Options:** * **Renal Angiomyolipoma (Option A):** These are the most common benign renal tumors in TSC patients [1]. They are composed of thick-walled blood vessels, smooth muscle, and adipose tissue. They are often bilateral and multicentric in TSC. * **Subependymal Giant Cell Astrocytoma (SEGA) (Option B):** These are low-grade (WHO Grade I) glial tumors typically located near the Foramen of Monro [1]. They are a classic CNS manifestation of TSC and can lead to obstructive hydrocephalus [1]. * **Cardiac Rhabdomyoma (Option C):** This is the most common primary cardiac tumor in infants and children [1]. In approximately 50-80% of cases, it is associated with Tuberous Sclerosis. These tumors often spontaneously regress over time. Since all three tumors are hallmark manifestations of the syndrome, **Option D** is the correct answer. **High-Yield Clinical Pearls for NEET-PG:** * **Vogt’s Triad:** Epilepsy, Intellectual disability, and Adenoma sebaceum (facial angiofibromas) [1]. * **Dermatological findings:** Ash-leaf spots (hypopigmented macules - earliest sign), Shagreen patches (connective tissue nevi), and Periungual fibromas (Koenen tumors). * **Pulmonary:** Lymphangioleiomyomatosis (LAM), primarily seen in females [1]. * **Imaging:** "Candle guttering" appearance on ventricles due to subependymal nodules [1]. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Central Nervous System, pp. 1318-1319.

Q: In thymoma, all are seen except -

Hyperalbuminemia. ### Explanation Thymoma is a neoplasm of thymic epithelial cells and is famously associated with various **paraneoplastic syndromes** due to the thymus's central role in immune tolerance and T-cell maturation. **Why Hyperalbuminemia is the Correct Answer:** Hyperalbuminemia is not a feature of thymoma. In fact, thymomas are often associated with **hypoalbuminemia** if they occur alongside protein-losing conditions or chronic inflammatory states. Hyperalbuminemia is rarely a primary clinical finding in any pathology, usually indicating dehydration rather than a neoplastic process. **Analysis of Other Options:** * **Myasthenia Gravis (Option D):** This is the most common association, seen in approximately 30–50% of thymoma patients [1], [2]. It is caused by autoantibodies against acetylcholine receptors (AChR) at the neuromuscular junction [1], [2]. * **Pure Red Cell Aplasia (Option C):** About 5–15% of patients with thymoma develop PRCA. It is characterized by a selective maturation arrest of erythroid precursors in the bone marrow. * **Hypogammaglobulinemia (Option A):** Also known as **Good Syndrome**, this triad consists of thymoma, hypogammaglobulinemia, and increased susceptibility to infections. **NEET-PG High-Yield Pearls:** * **Most common mediastinal tumor:** Thymoma (specifically in the anterior mediastinum). * **Good Syndrome:** Thymoma + Hypogammaglobulinemia (distinct from DiGeorge Syndrome). * **Staging:** The **Masaoka Staging System** is used to determine the clinical extent and prognosis of thymomas. * **Histology:** Look for a "dual population" of neoplastic epithelial cells and non-neoplastic reactive T-lymphocytes. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Diseases of the Immune System, pp. 213-214. [2] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Peripheral Nerves and Skeletal Muscles, pp. 1237-1238.

Question 1

What is true about carcinoembryonic antigen (CEA)?

Accepted Answer

Useful for screening of carcinoma of the colon

Answer

Gives confirmative evidence of carcinoma of the colon

Answer

Helpful for follow-up after resection

Answer

Levels decrease immediately after resection of the tumour

Question 2

What is considered a dimorphic carcinoma?

Accepted Answer

Papillary carcinoma of the breast

Answer

Follicular carcinoma of the thyroid

Answer

Gastric adenocarcinoma

Answer

Endometrial carcinoma

Question 3

All of the following statements about Mucosa Associated Lymphoid Tissue (MALT) lymphomas are true, except:

Accepted Answer

Present as stromal polyps

Answer

Present at extranodal sites

Answer

Predisposed by H. pylori infection

Answer

Are sensitive to chemotherapy

Question 4

All of the following are precancerous conditions except?

Accepted Answer

SLE

Answer

Peutz-Jeghers syndrome

Answer

Plummer-Vinson syndrome

Answer

Xeroderma pigmentosum

Question 5

Which tumors are associated with tuberous sclerosis?

Accepted Answer

All the above

Answer

Renal angiomyoma

Answer

Subependymal giant cell astrocytoma

Answer

Rhabdomyoma

Question 6

Prognosis in a soft tissue tumour is determined by?

Accepted Answer

Grade of tumour

Answer

Bulk of the tumour

Answer

Depth of invasion

Answer

Lymph nodal involvement

Question 7

Which is the most common tumor caused by a virus?

Accepted Answer

Warts

Answer

Carcinoma of the cervix

Answer

Nasopharyngeal carcinoma

Answer

Lymphoma

Question 8

All of the following changes are seen in dysplasia of the squamo-columnar junction, except?

Accepted Answer

Breaking of the basement membrane

Answer

Change of epithelium

Answer

Hyperchromatic nuclei

Answer

Increased mitotic figures

Question 9

In thymoma, all are seen except -

Accepted Answer

Hyperalbuminemia

Answer

Hypogammaglobulinemia

Answer

Red cell aplasia

Answer

Myasthenia Gravis

Question 10

Which of the following tumors demonstrates increased activity of C-KIT?

Accepted Answer

Seminoma

Answer

Granulosa cell tumor

Answer

Embryonal carcinoma

Answer

Choriocarcinoma

Neoplasia — MCQs

Neoplasia — MCQs

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