Neoplasia Practice Questions

Q: C-MYC translocation is seen in which of the following tumors?

Burkitt lymphoma. **Explanation:** **C-MYC** is a proto-oncogene located on chromosome 8 that encodes a transcription factor involved in cell cycle progression and apoptosis. 1. **Why Burkitt Lymphoma is correct:** Burkitt lymphoma is the classic example of a tumor driven by **C-MYC translocation** [1]. The most common translocation is **t(8;14)**, where the *MYC* gene on chromosome 8 is moved adjacent to the **Immunoglobulin Heavy Chain (IgH)** locus on chromosome 14 [1]. This leads to the constitutive over-expression of the MYC protein, resulting in rapid cellular proliferation and the characteristic "starry-sky" histological appearance. 2. **Why other options are incorrect:** * **Neuroblastoma:** This tumor is typically associated with **N-MYC amplification** (double minute chromosomes or HSRs), not C-MYC translocation. N-MYC amplification is a key prognostic marker in Neuroblastoma. * **Malignant Melanoma:** Often associated with mutations in **BRAF (V600E)** or **NRAS**, rather than MYC translocations. * **Breast Cancer:** Frequently involves the amplification of **HER2/neu (ERBB2)** or mutations in **BRCA1/2**, but C-MYC translocation is not a defining genetic feature. **High-Yield Clinical Pearls for NEET-PG:** * **Translocations in Burkitt Lymphoma:** While t(8;14) is most common (80%), variant translocations include **t(2;8)** [kappa light chain] and **t(8;22)** [lambda light chain] [1]. * **L-MYC:** Associated with Small Cell Carcinoma of the Lung. * **MYC Function:** It activates cyclins and downregulates p21 (a CDK inhibitor). * **Burkitt Lymphoma Triad:** EBV association, "Starry-sky" morphology, and t(8;14). **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Neoplasia, pp. 324-325.

Q: Cylindroma is classified as which of the following types of tumors?

Appendage tumor. **Explanation:** **Cylindroma** is a benign adnexal neoplasm, specifically classified as an **appendage tumor** of the skin [1]. It most commonly arises from the sweat glands (eccrine or apocrine differentiation). These tumors typically present as smooth, firm, dome-shaped nodules, most frequently on the scalp and forehead. When multiple cylindromas cover the scalp, they are clinically referred to as a **"Turban Tumor."** **Analysis of Options:** * **A. Appendage tumor (Correct):** Cylindromas are classic examples of skin appendage tumors [1]. Histologically, they show a characteristic **"jigsaw puzzle" appearance**, consisting of nests of epithelial cells surrounded by thick, eosinophilic, PAS-positive basement membrane material [1]. * **B. Acinic cell carcinoma:** This is a malignant salivary gland tumor, most commonly found in the parotid gland. While it may show a microcystic pattern, it is not an appendage tumor. * **C. Pleomorphic adenoma:** Also known as a "Mixed Tumor," this is the most common benign salivary gland tumor. It is characterized by a mix of epithelial and mesenchymal (mucoid, chondroid) elements. * **D. Warthin's tumor:** Also known as Papillary Cystadenoma Lymphomatosum, this is a benign salivary gland tumor almost exclusively found in the parotid gland, characterized by a double layer of oncocytic epithelium and a dense lymphoid stroma. **High-Yield Clinical Pearls for NEET-PG:** * **Genetics:** Multiple cylindromas are associated with **Brooke-Spiegler Syndrome**, caused by a mutation in the **CYLD gene** (a tumor suppressor gene on chromosome 16q). * **Histology Keyword:** Look for the **"Jigsaw puzzle"** pattern or "islands of cells fitted together" [1]. * **Clinical Keyword:** **"Turban tumor"** is a classic buzzword for extensive scalp involvement. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Skin, pp. 1154-1156.

Question 1

The MEN1 tumor suppressor gene is associated with all of the following, except:

Accepted Answer

GDNF (glial-derived neurotrophic factor)

Answer

Menin

Answer

JunD

Answer

KMT2A (MLL)

Question 2

Human papillomavirus 16 increases the risk of all the following conditions EXCEPT?

Accepted Answer

Endometroid adenocarcinoma

Answer

Cervical squamous cell cancer

Answer

Anal cancer

Answer

Oropharyngeal cancer

Question 3

Lymphoma is caused by all of the following viruses except?

Accepted Answer

HSV

Answer

HIV

Answer

EBV

Answer

HHV8

Question 4

C-MYC translocation is seen in which of the following tumors?

Accepted Answer

Burkitt lymphoma

Answer

Neuroblastoma

Answer

Malignant melanoma

Answer

Breast cancer

Question 5

Which of the following conditions is NOT associated with thymoma?

Accepted Answer

SIADH

Answer

Myasthenia gravis

Answer

Cushing's syndrome

Answer

Hypogammaglobulinemia

Question 6

Von Hippel-Lindau disease is associated with all of the following except?

Accepted Answer

Hemangioblastomas

Answer

Endolymphatic sac tumors

Answer

Pheochromocytoma

Answer

Islet cell tumors

Question 7

Cylindroma is classified as which of the following types of tumors?

Accepted Answer

Appendage tumor

Answer

Acinic cell carcinoma

Answer

Pleomorphic adenoma

Answer

Warthin's tumor

Question 8

Which of the following tumors is typically not seen in the first decade of life?

Accepted Answer

Ameloblastoma

Answer

Retinoblastoma

Answer

Rhabdomyosarcoma

Answer

Neuroblastoma

Question 9

Migratory thrombophlebitis is most commonly associated with which condition?

Accepted Answer

Pancreatic carcinoma

Answer

Colonic carcinoma

Answer

Nasopharyngeal carcinoma

Answer

Meningioma

Question 10

Colon carcinogenesis is associated with all of the following oncogenes/genes except:

Accepted Answer

None of the above

Answer

APC

Answer

kRAS

Answer

B-catenin

Neoplasia — MCQs

Neoplasia — MCQs

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