Neoplasia Practice Questions

Q: Which of the following is NOT a characteristic of breast papilloma?

Regular polarized gland pattern. **Explanation:** The core concept in differentiating benign from malignant breast lesions is the preservation of the **dual cell layer**. **Why Option D is the Correct Answer:** A **"Regular polarized gland pattern"** is a hallmark of **well-differentiated adenocarcinoma** (malignancy), not benign papilloma. In benign lesions like intraductal papilloma, the architecture consists of branching fibrovascular cores covered by two layers of cells (epithelial and myoepithelial) [1]. The growth is often complex and crowded, lacking the organized, uniform, and polarized glandular arrangement seen in low-grade carcinomas. **Analysis of Incorrect Options:** * **A. Myoepithelial cells present:** This is a defining feature of benign breast lesions. The presence of a basal myoepithelial layer (highlighted by p63 or SMA stains) excludes malignancy [1]. * **B. Apocrine metaplasia:** This is a common reactive change seen in benign breast conditions, including papillomas and fibrocystic changes. Its presence strongly favors a benign diagnosis. * **C. Hyperplasia of adjacent ducts:** Intraductal papillomas are frequently associated with other proliferative breast changes, such as usual ductal hyperplasia (UDH) in the surrounding terminal duct lobular units. **High-Yield NEET-PG Pearls:** * **Clinical Presentation:** Intraductal papilloma is the most common cause of **bloody nipple discharge**. * **Location:** Solitary papillomas are usually **subareolar** (large ducts), while multiple papillomas are peripheral and carry a higher risk of subsequent carcinoma. * **Key Diagnostic Marker:** Loss of the myoepithelial layer is the "gold standard" for diagnosing invasive carcinoma. **References:** [1] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Liver And Biliary System Disease, pp. 446-447.

Q: Which of the following is the best example of a proto-oncogene activated by point mutation?

Ras. **Explanation:** **Correct Answer: A. Ras** The **Ras gene family** (H-ras, K-ras, N-ras) is the most common example of a proto-oncogene activated by **point mutations**. In its normal state, Ras flips between an active (GTP-bound) and inactive (GDP-bound) state. A single point mutation (most commonly at codons 12, 13, or 61) interferes with GTP hydrolysis, trapping Ras in a permanent "on" position. This leads to continuous mitogenic signaling to the nucleus. **Why the other options are incorrect:** * **B & C. N-myc and L-myc:** These members of the *myc* family are typically activated by **gene amplification** (increased copy number), not point mutations [1]. *N-myc* amplification is a classic prognostic marker in Neuroblastoma, while *L-myc* is associated with Small Cell Carcinoma of the lung. * **D. Abl:** The *c-Abl* proto-oncogene is activated by **balanced translocation**, specifically t(9;22), which forms the BCR-ABL fusion protein (Philadelphia chromosome) characteristic of Chronic Myeloid Leukemia (CML) [1], [2]. **High-Yield Clinical Pearls for NEET-PG:** * **K-ras mutations** are highly associated with **Pancreatic adenocarcinoma** (90%) and Colon cancer. * **H-ras mutations** are linked to Bladder tumors. * **N-ras mutations** are frequently seen in Melanomas and Hematologic malignancies. * **Mechanism Summary:** Ras activation = Point mutation; Myc activation = Amplification/Translocation; Abl activation = Translocation. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Neoplasia, p. 292. [2] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Neoplasia, pp. 295-296.

Question 1

A malignant tumor of childhood that metastasizes to bone most often is:

Accepted Answer

Neuroblastoma

Answer

Wilms' tumor

Answer

Adrenal gland tumor

Answer

Granulosa cell tumor of ovary

Question 2

Infantile polycythemia is seen in which of the following conditions?

Accepted Answer

Cerebellar hemangioma

Answer

Retinoblastoma

Answer

Hepatoblastoma

Answer

All of the above

Question 3

What is the wasting syndrome associated with cancer?

Accepted Answer

Cachexia

Answer

Achalasia

Answer

Atelectasis

Answer

Cacogeusia

Question 4

Which of the following is NOT a characteristic of breast papilloma?

Accepted Answer

Regular polarized gland pattern

Answer

Myoepithelial cells present

Answer

Apocrine metaplasia is seen

Answer

Hyperplasia of adjacent ducts

Question 5

Which of the following oncogenes functions as a growth factor?

Accepted Answer

sis

Answer

fos

Answer

myc

Answer

jun

Question 6

Which of the following sites are predisposed to carcinoma due to smoking?

Accepted Answer

Bladder, Buccal mucosa, Stomach

Answer

Bladder, Buccal mucosa, Breast

Answer

Bladder, Ovary, Breast

Answer

Ovary, Buccal mucosa, Stomach

Question 7

Somatic mutation E17K in the PH domain of the AKT-1 gene is associated with which type of cancer?

Accepted Answer

Breast cancer

Answer

Stomach cancer

Answer

Ovarian cancer

Answer

Pancreatic cancer

Question 8

All are malignant tumors, except:

Accepted Answer

Fibromatosis

Answer

Chloroma

Answer

Askin's tumor

Answer

Liposarcoma

Question 9

Which of the following is the best example of a proto-oncogene activated by point mutation?

Accepted Answer

Ras

Answer

N-myc

Answer

L-myc

Answer

Abl

Question 10

A 3-year-old boy is admitted to the hospital with signs of acute renal failure. Radiologic studies reveal that the boy has bilateral masses involving both kidneys. Examination of biopsy material confirms the diagnosis of Wilms tumor. Which of the following gene mutations is the most common in Wilms tumor?

Accepted Answer

The gene responsible for WT1

Answer

The gene responsible for HGF

Answer

The gene responsible for VEGF

Answer

The gene responsible for GDNF

Neoplasia — MCQs

Neoplasia — MCQs

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