Neoplasia Practice Questions

Q: Histopathological examination reveals the diagnosis as:

Hodgkin lymphoma. ***Hodgkin lymphoma*** - Characterized by the presence of **Reed-Sternberg cells** with **owl-eye nucleoli** and **binucleated giant cells**. - The classic histopathological appearance includes a **mixed inflammatory infiltrate** surrounding the characteristic malignant cells. *Ewing sarcoma* - Shows **small round blue cells** with **uniform nuclear morphology** and **high nuclear-to-cytoplasmic ratio**. - Typically positive for **CD99** immunostain and lacks the characteristic giant cells seen in lymphomas. *Kaposi Sarcoma* - Demonstrates **spindle cells** arranged in **fascicles** with **slit-like vascular spaces**. - Associated with **HHV-8 infection** and shows **extravasated red blood cells** with **hemosiderin deposits**. *Burkitt lymphoma* - Exhibits a **starry-sky pattern** due to **scattered tingible body macrophages** among uniform lymphoid cells. - Composed of **monomorphic medium-sized B cells** with **multiple nucleoli** and high mitotic activity.

Q: Endodermal sinus tumor is associated with which of the following?

Schiller-Duval bodies. **Explanation:** **Endodermal Sinus Tumor (Yolk Sac Tumor)** is the most common germ cell tumor in children [1]. The hallmark histological feature of this tumor is the **Schiller-Duval body**. 1. **Why Option A is Correct:** A Schiller-Duval body consists of a central capillary surrounded by visceral and parietal layers of neoplastic cells within a space, resembling a primitive glomerulus. This structure is pathognomonic for Yolk Sac Tumors. Additionally, these tumors characteristically produce **Alpha-Fetoprotein (AFP)**, which serves as a vital serum marker for diagnosis and monitoring. 2. **Why Other Options are Incorrect:** * **B. Multinucleate giant cells:** These are typically seen in granulomatous inflammation (e.g., Tuberculosis) or specific tumors like Choriocarcinoma (Syncytiotrophoblasts) and Giant Cell Tumor of the bone [2]. * **C. R-S cells (Reed-Sternberg cells):** These are the diagnostic "owl-eye" cells found in **Hodgkin Lymphoma**, not germ cell tumors. * **D. Plasma cells:** These are mature B-lymphocytes seen in chronic inflammation and **Multiple Myeloma** (Fried-egg appearance/Clock-face chromatin). **High-Yield Clinical Pearls for NEET-PG:** * **Serum Marker:** Elevated **AFP** is the most significant biochemical finding. * **Histology:** Look for **intracytoplasmic hyaline droplets** (PAS-positive) in addition to Schiller-Duval bodies. * **Age Group:** It is the most common testicular tumor in infants and young children (under 3 years) [1]. * **Ovarian counterpart:** In females, it presents as a rapidly growing, painful pelvic mass, usually in young women. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Lower Urinary Tract and Male Genital System, pp. 979-980. [2] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Lower Urinary Tract and Male Genital System, pp. 980-982.

Q: A patient complains of epigastric pain that fails to respond to antacids. Endoscopy demonstrates an ulcerated mass on the greater curvature of the stomach. Genetic studies on the tumor demonstrate an altered DCC gene. Which of the following tumor suppressor genes is found on the same chromosome as DCC?

DPC. **Explanation:** The question tests your knowledge of tumor suppressor gene (TSG) chromosomal locations. The **DCC gene** (Deleted in Colorectal Carcinoma) is located on **Chromosome 18q**. **1. Why DPC is correct:** The **DPC4 gene** (Deleted in Pancreatic Carcinoma, also known as **SMAD4**) is also located on **Chromosome 18q**. Both genes are frequently mutated or deleted in gastrointestinal malignancies. While DCC is classically associated with colorectal cancer (and occasionally gastric cancer, as seen in this clinical vignette), DPC4/SMAD4 is a critical marker for pancreatic adenocarcinoma and juvenile polyposis syndrome. **2. Why other options are incorrect:** * **BRCA-1:** Located on **Chromosome 17q**. It is associated with hereditary breast and ovarian cancer. * **NF-1 (Neurofibromin):** Located on **Chromosome 17q**. Mutation leads to Neurofibromatosis Type 1 (von Recklinghausen disease). * **NF-2 (Merlin):** Located on **Chromosome 22q**. Mutation leads to Neurofibromatosis Type 2 (bilateral acoustic neuromas). **Clinical Pearls for NEET-PG:** * **Mnemonic for Chromosome 18:** Remember "**18** is **D**eleted in **D**PC and **D**CC" (The 3 Ds). * **SMAD4/DPC4** is a signaling transducer for the TGF-β pathway; its loss leads to unchecked cellular proliferation. * **Chromosome 17** is a high-yield "hotspot" containing **TP53** (17p), **NF-1** (17q), and **BRCA-1** (17q). * **Chromosome 13** contains **RB1** and **BRCA-2**. * **Chromosome 5** contains **APC** (Adenomatous Polyposis Coli). **Clinical Presentation Note:** Gastric adenocarcinomas may present as an ulcerated tumor [1], with common symptoms including dyspepsia and epigastric pain [1]. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Gastrointestinal Tract, pp. 779-781.

Question 1

In a patient with non-Hodgkin B cell lymphoma, a nuclear gene is actively transcribed to mRNA and transported to the cytoplasm, where a protein is translated. This process is associated with up-regulation of BCL2. In a control group without lymphoma, translation of this mRNA does not occur. How is the silencing of this active gene's mRNA most likely to occur?

Accepted Answer

Binding to microRNA (miRNA)

Answer

Absence of transfer RNA (tRNA)

Answer

Methylation of DNA

Answer

Mutation of messenger RNA (mRNA)

Question 2

Which type of cancer is most commonly associated with radiation exposure?

Accepted Answer

Leukemia

Answer

Bronchogenic carcinoma

Answer

Thyroid carcinoma

Answer

Breast cancer

Question 3

Histopathological examination reveals the diagnosis as:

Accepted Answer

Hodgkin lymphoma

Answer

Ewing sarcoma

Answer

Kaposi Sarcoma

Answer

Burkitt lymphoma

Question 4

Which type of breast carcinoma is characterized by a pushing border?

Accepted Answer

Medullary carcinoma

Answer

Invasive ductal carcinoma

Answer

Invasive lobular carcinoma

Answer

Mucinous carcinoma

Question 5

In Wilms tumor, which of the following leads to emergence of resistance to chemotherapy?

Accepted Answer

Anaplasia

Answer

Nephrogenic rests

Answer

Monoblastic morphology

Answer

Capsular infiltration

Question 6

Endodermal sinus tumor is associated with which of the following?

Accepted Answer

Schiller-Duval bodies

Answer

Multinucleate giant cells

Answer

R-S cells

Answer

Plasma cells

Question 7

Which of the following immunohistochemical markers is positive in neuroendocrine tumors?

Accepted Answer

Synaptophysin

Answer

Cytokeratin

Answer

Calretinin

Answer

GEAP

Question 8

S100 is a marker of which of the following?

Accepted Answer

All of the above

Answer

Melanoma

Answer

Schwannoma

Answer

Histiocytoma

Question 9

What is the most common extragonadal site for germ cell tumors?

Accepted Answer

Mediastinum

Answer

Retroperitoneum

Answer

Sacrococcygeal region

Answer

Pineal gland

Question 10

A patient complains of epigastric pain that fails to respond to antacids. Endoscopy demonstrates an ulcerated mass on the greater curvature of the stomach. Genetic studies on the tumor demonstrate an altered DCC gene. Which of the following tumor suppressor genes is found on the same chromosome as DCC?

Accepted Answer

DPC

Answer

BRCA-1

Answer

NF-1

Answer

NF-2

Neoplasia — MCQs

Neoplasia — MCQs

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