Neoplasia Practice Questions

Q: Which of the following malignancies shows rosette-shaped arrangement of cells in histology?

Ependymoma. The correct answer is **Ependymoma**. In pathology, "rosettes" refer to a circular or spoke-like arrangement of cells around a central point. Ependymomas are classic examples of tumors that exhibit two specific types of rosette patterns [1]: 1. **Perivascular Pseudorosettes:** Tumor cells are arranged around a blood vessel, separated by a fibrillary zone (most common and diagnostic) [1]. 2. **True Ependymal Rosettes:** Tumor cells are arranged around a central lumen or canal (resembling the neural tube) [1]. **Analysis of Incorrect Options:** * **A. Thecoma of the ovary:** These are sex cord-stromal tumors characterized by spindle-shaped cells with lipid-laden cytoplasm. They do not form rosettes. * **C. Neurofibroma:** These are peripheral nerve sheath tumors composed of a mixture of Schwann cells, fibroblasts, and perineural cells in a loose collagenous stroma (shredded-carrot appearance). They lack rosette formations. * **D. Lymphoma:** Histologically, lymphomas typically show a diffuse sheet-like infiltration of monomorphic lymphoid cells. They do not form organized architectural patterns like rosettes. **High-Yield Clinical Pearls for NEET-PG:** * **Homer-Wright Rosettes:** Characterized by a central fibrillar (neuropil) core without a lumen. Seen in **Neuroblastoma**, **Medulloblastoma**, and **Retinoblastoma**. * **Flexner-Wintersteiner Rosettes:** Characterized by a central lumen. Highly specific for **Retinoblastoma**. * **Ependymoma Location:** In children, they typically occur in the **fourth ventricle** (leading to hydrocephalus); in adults, they are most common in the **spinal cord**. [1] * **Rod-shaped Blepharoplasts:** Basal bodies of cilia seen on electron microscopy in Ependymomas. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Central Nervous System, pp. 1312-1313.

Q: Which of the following malignancies is associated with a BRAF gene mutation?

Melanoma. **Explanation:** **BRAF** is a proto-oncogene that encodes a serine/threonine protein kinase involved in the **MAPK/ERK signaling pathway**, which regulates cell growth and proliferation [1]. The most common mutation is **V600E** (substitution of valine by glutamic acid at codon 600). 1. **Why Melanoma is Correct:** Approximately **40-60% of cutaneous melanomas** harbor a BRAF mutation [1]. This mutation leads to constitutive activation of the downstream signaling pathway, driving uncontrolled melanocyte proliferation [1]. It is a critical therapeutic target; BRAF inhibitors like **Vemurafenib** and **Dabrafenib** are standard treatments for BRAF-mutant metastatic melanoma [1]. 2. **Why Other Options are Incorrect:** * **Breast Carcinoma:** Primarily associated with mutations in **BRCA1/BRCA2**, TP53, or amplification of **HER2/neu**. * **Osteosarcoma:** Characterized by complex karyotypes, most commonly involving mutations in tumor suppressor genes **RB1** (Retinoblastoma) and **TP53** (Li-Fraumeni syndrome). * **Prostate Carcinoma:** Frequently associated with **TMPRSS2-ERG** gene fusions and PTEN deletions, rather than BRAF mutations. **High-Yield Clinical Pearls for NEET-PG:** * **Other BRAF-associated tumors:** Papillary Thyroid Carcinoma (most common mutation), Hairy Cell Leukemia (nearly 100% frequency), and Colon Adenocarcinoma (indicates poor prognosis). * **Zebra Sign:** In Hairy Cell Leukemia, BRAF V600E is a diagnostic hallmark. * **Pathway:** BRAF is a part of the **RAS-RAF-MEK-ERK** pathway [1]. * **Therapeutic Note:** BRAF inhibitors are often combined with MEK inhibitors (e.g., Trametinib) to prevent acquired resistance. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Skin, pp. 1150-1153.

Question 1

Which of the following is an example of transplacental carcinogenesis?

Accepted Answer

Vaginal carcinoma

Answer

Pancreatic carcinoma

Answer

Colon carcinoma

Answer

Breast cancer

Question 2

According to WHO classification, which of the following is a nerve sheath tumor?

Accepted Answer

Schwannoma

Answer

Paraganglioma

Answer

Medulloblastoma

Answer

Astrocytoma

Question 3

Beta-2 microglobulin is used as a tumor marker for which of the following diseases?

Accepted Answer

Multiple myeloma

Answer

Acute lymphoblastic leukemia

Answer

Hairy cell leukemia

Answer

Lymphoplasmacytic lymphoma

Question 4

Maximum increase in alpha-fetoprotein is seen with which condition?

Accepted Answer

Hepatocellular carcinoma

Answer

Benign mature teratoma

Answer

Choriocarcinoma

Answer

Teratoma

Question 5

Which of the following malignancies shows rosette-shaped arrangement of cells in histology?

Accepted Answer

Ependymoma

Answer

Thecoma of the ovary

Answer

Neurofibroma

Answer

Lymphoma

Question 6

Low dietary fiber intake is related to which carcinoma?

Accepted Answer

Colon

Answer

Breast

Answer

Lung

Answer

Kidney

Question 7

Which of the following malignancies is associated with a BRAF gene mutation?

Accepted Answer

Melanoma

Answer

Breast carcinoma

Answer

Osteosarcoma

Answer

Prostate carcinoma

Question 8

Tumor-containing cells of all three germ layers are called?

Accepted Answer

Teratoma

Answer

Leiomyoma

Answer

Squamous cell carcinoma

Answer

Adenocarcinoma

Question 9

Burkitt's Lymphoma is associated with which of the following viruses?

Accepted Answer

EBV (Epstein-Barr Virus)

Answer

HTLV-1 (Human T-lymphotropic virus 1)

Answer

HHV-8 (Human herpesvirus 8)

Answer

Adenovirus

Question 10

Which of the following is NOT a tumor suppressor gene?

Accepted Answer

RAS

Answer

WT-1

Answer

Rb

Answer

p53

Neoplasia — MCQs

Neoplasia — MCQs

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