Neoplasia Practice Questions

Q: Which one of the following is NOT associated with BRCA1/BRCA2 genes?

Liver cancer. ***Liver cancer*** - **BRCA1/BRCA2 mutations** are primarily associated with an increased risk of breast, ovarian, and prostate cancers, but not typically with **liver cancer**. - While liver cancer does have genetic predispositions, they are generally linked to other genes and environmental factors like chronic viral hepatitis or alcohol abuse. *Ovarian cancer* - **BRCA1/BRCA2 gene mutations** significantly increase the risk of developing **hereditary ovarian cancer**, particularly serous ovarian carcinoma [2]. - Individuals with these mutations often undergo prophylactic oophorectomy to reduce their risk [2]. *Prostate cancer* - **BRCA1/BRCA2 mutations**, especially **BRCA2**, are associated with an increased risk of developing **prostate cancer**, often an aggressive form, particularly in younger men. - Screening guidelines for men with BRCA mutations may include earlier and more frequent PSA testing. *Breast cancer* - **BRCA1 and BRCA2 genes** are tumor suppressor genes, and mutations in these genes are the most common cause of **hereditary breast cancer** [1], [2]. - Individuals with BRCA mutations have a significantly higher lifetime risk of developing breast cancer, and often have a higher incidence of bilateral breast cancer [2]. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Breast, p. 1058. [2] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Breast, pp. 1058-1059.

Q: In which of the following is the term low and high grade squamous intraepithelial neoplasia used?

Bethesda classification. ***Bethesda classification*** - The Bethesda classification system is used for reporting **cervical cytology** results (Pap test) [1]. - It categorizes squamous cell abnormalities into **low-grade squamous intraepithelial lesion (LSIL)** and **high-grade squamous intraepithelial lesion (HSIL)** [1]. *Shaw's classification* - **Shaw's classification** is not a recognized system for reporting cervical cytopathology. - This term does not apply to the categorization of squamous intraepithelial neoplasia. *FIGO staging* - **FIGO (International Federation of Gynecology and Obstetrics) staging** is used for the clinical staging of **gynecologic cancers**, not for initial cytological screening results [1]. - It describes the extent of cancer progression, not intraepithelial lesions. *Papanicolaou method* - The **Papanicolaou (Pap) method** refers to the staining technique and the general cytological test for cervical cancer screening [1]. - While it's the test itself, the **interpretation and reporting** of results, including terms like LSIL and HSIL, fall under the Bethesda classification system [1]. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Female Genital Tract, pp. 1006-1010.

Q: Which one of the following is not an epithelial tumour of the ovary?

Endodermal sinus tumour. ***Endodermal sinus tumour*** - This is a type of **germ cell tumor** of the ovary, not an epithelial tumor. - It is characterized by the presence of **Schiller-Duval bodies** and elevated **alpha-fetoprotein (AFP)** levels. *Clear cell tumour* - This is a well-recognized sub-type of **epithelial ovarian cancer**, often associated with **endometriosis** [1]. - The histology typically shows cells with clear cytoplasm, sometimes arranged in glandular or tubulocystic patterns [1]. *Serous cystadenoma* - This is a common **benign epithelial tumor** of the ovary, characterized by cysts lined by serous epithelium [2]. - It arises from the **surface epithelium** of the ovary. *Brenner's tumour* - This is a less common but distinct type of **epithelial ovarian tumor**, characterized by nests of **transitional epithelial cells** resembling bladder urothelium [3]. - It is usually **benign** and often discovered incidentally [3]. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Female Genital Tract, p. 1032. [2] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Female Genital Tract Disease, pp. 478-480. [3] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Female Genital Tract, pp. 1032-1033.

Q: Presence of signet-ring cells in a cellular or myxomatous stroma is diagnostic of:

Krukenberg tumour. ***Krukenberg tumour*** - **Krukenberg tumours** are characterized by mucin-filled **signet-ring cells** within a fibrous or myxomatous stroma. [1] - They represent metastatic adenocarcinomas, commonly originating from the **gastrointestinal tract**, particularly the stomach. [1] *Gynandroblastoma* - This is a rare **sex cord-stromal tumour** of the ovary that contains both female **(granulosa/theca cells)** and male **(Sertoli/Leydig cells)** components. - It does not typically feature signet-ring cells. *Hilus cell tumour* - **Hilus cell tumours** are **Leydig cell tumours** found in the ovarian hilum, characterized by cells containing **Reinke crystals**. - These tumours are associated with **androgen production** and virilization, and do not contain signet-ring cells. *Struma ovarii* - **Struma ovarii** is a specialized form of **ovarian teratoma** in which **thyroid tissue** is the predominant component (more than 50%). - While it can be functional and cause hyperthyroidism, it is not characterized by the presence of signet-ring cells. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Gastrointestinal Tract, p. 779.

Q: Which of the following statements regarding Paget's disease of nipple are correct? 1. It represents benign pathology of nipple areola complex 2. It is eczema like condition of nipple and areola 3. Erosion of nipple is seen 4. Nipple biopsy is required for definitive diagnosis Select the correct answer using the code given below:

2, 3 and 4. ***2, 3 and 4*** - **Paget's disease** presents as an **eczema-like rash** on the nipple and areola, and is characterized by **nipple erosion** [1] and ulceration. - It is an **intraepithelial adenocarcinoma** of the nipple [1], and a definitive diagnosis requires a **nipple biopsy** [1] to identify Paget's cells [2]. *2 and 4 only* - This option is incomplete as it misses the important clinical feature of **nipple erosion**, which is a common presentation of Paget's disease. - While it correctly identifies the eczema-like appearance and the need for biopsy, it understates the full clinical picture. *1, 2 and 3* - Statement 1 is incorrect because Paget's disease of the nipple is a **malignant condition** [2], not a benign one. - It arises from **ductal carcinoma in situ** [1] or invasive breast cancer extending to the nipple epidermis. *1, 3 and 4* - Statement 1 is incorrect as **Paget's disease is malignant**, representing an underlying breast cancer [2], not a benign pathology. - This option incorrectly classifies the disease as benign, which is a critical misunderstanding of its nature. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Breast, pp. 1061-1062. [2] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Liver And Biliary System Disease, pp. 456-457.

Q: Which of the statements regarding Salivary gland neoplasms are correct? 1. 80–90% of parotid tumors are benign 2. 90% of sublingual gland tumors are malignant 3. 60–70% of submandibular gland tumors are benign 4. Parotid gland is most common site for salivary gland tumors Select the correct answer using the code given below:

1, 2 and 3. ***1, 2 and 3*** - The statement that **80–90% of parotid tumors are benign** is correct; pleomorphic adenoma is the most common benign tumor, and approximately 80% of parotid tumors are benign [1]. - The statement that **90% of sublingual gland tumors are malignant** is correct; sublingual gland tumors have the highest malignancy rate (70-90%) among major salivary glands [1]. - The statement that **60–70% of submandibular gland tumors are benign** is correct; approximately 50-65% of submandibular tumors are benign [1]. - Statement 4, while factually accurate that the parotid is the most common site, when combined with the other three statements may create ambiguity in the context of this specific question stem [1]. *2, 3 and 4* - This option incorrectly excludes statement 1, which accurately reflects that **80–90% of parotid tumors are benign** [1]. - While statements 2, 3, and 4 are individually correct, omitting the well-established benign predominance of parotid tumors makes this combination incomplete. *1, 2 and 4* - This option incorrectly excludes statement 3 about **submandibular gland tumors**, which correctly states that 60–70% are benign [1]. - The submandibular gland malignancy rate is an important epidemiological fact that should not be omitted. *1, 3 and 4* - This option incorrectly excludes statement 2 about **sublingual gland tumors having 90% malignancy** [1]. - The high malignancy rate of sublingual tumors is a crucial high-yield fact for salivary gland pathology. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Head and Neck, pp. 750-755.

Question 1

The malignancy associated with Stewart-Treves syndrome is

Accepted Answer

Lymphangiosarcoma

Answer

Basal cell carcinoma

Answer

Liposarcoma

Answer

Malignant melanoma

Question 2

Which one of the following is NOT associated with BRCA1/BRCA2 genes?

Accepted Answer

Liver cancer

Answer

Ovarian cancer

Answer

Prostate cancer

Answer

Breast cancer

Question 3

In which of the following is the term low and high grade squamous intraepithelial neoplasia used?

Accepted Answer

Bethesda classification

Answer

Shaw's classification

Answer

FIGO staging

Answer

Papanicolaou method

Question 4

Which one of the following is not an epithelial tumour of the ovary?

Accepted Answer

Endodermal sinus tumour

Answer

Clear cell tumour

Answer

Serous cystadenoma

Answer

Brenner’s tumour

Question 5

Which of the following pairs is not correctly matched?

Accepted Answer

Sister Joseph’s nodule ……… Solitary secondary deposit in the liver

Answer

Krukenberg tumour ……… Peritoneal seeding involving ovaries

Answer

Virchow’s node ……… Palpable node in left supraclavicular space

Answer

Blumer’s shelf ……… Secondary deposits in pelvic cul-de-sac

Question 6

Presence of signet-ring cells in a cellular or myxomatous stroma is diagnostic of:

Accepted Answer

Krukenberg tumour

Answer

Gynandroblastoma

Answer

Hilus cell tumour

Answer

Struma ovarii

Question 7

Match List-I with List-II and select the correct answer using the code given below the Lists:

Accepted Answer

A→4  B→1  C→2  D→3

Answer

A→3  B→2  C→1  D→4

Answer

A→3  B→1  C→2  D→4

Answer

A→4  B→2  C→1  D→3

Question 8

Which of the following statements regarding Paget's disease of nipple are correct?

1. It represents benign pathology of nipple areola complex
2. It is eczema like condition of nipple and areola
3. Erosion of nipple is seen
4. Nipple biopsy is required for definitive diagnosis

Select the correct answer using the code given below:

Accepted Answer

2, 3 and 4

Answer

2 and 4 only

Answer

1, 2 and 3

Answer

1, 3 and 4

Question 9

No increased relative risk of invasive breast carcinoma based on histopathological examination of benign breast tissue is for all of the following EXCEPT:

Accepted Answer

Solitary papilloma of lactiferous sinus

Answer

Squamous metaplasia

Answer

Usual ductal hyperplasia

Answer

Periductal mastitis

Question 10

Which of the statements regarding Salivary gland neoplasms are correct?

1. 80–90% of parotid tumors are benign
2. 90% of sublingual gland tumors are malignant
3. 60–70% of submandibular gland tumors are benign
4. Parotid gland is most common site for salivary gland tumors

Select the correct answer using the code given below:

Accepted Answer

1, 2 and 3

Answer

1, 3 and 4

Answer

2, 3 and 4

Answer

1, 2 and 4

Neoplasia — MCQs

Neoplasia — MCQs

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