Neoplasia Practice Questions

Q: Which of the following statements about MALToma is true?

H. Pylori infection is a known risk factor. ***H. Pylori infection is a risk factor*** - MALToma, or **mucosa-associated lymphoid tissue lymphoma**, is often associated with chronic **H. Pylori infection**, making it a significant risk factor [1]. - **Eradication of H. Pylori** can lead to regression of MALT lymphoma, further supporting the association. *They are a type of T cell lymphoma* - MALToma is classified as a **B-cell lymphoma**, primarily arising from **marginal zone B cells** [1]. - T-cell lymphomas differ significantly in their **pathophysiology** and typical clinical presentations. *They are secondary gastric lymphomas* - MALTomas typically arise **primarily** in the gastric mucosa rather than as secondary lymphomas from another site [1]. - Secondary lymphomas are usually related to more aggressive forms and are often associated with **systemic involvement**. *Commonly seen in gastric cardia* - MALTomas are most frequently found in the **stomach** but are not specifically concentrated in the **gastric cardia** region. - They can also manifest in other areas such as the **antrum**, making this statement misleading. **References:** [1] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Alimentary System Disease, pp. 356-358.

Q: Which viral proteins are known to act as carcinogens in causing carcinoma cervix?

E - gene. ***E - gene*** - The **E - gene** in human papillomavirus (HPV) is known to play a crucial role in the **transformation of cervical cells**, leading to cancer development [1]. - Specifically, the **E6 and E7 proteins** encoded by this gene interfere with tumor suppressor functions, contributing to cervical carcinoma [1,2]. *L - gene* - The **L - gene** is associated with the virus's structural proteins, primarily aiding in the formation of the viral capsid. - It does not have a direct role in the oncogenic process leading to cervical cancer. *H - gene* - The **H - gene** is not specifically linked to the oncogenic effects of HPV; it is not recognized for contributing to cancer development. - It is often confused in discussions but doesn't directly influence the carcinogenic pathway like the E gene does. *P 24 - gene* - The **P 24 - gene** is not related to HPV; instead, it is associated with **HIV** and its structural components. - This gene does not play any role in the development of cervical carcinoma or transformation of cervical cells. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Female Genital Tract, pp. 1006-1007. [2] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Neoplasia, pp. 334-335.

Q: Which of the following markers is specific for gastro-intestinal stromal tumor (GIST)?

CD117. ***CD 117*** - CD 117 (c-KIT) is the **primary marker** for gastrointestinal stromal tumors (GIST), indicating the presence of the **c-KIT gene mutation** [1]. - Its expression is crucial for diagnosing GISTs, as it is found in nearly all cases of these tumors. *CD 34* - While CD 34 is expressed in some GISTs, it is a **more general marker** associated with stem cells and not specific for GISTs. - GISTs can be negative for CD 34, making it unsuitable for definitive diagnosis. *S-100* - S-100 is typically a marker for **melanocytes** and neuroectodermal tumors, not for GISTs. - It is often used to identify **schwannomas** or **melanomas**, which are unrelated to GIST pathology. *CD 23* - CD 23 is primarily a marker for **chronic lymphocytic leukemia (CLL)** and some forms of lymphoma, not associated with GISTs. - Its presence indicates **lymphoid** lineage, further diverging from GISTs, which are **mesenchymal tumors**. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Gastrointestinal Tract, pp. 782-783.

Q: Which histological type of lung cancer is most commonly associated with metastasis?

Small cell carcinoma. ***Squamous cell CA*** - Known for its **aggressive nature** and propensity to metastasize, particularly in later stages. - Typically arises in the **central part of the lungs**, often associated with smoking and leads to local invasion and distant spread. *Alveolar-carcinoma* - Rarely found and tends to be **less aggressive** compared to squamous cell carcinoma. - Usually has a more localized effect without the same potential for widespread metastasis. *Small cell carcinoma* - Although it is **highly metastatic**, it is less common than squamous cell carcinoma in terms of overall lung cancer incidence. - Characterized by its rapid growth and early metastasis [1], but mostly associated with a specific subtype of lung cancer cases. *Adenocarcinoma* - Generally presents as a **peripheral lung lesion** and has **less propensity for early metastasis** compared to squamous cell carcinoma. - More common in non-smokers and tends to have a less aggressive metastatic pattern. **References:** [1] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Respiratory Tract Disease, pp. 337-338.

Q: Which of the following is a good prognostic factor in neuroblastomas?

Hyperdiploidy. ***Hyperdiploidy*** - An increased number of chromosomes (hyperdiploidy) (more than diploid, typically triploid or tetraploid) is associated with a **favorable outcome** in neuroblastoma, particularly in infants [1]. - This chromosomal characteristic indicates a less aggressive tumor biology and often correlates with better response to treatment and **higher survival rates** [1]. *N-myc amplification* - Amplification of the **N-myc oncogene** is a strong indicator of **poor prognosis** in neuroblastoma, leading to rapid tumor progression and resistance to therapy [1]. - It is associated with **advanced disease stage** and is a key factor in risk stratification for treatment intensity [1]. *RAS oncogene* - While mutations in the **RAS oncogene** are found in various cancers, their specific prognostic significance in neuroblastoma is less consistently favorable than hyperdiploidy. - RAS mutations can sometimes be associated with **tumor resistance** to certain therapies. *Translocations* - **Chromosomal translocations** in general are often associated with oncogenesis and can have variable prognostic implications depending on the specific genes involved. - In neuroblastoma, specific translocations are generally not considered a good prognostic factor; instead, they can sometimes be linked to **aggressive disease** [1]. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Diseases of Infancy and Childhood, pp. 486-487.

Q: Which chromosomal translocation is associated with follicular thyroid carcinoma?

PAX8 - PPARγ. ***PAX8 - PPARγ*** - The **PAX8-PPARγ fusion oncogene** is a well-established molecular marker directly associated with **follicular thyroid carcinoma (FTC)**. - This translocation leads to the expression of a fusion protein that contributes to **thyroid cell proliferation** and **tumorigenesis**. *ALK - NPM1* - The **ALK-NPM1 fusion** is primarily observed in some types of **anaplastic large cell lymphoma**, not thyroid cancers. - This translocation typically results in an **activated anaplastic lymphoma kinase (ALK)**, driving lymphoproliferation. *ETV6 - NTRK3* - The **ETV6-NTRK3 rearrangement** is characteristic of **secretory carcinoma** (formerly mammary analogue secretory carcinoma), often affecting salivary glands, and is not a common finding in thyroid malignancies. - This fusion leads to the activation of the **NTRK3 receptor tyrosine kinase**, involved in cell growth and survival. *RET - PTC1* - The **RET-PTC1 rearrangement (RET/papillary thyroid carcinoma 1)** is specifically associated with **papillary thyroid carcinoma (PTC)**, which is histologically distinct from follicular thyroid carcinoma. - This fusion activates the **RET proto-oncogene**, promoting cell proliferation and survival in papillary thyroid cancer.

Q: Most common lung cancer in non-smokers is:

Adenocarcinoma. ***Adenocarcinoma*** - **Adenocarcinoma** is the most common type of lung cancer found in non-smokers, often associated with peripheral lung nodules. - This subtype has a rising incidence rate, particularly among women and younger individuals, often linked to factors like **environmental exposures** or **genetics**. *None of the above* - This option is incorrect since adenocarcinoma is a recognized **primary lung cancer** type in non-smokers. - The statement does not address the specific cancer types and neglects to acknowledge the commonality of adenocarcinoma. *Squamous cell carcinoma* - Generally associated with smoking [1,2] and presents centrally in the lungs, making it less common among non-smokers. - Often linked to **cavitary lesions** [1] and associated with **hypercalcemia** due to parathyroid hormone-related peptide secretion. *Oat cell carcinoma* - Also known as small cell lung cancer (SCLC), is primarily linked to smoking and has a **very aggressive** nature. - Typically arises in the central airways and is associated with **paraneoplastic syndromes**, which are not relevant to the non-smoker context. **References:** [1] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Respiratory Tract Disease, pp. 336-337. [2] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Lung, pp. 720-721.

Question 1

Which of the following statements about MALToma is true?

Accepted Answer

H. Pylori infection is a known risk factor

Answer

They are primary gastric lymphomas

Answer

They are a type of T cell lymphoma

Answer

Exclusively seen in the gastric antrum

Question 2

Which of the following is NOT a recognized cause of Urothelial Carcinomas?

Accepted Answer

Alcohol consumption

Answer

Industrial solvents

Answer

Exposure to thorotrast

Answer

Smoking

Question 3

Which viral proteins are known to act as carcinogens in causing carcinoma cervix?

Accepted Answer

E - gene

Answer

P 24 - gene

Answer

L - gene

Answer

H - gene

Question 4

Which of the following markers is specific for gastro-intestinal stromal tumor (GIST)?

Accepted Answer

CD117

Answer

CD34

Answer

CD23

Answer

S-100

Question 5

Which histological type of lung cancer is most commonly associated with metastasis?

Accepted Answer

Small cell carcinoma

Answer

Squamous cell carcinoma

Answer

Adenocarcinoma

Answer

Large cell carcinoma

Question 6

Which of the following is a good prognostic factor in neuroblastomas?

Accepted Answer

Hyperdiploidy

Answer

N-myc amplification

Answer

RAS oncogene

Answer

Translocations

Question 7

Which chromosomal translocation is associated with follicular thyroid carcinoma?

Accepted Answer

PAX8 - PPARγ

Answer

ALK - NPM1

Answer

ETV6 - NTRK3

Answer

RET - PTC1

Question 8

Which substance plays a significant role in the tumor metastasis cascade?

Accepted Answer

MMP-2 (Matrix Metalloproteinase-2)

Answer

TNF-alpha

Answer

CD99

Answer

NM23

Question 9

Which of the following has tumor promoting effect?

Accepted Answer

MYC

Answer

BRCA

Answer

RB

Answer

p16

Question 10

Most common lung cancer in non-smokers is:

Accepted Answer

Adenocarcinoma

Answer

Squamous cell carcinoma

Answer

Oat cell carcinoma

Answer

Large cell carcinoma

Neoplasia — MCQs

Neoplasia — MCQs

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