Reproductive Pathology Practice Questions

Q: Which breast cancer type is characterized by the single file pattern?

Infiltrating lobular. **Explanation:** The characteristic **"single file pattern"** (also known as Indian filing) is the hallmark histological feature of **Infiltrating Lobular Carcinoma (ILC)** [1]. **1. Why Infiltrating Lobular Carcinoma is correct:** The underlying molecular defect in ILC is the **loss of E-cadherin expression** (due to mutations in the *CDH1* gene). E-cadherin is a cell-surface adhesion molecule responsible for keeping epithelial cells glued together. Without it, the tumor cells lose their cohesiveness and cannot form tubules or solid nests. Instead, they migrate through the stroma individually, lining up one behind the other in a "single file" arrangement [1]. **2. Why other options are incorrect:** * **Intraductal (DCIS):** This is a non-invasive cancer where malignant cells are confined within the basement membrane of the ducts. They typically form patterns like solid, comedo, or cribriform (sieve-like), but not single files. * **Infiltrating Ductular (IDC-NOS):** This is the most common type of breast cancer. Because E-cadherin is preserved, the cells remain cohesive and typically form nests, cords, or gland-like structures. **High-Yield Clinical Pearls for NEET-PG:** * **Targetoid Pattern:** ILC cells often arrange themselves concentrically around normal ducts, resembling a "bullseye" [1]. * **Bilateral/Multicentric:** ILC has a higher tendency to be bilateral and multifocal compared to ductal carcinoma [1]. * **Signet Ring Cells:** A variant of ILC can show signet ring morphology (mucin pushing the nucleus to the periphery) [1]. * **Metastasis:** ILC has a unique metastatic profile, often spreading to the peritoneum, leptomeninges, and ovaries (Krukenberg tumor). **References:** [1] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Liver And Biliary System Disease, pp. 454-455.

Q: Schiller-Duval bodies are characteristic findings in which of the following conditions?

Endodermal sinus tumor (Yolk sac tumor). **Explanation:** **Schiller-Duval bodies** are the pathognomonic histological hallmark of **Endodermal Sinus Tumor (Yolk Sac Tumor)**. These structures consist of a central capillary surrounded by a layer of visceral and parietal cells, mimicking a primitive glomerulus. 1. **Why Option A is Correct:** Yolk sac tumors are the most common germ cell tumors in children [1]. They characteristically produce **Alpha-Fetoprotein (AFP)**. On microscopy, the presence of Schiller-Duval bodies confirms the diagnosis. These tumors also show eosinophilic, PAS-positive hyaline droplets [1]. 2. **Why Other Options are Incorrect:** * **Choriocarcinoma:** Characterized by the proliferation of cytotrophoblasts and syncytiotrophoblasts without villi [1]. It is associated with markedly elevated **hCG** levels. * **Granulosa Cell Tumor:** Known for **Call-Exner bodies** (small follicles filled with eosinophilic material) and "coffee-bean" nuclei. These tumors secrete estrogen. * **Sertoli-Leydig Cell Tumor:** Characterized by tubules lined by Sertoli cells and nests of Leydig cells containing **Reinke crystals**. These are androgen-secreting tumors leading to virilization. **NEET-PG High-Yield Pearls:** * **Yolk Sac Tumor Marker:** AFP (used for diagnosis and monitoring recurrence). * **Most common site:** Ovary (females) and Testis (infants/young boys) [1]. * **Histology Tip:** If you see "glomeruloid-like structures" in a germ cell tumor context, always think Schiller-Duval bodies. * **Immunohistochemistry (IHC):** Positive for Glypican-3 and AFP. **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.

Question 1

Signet-ring cells are characteristically found in which type of breast cancer?

Accepted Answer

Invasive lobular carcinoma

Answer

Papillary carcinoma

Answer

Tubular carcinoma

Answer

Invasive ductal carcinoma

Question 2

In Pseudomyxoma Peritonei, mucinous cyst adenocarcinoma most commonly arises from which of the following organs?

Accepted Answer

Ovary

Answer

Pancreas

Answer

Kidney

Answer

Abdominal testis

Question 3

Pseudomyxoma peritonei most commonly occurs in association with which of the following conditions?

Accepted Answer

Mucinous cystadenocarcinoma of the ovary

Answer

Carcinoma of the endometrium

Answer

Ovarian dermoid

Answer

Fibroid uterus

Question 4

Which breast cancer type is characterized by the single file pattern?

Accepted Answer

Infiltrating lobular

Answer

Intraductal

Answer

Infiltrating ductular

Answer

All of the above

Question 5

Schiller-Duval bodies are characteristic findings in which of the following conditions?

Accepted Answer

Endodermal sinus tumor (Yolk sac tumor)

Answer

Choriocarcinoma

Answer

Granulosa cell tumor

Answer

Sertoli-Leydig cell tumor (Arrhenoblastoma)

Question 6

What are the predisposing features for germ cell tumors?

Accepted Answer

All of the above

Answer

Cryptorchidism

Answer

Testicular feminizing syndrome

Answer

Klinefelter's syndrome

Question 7

A 40-year-old woman presented with severe abdominal pain, fever, and nausea. Explorative laparotomy revealed a purple-red tumor on the uterus with a fishy odor. Careful examination showed that some large veins on the tumor were thrombosed. What is the possible diagnosis?

Accepted Answer

Red degeneration of a myoma

Answer

Sarcomatous change in a pre-existing myoma

Answer

Fatty degeneration of a myoma

Answer

Hyaline degeneration of a myoma

Question 8

What is the percentage of cystic glandular hyperplasia that progresses to malignancy?

Accepted Answer

1%

Answer

0.10%

Answer

2%

Answer

10%

Question 9

Which of the following statements is true about seminoma of the testis?

Accepted Answer

It commonly occurs in the 6th decade

Answer

An undescended testis is more liable to develop this tumor

Answer

Histologically it resembles dysgerminoma of the ovary

Answer

It is radioresistant

Question 10

Syncitiotrophoblast is seen in which of the following conditions?

Accepted Answer

Choriocarcinoma

Answer

Partial mole

Answer

Complete mole

Answer

Placental site of trophoblastic tumor

Reproductive Pathology — MCQs

Reproductive Pathology — MCQs

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