Reproductive Pathology Practice Questions

Q: What is the most common testicular tumor in the elderly?

Lymphoma. **Explanation:** In the context of testicular pathology, the patient's age is the most critical diagnostic clue. While germ cell tumors (GCTs) dominate in younger populations, **Lymphoma** (specifically Diffuse Large B-Cell Lymphoma) is the most common testicular malignancy in men aged **over 60**. It is often bilateral (synchronous or metachronous) and carries a poor prognosis due to its propensity for systemic spread. **Analysis of Options:** * **A. Seminoma:** This is the most common *primary germ cell tumor* overall, but it typically peaks between **30–40 years** of age. It is rare in the elderly. * **B. Spermatocytic Seminoma:** Now termed "Spermatocytic Tumor," this is a distinct entity from classic seminoma. While it occurs in older men (median age 50+), it is **extremely rare** compared to the incidence of testicular lymphoma. It is characterized by a lack of association with GCNIS and an excellent prognosis. * **C. Yolk Sac Tumor:** This is the most common testicular tumor in **infants and children** (up to 3 years). It is marked by elevated Alpha-Fetoprotein (AFP) and Schiller-Duval bodies. **High-Yield Clinical Pearls for NEET-PG:** * **Age-wise distribution:** * Infants: Yolk Sac Tumor. * 15–35 years: Mixed Germ Cell Tumors / Teratoma. * 30–40 years: Seminoma. * **>60 years: Lymphoma.** * Testicular lymphoma is the most common cause of a **bilateral** testicular mass in elderly men. * Unlike GCTs, lymphoma often involves the spermatic cord and epididymis.

Q: Corkscrew shaped endometrial glands are seen in which phase of the menstrual cycle?

Late secretory phase. **Explanation:** The morphology of the endometrial glands undergoes predictable changes under the influence of estrogen and progesterone. The correct answer is **Late secretory phase** because this phase is characterized by maximal glandular tortuosity [1]. 1. **Why Late Secretory Phase is correct:** Following ovulation, progesterone from the corpus luteum causes the endometrial glands to become increasingly coiled and dilated to maximize surface area for nutrient secretion. By the late secretory phase (days 20–28), these glands achieve a classic **"corkscrew" or "saw-tooth" appearance** [1]. The stroma also becomes edematous and undergoes a pre-decidual reaction. 2. **Why other options are incorrect:** * **Early/Late Proliferative Phase:** Under estrogen influence, glands are initially tubular, thin, and straight [1]. While they become slightly more coiled in the late proliferative phase, they remain narrow and lack the dramatic "corkscrew" morphology. * **Early Secretory Phase:** This phase is histologically defined by **sub-nuclear vacuoles** [1] (the first sign of ovulation). While the glands begin to coil, the prominent corkscrew shape is not yet fully developed. **High-Yield Pearls for NEET-PG:** * **Dating the Endometrium:** The most reliable sign of recent ovulation is the presence of sub-nuclear vacuoles (Day 16-17) [1]. * **Arias-Stella Reaction:** Hypersecretory glands with enlarged, hyperchromatic nuclei; seen in pregnancy (normal) or ectopic pregnancy. * **Chronic Endometritis:** Diagnosed by the presence of **Plasma Cells** in the endometrial stroma. * **Swiss-Cheese Appearance:** Characteristic of Cystic Glandular Hyperplasia (due to unopposed estrogen). **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Female Genital Tract, pp. 1011-1013.

Question 1

What is the most common site of metastasis for prostate cancer?

Accepted Answer

Lumbar spine

Answer

Skull

Answer

Femur

Answer

Sacrum

Question 2

A histopathological examination of an excision specimen from a lesion on the dorsal surface of the penis reveals a papillary lesion with clear vacuolization of epithelial cells on the surface and extension of the hyperplastic epithelium into the underlying tissue. What is the possible diagnosis?

Accepted Answer

Verrucous carcinoma

Answer

Bowen's disease

Answer

Erythroplasia of Queyrat

Answer

Condyloma acuminatum

Question 3

What is the most common testicular tumor in the elderly?

Accepted Answer

Lymphoma

Answer

Seminoma

Answer

Spermatocytic seminoma

Answer

Yolk sac tumor

Question 4

A 30-year-old female presents with a palpable mass in her left breast that has been steadily increasing in size over the past year. On examination, the mass is well-circumscribed, freely mobile, and measures approximately 5.7 cm in its greatest dimension. A core needle biopsy is performed. What is the most probable diagnosis?

Accepted Answer

Giant fibroadenoma

Answer

Fibroadenoma

Answer

Ductal Carcinoma In Situ (DCIS)

Answer

Intraductal papilloma

Question 5

Which of the following is NOT a tumor marker for testicular tumors?

Accepted Answer

CEA

Answer

HCG

Answer

AFP

Answer

Alpha 1 antitrypsin

Question 6

Corkscrew shaped endometrial glands are seen in which phase of the menstrual cycle?

Accepted Answer

Late secretory phase

Answer

Early proliferative phase

Answer

Late proliferative phase

Answer

Early secretory phase

Question 7

Reinke crystalloids can be seen in which of the following sex cord-stromal tumors?

Accepted Answer

Leydig cell tumor

Answer

Granulosa cell tumor

Answer

Gonadoblastoma

Answer

Thecoma

Question 8

Which tumor typically presents with a grape-like cluster appearance and consistency?

Accepted Answer

Embryonal rhabdomyosarcoma

Answer

Embryonal cell carcinoma

Answer

Adenocarcinoma

Answer

Clear cell carcinoma

Question 9

What is the first histological sign of ovulation?

Accepted Answer

Subnuclear vacuoles and pseudostratification in the basal portion of glandular epithelium.

Answer

Vacuoles at the apical portion of secretory nonciliated cells.

Answer

Cessation of glandular cell mitosis.

Answer

Absent glycoprotein in secretory non-ciliated cells.

Question 10

Which of the following is NOT true about atrophic testis?

Accepted Answer

Leydig cell hypoplasia

Answer

Lymphocyte infiltration

Answer

Small size

Answer

Normal Sertoli cells

Reproductive Pathology — MCQs

Reproductive Pathology — MCQs

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