NEET-PG 2019 - Pathology Practice Questions

Q: Bellini duct cancer is seen in which of the following?

Kidney. ***Kidney*** - Bellini duct carcinoma is a **rare and aggressive subtype of renal cell carcinoma (RCC)**, originating from the collecting ducts of Bellini in the kidney. [1] - It accounts for a very small percentage of all RCCs and is characterized by a **poor prognosis**. *Liver* - The liver is affected by primary cancers like **hepatocellular carcinoma** and **cholangiocarcinoma**, or by metastatic disease, none of which arise from Bellini ducts. - Bellini ducts are structures **exclusive to the kidney**, not found in the liver. *Spleen* - Primary cancers of the spleen are **extremely rare**, with most malignant lesions being **lymphomas** or metastases. [2] - The spleen is a **lymphoid organ** and does not contain Bellini ducts. *Heart* - Primary cardiac tumors are uncommon, with the majority being **benign myxomas**. Malignant tumors include **sarcomas**. - The heart's anatomy is distinct and **does not contain any structures analogous to Bellini ducts**. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Kidney, pp. 959-961. [2] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Diseases of White Blood Cells, Lymph Nodes, Spleen, and Thymus, pp. 605-606.

Q: Which type of necrosis is characterized by deposition of immune complexes and fibrin in the walls of blood vessels?

Fibrinoid necrosis. ***Fibrinoid necrosis*** - This type of necrosis is classically associated with **immune-mediated vascular damage**, where antigen-antibody complexes are deposited in arterial walls [2]. - The microscopic appearance is characterized by bright pink, amorphous material composed of **fibrin and immune complexes**, giving a fibrin-like staining pattern [1]. *Liquefactive necrosis* - Characterized by the **dissolution of dead cells into a viscous liquid mass**, often seen in bacterial infections or brain infarcts. - The necrotic tissue is replaced by inflammatory cells and fluid, rather than immune complex deposits. *Coagulative necrosis* - Occurs due to **ischemia**, leading to protein denaturation and preservation of cell outlines for a period. - It does not involve the deposition of immune complexes or fibrin in vessel walls. *Caseous necrosis* - A form of coagulative necrosis associated with **tuberculosis**, characterized by a friable, "cheese-like" appearance. - It primarily involves granulomatous inflammation and macrophage accumulation, not immune complex deposition in blood vessels. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Diseases of Infancy and Childhood, pp. 514-518. [2] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Diseases of the Immune System, pp. 214-242.

Question 1

Which of the following is positive in Follicular lymphoma?

Accepted Answer

Bcl-2 protein

Answer

Cyclin D1 (Bcl-1)

Answer

Bcl-10 signaling protein

Answer

Bcl-6 transcription factor

Question 2

Bellini duct cancer is seen in which of the following?

Accepted Answer

Kidney

Answer

Liver

Answer

Spleen

Answer

Heart

Question 3

Which type of necrosis is characterized by deposition of immune complexes and fibrin in the walls of blood vessels?

Accepted Answer

Fibrinoid necrosis

Answer

Liquefactive necrosis

Answer

Coagulative necrosis

Answer

Caseous necrosis

NEET-PG 2019 — Pathology