Neoplasia MCQs Quiz Questions And Answers

Invasion of surrounding tissue is most likely to indicate that the neoplasm is malignant. This finding suggests that the tumor has the ability to invade and spread into nearby tissues, which is a characteristic feature of malignant tumors. Atypia, increased nucleus to cytoplasmic ratio, necrosis, and pleomorphism are also features that can be seen in malignant tumors, but invasion of surrounding tissue is a more definitive indicator of malignancy.

The RB suppressor gene is most likely responsible for these eye and bone lesions. RB stands for retinoblastoma, which is a rare type of eye cancer that typically affects young children. The RB gene is a tumor suppressor gene that helps regulate cell growth and division. Mutations in this gene can lead to the development of retinoblastoma as well as other types of cancers, including osteosarcoma. Therefore, the presence of both eye and bone lesions in this patient suggests a mutation in the RB suppressor gene.

This question describes a scenario where a child is born with a single functional allele of a tumor suppressor gene. At the age of five, the remaining normal allele is lost through a point mutation. This loss of the tumor suppressor gene's function leads to the inability to halt the transition from G1 to the S phase of the cell cycle. Retinoblastoma is most likely to arise via this mechanism because it is a cancer that is commonly associated with mutations in the RB1 gene, which is a tumor suppressor gene involved in regulating the cell cycle.

Based on the information provided, the best interpretation for these neoplasms is that they are most likely well differentiated and localized. This is because the biopsies are designated as grade 1 and stage 1, which suggests that the neoplasms are well differentiated and have not spread beyond their original location.

The correct answer is Leiomyoma. A leiomyoma is a benign neoplasm of smooth muscle cells, commonly known as a fibroid. It is the most likely diagnosis in this case because the patient is asymptomatic and the mass has slowly increased in size over time. Leiomyomas are common in women of reproductive age and are frequently discovered incidentally during routine physical examinations. They are typically firm and palpable masses on the uterus. Metastatic tumors from the colon, adenocarcinoma, hematoma, and leiomyosarcoma would be less likely in this case, as they would typically present with different symptoms and clinical findings.

The correct answer is "Invasive squamous cell carcinoma, well differentiated." This is the best description of the lesion based on the information provided. The PAP smear showed atypical cells with a high nuclear-to-cytoplasmic ratio, hyperchromatic and pleomorphic nuclei, indicating abnormal cell growth. The biopsy confirmed the presence of malignant squamous cells invading the underlying stroma, and the presence of keratin pearls further supports the diagnosis of squamous cell carcinoma. The term "well differentiated" suggests that the tumor cells still retain some resemblance to normal squamous cells, indicating a less aggressive form of carcinoma.

The most likely diagnosis based on the clinical presentation and histologic examination is squamous cell carcinoma. The patient's risk factors, including a history of smoking and frequent consumption of hot tea, are associated with the development of squamous cell carcinoma of the esophagus. The ulcerated lesion seen on esophagoscopy and the histologic findings support this diagnosis. Barrett esophagus is characterized by metaplastic columnar epithelium in the distal esophagus, which is not consistent with the findings described. Carcinoma in situ refers to pre-invasive carcinoma and would not present as an ulcerated lesion. Squamous cell papilloma is a benign lesion and would not explain the patient's symptoms or histologic findings.

The presence of pigmented spots with irregular margins scattered over the body and small brown nodules in the irises suggests the possibility of neurofibromatosis type 1 (NF1). NF1 is a genetic disorder caused by mutations in the NF1 gene, which encodes for neurofibromin, a protein that negatively regulates the RAS-RAF-MAP-kinase pathway. In NF1, the loss of neurofibromin function leads to overactivation of this pathway, resulting in the development of various tumors and characteristic clinical features. Therefore, the RAS-RAF-MAP-kinase pathway is most likely affected in this case.

AFP (alpha-fetoprotein) is a tumor marker that is useful for monitoring recurrence of hepatocellular carcinoma following surgery. Elevated levels of AFP in the blood are associated with the presence of hepatocellular carcinoma. Therefore, monitoring AFP levels can help detect recurrence of the disease after surgery. CEA (carcinoembryonic antigen), CA-125, HCG (human chorionic gonadotropin), and PSA (prostate-specific antigen) are tumor markers that are associated with other types of cancer and would not be as useful for monitoring recurrence of hepatocellular carcinoma.

The most likely characteristic seen on the sample is cellular hyperplasia with glandular architecture. Fibroadenomas are benign breast tumors that are composed of both glandular and fibrous tissue. The presence of cellular hyperplasia indicates an increase in the number of cells in the glandular component, while the preservation of glandular architecture suggests that the cells are still organized in a normal pattern. This finding is consistent with fibroadenoma and helps to differentiate it from other breast masses, such as breast cancer.

Burkitt's lymphoma (or "Burkitt's tumor", Burkitt lymphoma or "malignant lymphoma, Burkitt's type") is a cancer of the lymphatic system (in particular, B lymphocytes).

The most common pathway for metastasis of this neoplasm is through the lymphatics. This is suggested by the presence of atypical, hyperchromatic squamous cells in the sputum cytology, which is indicative of a squamous cell carcinoma. Squamous cell carcinomas of the lung commonly spread through the lymphatic system to regional lymph nodes before spreading to distant sites. The absence of abnormal findings on physical examination and the presence of a right hilar mass on chest radiograph further support the possibility of lymphatic spread.

The most likely diagnosis in this case is urothelial carcinoma in situ. This is suggested by the patient's presentation with dysuria and intermittent hematuria, as well as the findings on cystoscopy of granular and hyperemic spots on the bladder mucosa. The histologic examination of the bladder mucosa confirms the diagnosis. Invasive urothelial carcinoma would typically present with intraluminal masses, which were not identified in this case. Acute cystitis would typically present with different symptoms and would not be associated with the findings on cystoscopy. Urothelial papilloma would typically present with a papillary growth pattern, which was not seen in this case.

Based on the information provided, the patient's father died of colorectal cancer at a relatively young age, suggesting a potential genetic component to the development of the disease. Adenomatosis polyposis coli (APC) gene mutations are associated with familial adenomatous polyposis (FAP), a condition characterized by the development of numerous polyps in the colon. FAP increases the risk of developing colorectal cancer at a young age, making the APC gene the most likely gene affected in this case.

The most likely genetic mechanism of the described pathologic condition is microsatellite instability due to defective mismatch repair. This is indicated by the presence of three small polyps in the cecum and a 3-cm ulcerated exophytic mass in the ascending colon. Microsatellite instability is commonly associated with hereditary nonpolyposis colorectal cancer (HNPCC) or Lynch syndrome, which is characterized by a defect in the DNA mismatch repair system. This defect leads to an accumulation of errors in DNA replication, resulting in the development of tumors.

The answer is D because the gross and microscopic appearance of the liver in the image shows multiple well-circumscribed nodules. This is indicative of metastatic liver lesions, suggesting that the primary pathologic process originated from another site in the body and spread to the liver.

The normal function of the protein that is altered in this condition is to facilitate DNA repair. This is evident from the fact that the patient developed a malignancy in both eyes, indicating a defect in DNA repair mechanisms. The protein that is altered is likely involved in repairing DNA damage, and its dysfunction leads to the development of malignancies. This explanation is supported by the fact that the patient was treated with radiation, which suggests that the DNA damage caused by the malignancy was attempted to be repaired through radiation therapy.

The elevated serum calcium levels in this patient can be best explained by ectopic production of PTH-related peptide. This peptide is produced by certain tumors, including squamous cell carcinoma of the lung, and acts similarly to parathyroid hormone (PTH). It increases the release of calcium from bones and reduces calcium excretion by the kidneys, leading to hypercalcemia. The other options, such as ectopic production of PTH, ACTH, or ADH, are not typically associated with squamous cell carcinoma of the lung. Metastatic deposits in bone can also cause hypercalcemia, but ectopic production of PTH-related peptide is a more likely explanation in this case.

Elevation of alpha-fetoprotein (AFP) would be confirmatory in this case. AFP is a serum marker that is typically elevated in certain types of cancer, including testicular cancer. The patient's presentation with dyspnea, hemoptysis, and an enlarged right testicle, along with the results of the chest x-ray and testicular biopsy, suggest the possibility of testicular cancer. An elevated AFP level would provide further evidence to support this diagnosis.