Which of the following tumors is not derived from the meninges?
What is a Klatskin tumor?
In which organ are corpora amylacea typically observed in a pathological context?
What color is emitted by FITC after absorbing blue light?
Which of the following does not belong to the family of selectins?
In which type of Hodgkin's Lymphoma are lacunar cells typically observed?
What type of anaemia is primarily associated with leukaemia?
Which of the following is not typically seen in Disseminated Intravascular Coagulation (DIC)?
Which of the following statements about desmoid tumors is incorrect?
Which tumor marker is most commonly associated with lung and breast carcinoma?
NEET-PG 2012 - Pathology NEET-PG Practice Questions and MCQs
Question 31: Which of the following tumors is not derived from the meninges?
- A. Meningioma
- B. Hemangiopericytoma
- C. Schwannoma
- D. Hemangioblastoma (Correct Answer)
Explanation: ***Hemangioblastoma*** - This tumor is derived from **vascular endothelial cells and stromal cells**, not meningeal cells [1] - Typically found in the **cerebellum** and strongly associated with **von Hippel-Lindau disease** [1] - Has **no meningeal origin** and represents a distinct vascular neoplasm *Meningioma* - Derived from **arachnoidal cap cells** of the meninges [2] - Most common **benign primary intracranial tumor** arising from meningeal coverings [2] - Clearly of **meningeal origin** [3] *Schwannoma* - Originates from **Schwann cells** of peripheral nerve sheaths (neural crest origin) [4] - While not meningeal in origin, it commonly occurs **intracranially** affecting cranial nerves (especially CN VIII) [2] - Though also not meningeal, **hemangioblastoma is the better answer** as it's purely parenchymal/vascular, whereas schwannomas can have anatomic association with meninges [4] *Hemangiopericytoma* - Now classified as **solitary fibrous tumor/hemangiopericytoma** (WHO classification) - Arises from **meningeal pericytes** around blood vessels in the meninges - Despite mesenchymal origin, it is considered part of the **meningeal tumor spectrum** and has meningeal associations **References:** [1] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Manifestations Of Central And Peripheral Nervous System Disease, pp. 726-727. [2] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Manifestations Of Central And Peripheral Nervous System Disease, pp. 727-728. [3] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Central Nervous System, pp. 1316-1317. [4] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Peripheral Nerves and Skeletal Muscles, pp. 1248-1249.
Question 32: What is a Klatskin tumor?
- A. Fibrolamellar hepatocellular carcinoma
- B. Gall bladder carcinoma
- C. Hepatocellular carcinoma
- D. Hilar cholangiocarcinoma (Correct Answer)
Explanation: ***Nodular type of cholangiocarcinoma*** - Klatskin tumors are a specific form of **cholangiocarcinoma** occurring at the junction of the left and right hepatic bile ducts [1]. - These tumors are characterized by **biliary obstruction** and often present with **jaundice** as a prominent clinical feature. *Fibrolamellar hepatocellular carcinoma* - This is a variant of **hepatocellular carcinoma** known for its fibrous stroma, distinct from Klatskin tumors which arise from bile ducts. - **Fibrolamellar** is more common in younger patients and typically does not cause **biliary obstruction** characteristic of Klatskin tumors. *Gall bladder carcinoma* - Gall bladder carcinoma originates from the **gallbladder epithelium**, not the bile ducts, differentiating it from Klatskin tumors. - It may present with symptoms such as **abdominal pain** and **weight loss**, rather than the specific obstructive jaundice seen in Klatskin cases. *Hepatocellular carcinoma* - This cancer arises directly from hepatocytes and is unrelated to bile duct tumors like Klatskin tumors. - Commonly linked to **chronic liver disease** and liver cirrhosis, it does not typically present with **obstructive jaundice** as seen in cholangiocarcinomas [1]. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Liver and Gallbladder, pp. 880-881.
Question 33: In which organ are corpora amylacea typically observed in a pathological context?
- A. Thymus
- B. Lymph node
- C. Spleen
- D. Prostate (Correct Answer)
Explanation: ***Prostate*** - **Corpora amylacea**, also known as prostatic concretions, are common, benign findings in the prostate gland, especially with increasing age. - They are composed of glycoproteins and often found within the **acini and ducts of the prostate**. *Thymus* - The thymus is known for **Hassall's corpuscles**, which are epithelial reticular cells arranged concentrically, playing a role in T-cell selection. - **Corpora amylacea** are not typically found in the normal thymus. *Lymph node* - Lymph nodes are characterized by their lymphoid follicles, germinal centers, and medullary cords. - While they can have various inclusions or changes in disease states, **corpora amylacea** are not a typical pathological finding in lymph nodes. *Spleen* - The spleen is primarily involved in filtering blood and immune responses, with distinct red and white pulp regions. - **Corpora amylacea** are not associated with the normal or pathological histology of the spleen.
Question 34: What color is emitted by FITC after absorbing blue light?
- A. Yellow-green (Correct Answer)
- B. Orange-red
- C. Apple-green
- D. Golden-brown
Explanation: ***Yellow-green*** - Fluorescein isothiocyanate (FITC) is a common fluorochrome used in **fluorescence microscopy** and flow cytometry. - Upon excitation by blue light (typically around 495 nm), FITC emits light in the **yellow-green spectrum**, specifically around 521 nm. - This is the **spectroscopically accurate** description of FITC's emission peak. *Orange-red* - **Orange-red emission** is characteristic of fluorochromes like **phycoerythrin (PE)** or **Texas Red**, not FITC. - These fluorochromes have different **excitation and emission maxima** compared to FITC. *Apple-green* - While FITC fluorescence is sometimes clinically described as **"apple-green"** (especially in immunofluorescence), this is a **subjective visual description** rather than a precise spectral term. - The more **spectroscopically accurate** description is **yellow-green**, which reflects FITC's specific emission peak at 521 nm. - "Apple-green" typically suggests a purer green without the yellow component. *Golden-brown* - **Golden-brown** is not a typical emission color for fluorochromes like FITC. - This color is generally associated with **pigments** or stained tissues (e.g., lipofuscin, hemosiderin), not fluorescent probes.
Question 35: Which of the following does not belong to the family of selectins?
- A. P selectin
- B. L selectin
- C. A selectin (Correct Answer)
- D. E selectin
Explanation: ***A selectin*** - ***A selectin*** is not a recognized member of the selectin family, which includes other specific types. - The known selectins are **E-selectin**, **L-selectin**, and **P-selectin**, demonstrating a distinct classification [1]. *E selectin* - E selectin is a specific type of selectin expressed on **endothelial cells** activated by cytokines [1]. - It plays a crucial role in **leukocyte adhesion** during inflammation, distinguishing it as part of the selectin family [1]. *L selectin* - L selectin is involved in the **homing** of leukocytes to lymph nodes and forms part of the selectin family [1]. - Responsible for the initial tethering and rolling of leukocytes on **venular endothelium** [1]. *P selectin* - P selectin is found on platelets and endothelial cells and is critical in the **aggregation** of platelets and leukocytes. - It is also an established member of the selectin family, involved in **inflammatory responses** [1]. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Inflammation and Repair, p. 87.
Question 36: In which type of Hodgkin's Lymphoma are lacunar cells typically observed?
- A. Mixed cellularity type
- B. Lymphocyte predominant type
- C. Nodular Sclerosis type (Correct Answer)
- D. All of the options
Explanation: ***Nodular Sclerosis Type*** - **Lacunar cells** are characteristically seen in **Nodular Sclerosis Hodgkin lymphoma**, which is the most common subtype [1][3]. - These cells are large **Reed-Sternberg cells** with a distinctive morphology, typically found in **fibrous areas** of the lymph node [1]. *Mixed cellularity type* - This subtype is associated with a diverse cell population but does not primarily feature **lacunar cells** [2][4]. - It predominantly contains **Reed-Sternberg cells** without the specific morphology seen in nodular sclerosis [2]. *Lymphocyte predominant* - Lymphocyte predominant type mainly consists of **lymphocytes** with few Reed-Sternberg cells, and lacks **lacunar cells** [5]. - The histology is significantly different, exhibiting a more lymphocytic composition and not the classic lucent spaces [5]. *All of the above* - This option is incorrect as neither **Mixed cellularity** nor **Lymphocyte predominant** types contain **lacunar cells** [2][4][5]. - Lacunar cells are a distinctive feature solely of the **Nodular Sclerosis type** in Hodgkin lymphoma [1]. **References:** [1] 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, p. 616. [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. 616-618. [3] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Diseases Of The Urinary And Male Genital Tracts, pp. 558-559. [4] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Diseases Of The Urinary And Male Genital Tracts, pp. 559-560. [5] 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, p. 618.
Question 37: What type of anaemia is primarily associated with leukaemia?
- A. Aplastic anaemia
- B. Iron deficiency anaemia
- C. Megaloblastic anaemia
- D. Myelophthisic anaemia (Correct Answer)
Explanation: ***Myelophthisic anaemia*** - This condition arises from the **displacement of normal hematopoietic tissue** in the bone marrow by abnormal cells, like those seen in leukaemia, leading to **extramedullary hematopoiesis**. - Marrow infiltration causes **pancytopenia** and often results in the presence of **immature granulocytes** and **nucleated red blood cells** in the peripheral blood (leukoerythroblastosis). *Iron deficiency anaemia* - This type of anaemia is caused by insufficient iron for **hemoglobin synthesis**, often due to chronic blood loss or inadequate dietary intake. - While leukaemia patients can develop iron deficiency due to bleeding, it is not the **primary type of anaemia** directly resulting from the marrow infiltration by leukaemic cells. *Megaloblastic anaemia* - Characterized by the production of abnormally large, immature red blood cells, primarily due to **vitamin B12** or **folate deficiency**. - There is no direct causal link between leukaemia and the development of megaloblastic anaemia as a **primary haemato-pathological mechanism**. *Aplastic anaemia* - Characterized by **pancytopenia** due to bone marrow failure with hypocellular marrow, not marrow infiltration. - While both leukaemia and aplastic anaemia can present with cytopenias, aplastic anaemia shows a **hypocellular marrow** whereas leukaemia shows a **hypercellular marrow** with infiltration by malignant cells.
Question 38: Which of the following is not typically seen in Disseminated Intravascular Coagulation (DIC)?
- A. Thrombocytopenia
- B. PT elevation
- C. Fibrinogen decreased
- D. Normal aPTT (Correct Answer)
Explanation: ***Normal APTT*** - In Disseminated Intravascular Coagulation (**DIC**), **APTT** is typically **prolonged** due to consumption of clotting factors [1]. - The presence of normal APTT indicates that coagulation pathways are not significantly affected, which is contrary to what is seen in DIC. *Fibrinogen decreased* - **Decreased fibrinogen levels** are common in DIC, reflecting its consumption during the coagulation process [1]. - This depletion is linked to the increased clotting and is a hallmark of DIC, making this statement false in the context of the question. *Thrombocytopenia* - **Thrombocytopenia** occurs in DIC as platelets are consumed during the formation of microclots [1]. - A significant drop in platelet count is a key feature of DIC, therefore this statement does not align with the "except" clause. *PT elevation* - Prothrombin Time (**PT**) is usually **elevated** in DIC due to the consumption of clotting factors [1]. - This reflects the ongoing activation of the coagulation cascade, supporting the exclusion in the question context. **References:** [1] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Blood And Bone Marrow Disease, pp. 625-626.
Question 39: Which of the following statements about desmoid tumors is incorrect?
- A. Show infiltrative growth pattern
- B. Often seen below the umbilicus
- C. More common in women
- D. Highly radiosensitive (Correct Answer)
Explanation: ***Highly radiosensitive*** - This is the **INCORRECT** statement and hence the correct answer to this question. - Desmoid tumors are **radioresistant**, not radiosensitive, meaning they do not respond well to radiation therapy. - Radiation therapy is typically reserved for cases where surgery is not feasible or for local control after incomplete resection, but it is not highly effective as a standalone treatment. - The radioresistant nature is an important clinical characteristic that influences treatment planning. *Often seen below the umbilicus* - This statement is **correct** about desmoid tumors. - Desmoid tumors frequently arise from the **anterior abdominal wall**, with a common location being below the umbilicus, particularly in postpartum women. - Abdominal wall desmoids are strongly associated with **pregnancy** and trauma, and can be locally aggressive. *Show infiltrative growth pattern* - This statement is **correct** about desmoid tumors. [1] - Desmoid tumors are characterized by their **locally aggressive** and infiltrative growth pattern, often invading adjacent tissues like muscle, fascia, and neurovascular structures. [1] - This infiltrative nature makes complete surgical resection challenging and contributes to a high rate of **local recurrence** (up to 20-40% after surgery). - Despite their aggressive local behavior, desmoid tumors do not metastasize. *More common in women* - This statement is **correct** about desmoid tumors. - Desmoid tumors show a **female predominance**, particularly affecting women during their reproductive years (ages 25-40). - This gender predilection is linked to **hormonal influences**, with increased risk during **pregnancy** and the postpartum period. - The association with estrogen is further supported by occasional tumor regression after menopause. **References:** [1] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Osteoarticular And Connective Tissue Disease, pp. 691-692.
Question 40: Which tumor marker is most commonly associated with lung and breast carcinoma?
- A. CEA (Correct Answer)
- B. hCG
- C. AFP
- D. CA-15-3
Explanation: ***CEA*** - **Carcinoembryonic antigen (CEA)** is a tumor marker commonly associated with **lung** and **breast cancers** [1]. - Elevated levels of CEA are often observed in **various malignancies**, making it useful for monitoring treatment response and recurrence. *CA-15-3* - While **CA-15-3** is a breast cancer marker, it is less specific than CEA and often used primarily for **monitoring** but not for initial diagnosis. - It is primarily elevated in **breast carcinoma**, not typically associated with **lung cancer**. *11CG* - This ppears to be incorrectly referenced and may not exist as a recognized tumor marker for lung or breast cancer. - There are no clinical associations with lung or breast cancer, making it irrelevant in this context. *AFP* - **Alpha-fetoprotein (AFP)** is primarily associated with **liver** and **germ cell tumors**, not commonly associated with lung or breast cancers [1]. - Elevated AFP levels do not correlate with lung or breast carcinomas, distinguishing it from CEA's relevance. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Neoplasia, p. 346.