Neoplasia Practice Questions

Q: Which of the following parotid malignancies is known for perineural spread?

Adenoid cystic carcinoma. **Explanation:** **Adenoid Cystic Carcinoma (ACC)** is the correct answer because it is classically characterized by its high propensity for **perineural invasion (PNI)**. In the context of the parotid gland, the tumor cells tend to track along the facial nerve (CN VII), often leading to facial nerve palsy—a clinical hallmark that distinguishes it from benign lesions. Histologically, it presents with a "Swiss-cheese" (cribriform) pattern, and its ability to spread along nerve sheaths often results in recurrence and late distant metastasis, even years after surgery. **Analysis of Incorrect Options:** * **Pleomorphic Adenoma (A):** This is the most common benign salivary gland tumor. While it can recur if the capsule is breached during surgery, it does not exhibit perineural spread. * **Warthin’s Tumor (C):** Also known as Papillary Cystadenoma Lymphomatosum, this is a benign tumor strongly associated with smoking. It is typically found in the tail of the parotid and does not invade nerves. * **Ductal Papilloma (D):** This is a rare, benign epithelial tumor of the salivary ducts. It lacks the invasive characteristics required for perineural spread. **High-Yield Clinical Pearls for NEET-PG:** * **Most common site for ACC:** Submandibular gland (though it occurs in the parotid, it is the most common malignant tumor of the minor salivary glands) [1]. * **Histological Hallmark:** Cribriform pattern with "cylindromatous" appearance (basement membrane-like material in spaces). * **Clinical Sign:** Pain is a frequent early symptom in ACC due to its affinity for nerves. * **Prognosis:** Characterized by a "relentless" course; 5-year survival is good, but 10-20 year survival is poor due to late metastases (often to the lungs). **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Head and Neck, pp. 753-755.

Q: Which of the following oncogenic viruses has not been shown to be oncogenic in humans?

Adenovirus. **Explanation:** The correct answer is **Adenovirus**. While Adenoviruses (specifically types 12, 18, and 31) are highly oncogenic in laboratory animals (rodents) and can transform human cells in vitro, there is **no epidemiological or clinical evidence** linking them to naturally occurring cancers in humans. **Why the other options are incorrect:** * **Hepatitis B Virus (HBV):** A DNA virus strongly associated with **Hepatocellular Carcinoma (HCC)**. It integrates into the host genome and promotes oncogenesis through the HBx protein, which interferes with p53. * **Epstein-Barr Virus (EBV):** Known as the first human virus to be linked to cancer. It is associated with **Burkitt lymphoma**, Nasopharyngeal carcinoma, Hodgkin lymphoma, and B-cell lymphomas in immunocompromised patients. * **Herpes Simplex Type 2 (HSV-2):** While its role as a direct carcinogen is debated compared to HPV, it is historically considered a "co-factor" in the development of **Cervical Carcinoma**. It has demonstrated the ability to transform cells in experimental models and is classified among potentially oncogenic viruses in medical literature. **High-Yield Clinical Pearls for NEET-PG:** * **DNA Oncogenic Viruses:** HPV (16, 18), EBV, HBV, HHV-8 (Kaposi Sarcoma), and Merkel Cell Polyomavirus. * **RNA Oncogenic Viruses:** HTLV-1 (Adult T-cell Leukemia) and HCV (Hepatocellular Carcinoma). * **Mechanism:** Most DNA oncogenic viruses act by neutralizing tumor suppressor proteins like **p53** and **RB** (e.g., HPV E6 and E7 proteins). * **Adenovirus in Medicine:** Though not oncogenic in humans, it is a common cause of conjunctivitis, pharyngitis, and hemorrhagic cystitis.

Question 1

Which of the following parotid malignancies is known for perineural spread?

Accepted Answer

Adenoid cystic carcinoma

Answer

Pleomorphic adenoma

Answer

Warthin's tumor

Answer

Ductal papilloma

Question 2

A 54-year-old woman diagnosed with early-stage breast cancer undergoes lumpectomy. The pathology report confirms the early stage and notes significant desmoplasia in the surrounding tissue. What does the term desmoplasia refer to?

Accepted Answer

Proliferation of non-neoplastic fibrous connective tissue.

Answer

An irregular accumulation of blood vessels.

Answer

Scanty connective tissue causing the neoplasm to be soft and fleshy.

Answer

Normal tissue misplaced within another organ.

Question 3

A patient presents with a mediastinal mass showing sheets of epithelial cells with an arborizing pattern and positivity for keratin, interspersed with lymphoid cells. What is the most likely diagnosis?

Accepted Answer

Thymoma

Answer

Thymic carcinoid

Answer

Primary mediastinal lymphoma

Answer

Non-Hodgkin lymphoma

Question 4

Which among the following is a marker of carcinoma?

Accepted Answer

Cytokeratin

Answer

Vimentin

Answer

Calretinin

Answer

CD 45

Question 5

BRCA2 gene is associated with all of the following malignancies except?

Accepted Answer

Uterine cancer

Answer

Breast cancer in men

Answer

Breast cancer in women

Answer

Ovarian cancer

Question 6

BRCA1 gene is located on which chromosome?

Accepted Answer

Chromosome 17

Answer

Chromosome 13

Answer

Chromosome 11

Answer

Chromosome 22

Question 7

A patient with a known mutation in the RB gene is disease-free from Retinoblastoma. The patient is at highest risk of developing which of the following malignancies?

Accepted Answer

Osteosarcoma

Answer

Renal cell carcinoma

Answer

Pinealoblastoma

Answer

Chondrosarcoma

Question 8

An 8-year-old boy presented with a skin tumor on his left cheek. He had always avoided exposure to sunlight because it made his skin blister. His skin had scattered areas of hyperpigmentation. What is the most likely underlying defect?

Accepted Answer

Defective DNA repair

Answer

Thymidine dimers

Answer

Trinucleotide repeats

Answer

Sugar changes

Question 9

Which of the following is NOT associated with tumor suppressor gene dysfunction?

Accepted Answer

Multiple endocrine neoplasia

Answer

Breast cancers

Answer

Neurofibromatosis

Answer

Retinoblastoma

Question 10

Which of the following oncogenic viruses has not been shown to be oncogenic in humans?

Accepted Answer

Adenovirus

Answer

Hepatitis B virus

Answer

Epstein-Barr virus

Answer

Herpes simplex Type 2

Neoplasia — MCQs

Neoplasia — MCQs

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