Neoplasia Practice Questions

Q: Which of the following is NOT a feature of neoplastic cells?

Nuclear-to-cytoplasmic ratio of 1:4. **Explanation:** The hallmark of neoplastic cells, particularly malignant ones, is **anaplasia** (lack of differentiation) [1]. This manifests as several morphological changes in the nucleus and cytoplasm [1]. **Why Option D is the correct answer:** In normal, mature cells, the **Nuclear-to-Cytoplasmic (N:C) ratio** is typically **1:4 or 1:6**. In neoplastic cells, the nucleus enlarges significantly while the cytoplasm remains scanty, leading to an **increased N:C ratio**, often reaching **1:1**. Therefore, a ratio of 1:4 represents a normal cellular state, not a neoplastic one. **Analysis of Incorrect Options:** * **A. Hyperchromasia:** Neoplastic cells exhibit dark-staining nuclei due to an abundance of DNA and chromatin [1]. This is a classic feature of malignancy. * **B. Pleomorphism:** This refers to variation in the size and shape of both cells and nuclei [1]. It is a fundamental feature of anaplasia. * **C. Atypical mitoses:** While increased mitotic activity can occur in normal hyperplasia, the presence of **atypical (tripolar, quadripolar, or "bird’s eye") mitotic figures** is a highly specific indicator of malignancy [1]. **High-Yield Clinical Pearls for NEET-PG:** * **Most important criterion of malignancy:** Metastasis (except for Gliomas and Basal Cell Carcinoma). * **Most reliable morphological sign of malignancy:** Invasiveness (breaching the basement membrane). * **Anaplasia vs. Dysplasia:** Anaplasia is a lack of differentiation (often irreversible) [2], whereas dysplasia is disordered growth (potentially reversible if the stimulus is removed) [2]. * **Nucleoli:** Neoplastic cells often show prominent, large nucleoli due to active RNA synthesis. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Neoplasia, pp. 276-278. [2] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Neoplasia, pp. 278-280.

Q: Which of the following is NOT a specific tumor marker?

CEA. **Explanation:** The question asks for the marker that is **NOT** a specific tumor marker. In oncology, "specificity" refers to a marker's ability to pinpoint a particular cell type or malignancy. **Why CEA is the Correct Answer:** **Carcinoembryonic Antigen (CEA)** is a classic example of an **oncofetal antigen** [1]. It is highly **non-specific** because it can be elevated in a wide variety of conditions. While most commonly associated with colorectal carcinoma, it is also elevated in cancers of the pancreas, stomach, breast, and lung [2]. Crucially, it also rises in non-neoplastic conditions like heavy smoking, cirrhosis, and inflammatory bowel disease [1]. Therefore, CEA is primarily used for **monitoring treatment response and detecting recurrence**, rather than initial diagnosis [1]. **Analysis of Incorrect Options:** * **CD 99 (MIC2):** A highly specific marker for **Ewing’s Sarcoma** and Primitive Neuroectodermal Tumors (PNET). It shows a characteristic membranous staining pattern. * **HMB 45:** A specific monoclonal antibody used to identify **Melanoma**. It reacts against gp100, a protein found in melanosomes. * **Beta-globulin:** While broad, in the context of specific diagnostic pathology (like Beta-2 Microglobulin), it serves as a specific prognostic marker for **Multiple Myeloma** and certain lymphomas. **NEET-PG High-Yield Pearls:** * **Most specific marker for Prostate Cancer:** PSA (though it is organ-specific, not cancer-specific) [2]. * **Calretinin:** Most specific marker for **Mesothelioma**. * **Alpha-fetoprotein (AFP):** Elevated in Hepatocellular Carcinoma (HCC) and Yolk Sac Tumors [2]. * **S-100:** A sensitive but non-specific marker for melanoma, neural tumors, and chondroid tumors. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Neoplasia, pp. 319-320. [2] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Neoplasia, p. 346.

Question 1

An overproduction of tissue normal to a particular area is called as what?

Accepted Answer

Hamartoma

Answer

Tumor

Answer

Hyperplasia

Answer

Hypertrophy

Question 2

HMB 45 is a tumor marker for which of the following conditions?

Accepted Answer

Malignant melanoma

Answer

Neuroblastoma

Answer

Neurofibroma

Answer

Angiosarcoma

Question 3

Alcohol abuse is associated with an increased risk of all the following types of cancer EXCEPT?

Accepted Answer

Cervical

Answer

Breast

Answer

Esophageal

Answer

Liver

Question 4

Rosettes are characteristically seen in which of the following neoplasms?

Accepted Answer

Retinoblastoma

Answer

Dysgerminoma

Answer

Melanoma

Answer

Lymphoma

Question 5

Serum alpha-fetoprotein concentration is elevated in which of the following conditions?

Accepted Answer

All of the above

Answer

Hepatoma

Answer

Cirrhosis

Answer

Endodermal sinus tumor

Question 6

Pseudo-rosettes are characteristic findings in which of the following conditions?

Accepted Answer

Retinoblastoma

Answer

Ophthalmic nodosa

Answer

Phacolytic glaucoma

Answer

Trachoma

Question 7

Which of the following is NOT a feature of neoplastic cells?

Accepted Answer

Nuclear-to-cytoplasmic ratio of 1:4

Answer

Hyperchromasia

Answer

Pleomorphism

Answer

Atypical mitoses

Question 8

What is true regarding carcinoembryonic antigen (CEA)?

Accepted Answer

It increases in colon cancer associated with only liver metastasis.

Answer

It is a glycoprotein.

Answer

It helps in knowing recurrence after resection.

Answer

It is usually associated with malignancies of the GI tract.

Question 9

Chronic, increased exposure to ionizing radiation results in damage to cellular DNA. As a consequence, a protein that normally arrests the cell in the G1 phase of the cell cycle is absent. Subsequently, the cell transforms and acquires unregulated growth. The absent protein is most likely the product of which of the following genes?

Accepted Answer

p53

Answer

RAS

Answer

VHL

Answer

MYC

Question 10

Which of the following is NOT a specific tumor marker?

Accepted Answer

CEA

Answer

CD 99

Answer

HMB 45

Answer

beta-globulin

Neoplasia — MCQs

Neoplasia — MCQs

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