Neoplasia Practice Questions

Q: Which tumor marker is most commonly associated with lung and breast carcinoma?

CEA. ***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.

Q: Which of the following is a key characteristic of virus-induced tumor cells?

Loss of contact inhibition in cells. ***Loss of contact inhibition in cells*** - **Contact inhibition** is a critical regulatory mechanism in normal cells, where cell growth and division are arrested upon contact with neighboring cells, preventing uncontrolled proliferation. - Virus-induced tumor cells often lose this inhibition, leading to **uncontrolled proliferation** and the formation of multi-layered foci in culture, a hallmark of their transformed state. *Loss of orientation* - While transformed cells may exhibit **disorganized growth patterns**, the primary functional hallmark of oncogenic transformation relevant to tumor formation is the uncontrolled proliferation, not merely a loss of physical orientation. - Loss of orientation is a general characteristic of many cell types under various conditions and lacks the specificity as a key characteristic of virus-induced tumor cells. *Formation of microtumor cells* - The term "microtumor cells" is not a standard characteristic or recognized cellular phenomenon describing virus-induced transformation. - Virus-induced tumor cells are known for their **uncontrolled growth** and ability to form macroscopic tumors, not specifically for forming uniquely "micro" tumor cells. *Change in size of cells* - While transformed cells can exhibit changes in cell size and morphology (e.g., pleomorphism), this is a general characteristic of many pathological processes and is not as defining of virus-induced tumor cells as the loss of contact inhibition. - Changes in cell size can occur due to various factors, including stress or metabolic alterations, and are not unique to oncogenic transformation.

Q: Which protein is commonly referred to as the "master regulator of the cell cycle"?

TP53. ***RB*** - The **retinoblastoma protein (RB)** is widely recognized as the "governor of proliferation" as it regulates the cell cycle [1]. - It acts by **inhibiting cell division** and promoting differentiation, particularly at the G1/S checkpoint [1][2]. *Patched* - This protein primarily functions in the **Hedgehog signaling pathway** and is involved in **tumor suppression** but is not known as the "governor of proliferation." - Its role is more about **cell growth regulation** in specific contexts rather than general proliferation control. *APC* - The **adenomatous polyposis coli (APC)** protein is crucial in the **Wnt signaling pathway** and is involved in controlling cell adhesion and proliferation but is not termed as the "governor of proliferation." - It primarily functions as a **tumor suppressor**, particularly in colorectal cancers, rather than a general regulator of proliferation. *TP53* - The **TP53 protein** is known as the "guardian of the genome," mainly involved in responding to DNA damage and regulating the cell cycle, but not specifically as the "governor of proliferation." - Its primary role is in **apoptosis** and **DNA repair**, rather than directly controlling cell proliferation like RB. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Neoplasia, pp. 301-302. [2] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Neoplasia, pp. 300-301.

Q: Which tumor suppressor gene is associated with familial gastric cancer and lobular breast carcinoma?

CDH1. ***CDH1*** - The **CDH1** gene encodes for **E-cadherin**, a cell adhesion protein; mutations are strongly linked to **hereditary diffuse gastric cancer** and **lobular breast carcinoma**. - A germline mutation in **CDH1** significantly increases the lifetime risk for both these types of cancers. *RB (Retinoblastoma)* - The **RB gene** is a tumor suppressor gene primarily associated with **retinoblastoma** (a rare childhood eye cancer). - It is also implicated in other cancers like **osteosarcoma** and small cell lung cancer, but not directly familial gastric cancer or lobular breast carcinoma. *PTEN* - **PTEN** is a tumor suppressor gene associated with **Cowden syndrome**, which increases the risk of breast, thyroid, and endometrial cancers. - While it has broad tumor suppressor functions, it is not the primary gene associated with familial gastric cancer or lobular breast carcinoma. *APC* - The **APC gene** is a tumor suppressor gene famously associated with **familial adenomatous polyposis (FAP)**, which leads to numerous colon polyps and a high risk of colorectal cancer. - Mutations in APC are not characteristic of familial gastric cancer or lobular breast carcinoma.

Q: A 12-year-old child presented with a maxillary mass, which on further investigation showed the presence of a "starry sky appearance" in the biopsy. All of the following statements are true except:

More commonly seen in adults. ***More commonly seen in adults*** - Burkitt lymphoma predominantly occurs in children and young adolescents, especially in endemic forms associated with malaria [1]. - While it can appear in adults, its incidence is significantly lower compared to pediatric populations [1]. *This condition is due to c-Myc gene activation* - Burkitt lymphoma is characteristically associated with translocations involving the **c-Myc gene**, primarily t(8;14). - This genetic alteration leads to **uncontrolled cell proliferation**, a hallmark of the disease. *This is non-Hodgkin lymphoma* - Burkitt lymphoma is indeed classified as a **non-Hodgkin lymphoma**, arising from B-lymphoid cells [1]. - It is known for its aggressive behavior and association with the **"starry sky appearance"** seen on biopsy [1]. *Burkitt lymphoma* - The **starry sky appearance** is a classic histopathological feature of Burkitt lymphoma, indicating high proliferation rates [1]. - It commonly presents as a maxillary or abdominal mass in children, confirming its diagnosis in this scenario [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, pp. 605-606.

Q: What is the most common initial site for the spread of cancers?

Lymph Nodes. ***LN*** - Lymph nodes (LN) are the **primary site for metastatic spread** due to their role in filtering lymphatic fluid, making them a common initial site for cancer spread. - The presence of cancer cells in lymph nodes can indicate **lymphatic dissemination**, often correlating with advanced disease stages. *Brain* - While the **brain** can be affected by metastases, it is not the **commonest site** for initial spread of cancers compared to lymph nodes. - Metastasis to the brain typically occurs later in the disease process and is more common with certain cancers like melanoma or lung cancer. *Lungs* - The **lungs** are often involved in metastatic disease, but they are generally not the initial site of spread; rather, they serve as a common final destination for metastatic lesions [1]. - Lung involvement is usually detected in advanced cancer stages when multiple sites of metastasis have occurred. *Liver* - The **liver** is a common site for metastasis due to its extensive blood supply and involvement in circulation; however, it is not the first site where cancers typically spread [1]. - Liver metastases often arise later in the course of a malignancy and are usually a result of dissemination from other primary sites. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Neoplasia, p. 282.

Q: Which of the following statements about Psammoma bodies is false?

Seen in teratoma. ***Seen in teratoma*** - **Psammoma bodies** are not typically found in teratomas; they are more commonly associated with other tumors such as meningiomas and papillary thyroid carcinoma. - Teratomas usually consist of differentiated tissues from all three germ layers, and do not exhibit the characteristic **laminated** appearance of psammoma bodies. *Seen in meningioma* - **Meningiomas** are indeed associated with psammoma bodies, which appear as laminated calcified structures [1]. - These bodies signify **calcium deposition** and are a pathological feature of certain tumors, particularly **meningeal** tumors [1]. *Contains Calcium deposits* - Psammoma bodies are known for their **calcium deposits**, characterized by their laminated structure [1]. - They represent focal areas of calcification within tumors, particularly in conditions like **meningiomas** and **thyroid papillary carcinoma**. *Concentric whorled appearance* - Psammoma bodies display a **concentric** laminated appearance, often described as **whorled layers**. - This histopathological feature is a distinguishing characteristic of psammoma bodies in confirmed tumors. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Central Nervous System, pp. 1316-1317.

Question 1

Which tumor marker is most commonly associated with lung and breast carcinoma?

Accepted Answer

CEA

Answer

hCG

Answer

AFP

Answer

CA-15-3

Question 2

Which of the following is a key characteristic of virus-induced tumor cells?

Accepted Answer

Loss of contact inhibition in cells

Answer

Loss of orientation

Answer

Formation of microtumor cells

Answer

Change in size of cells

Question 3

What is the earliest change of neoplastic transformation observed at the microscopic level?

Accepted Answer

Dysplasia

Answer

Atypical Hyperplasia

Answer

Invasive Carcinoma

Answer

Squamous Metaplasia

Question 4

Which protein is commonly referred to as the "master regulator of the cell cycle"?

Accepted Answer

TP53

Answer

APC

Answer

Patched

Answer

RB

Question 5

Which tumor suppressor gene is associated with familial gastric cancer and lobular breast carcinoma?

Accepted Answer

CDH1

Answer

PTEN

Answer

APC

Answer

RB (Retinoblastoma)

Question 6

Carney triad consists of:

Accepted Answer

Gastric GIST, pulmonary chondroma, extra-adrenal paraganglioma

Answer

Gastric leiomyoma, pulmonary hamartoma, adrenal adenoma

Answer

Gastric adenocarcinoma, bronchial carcinoid, pheochromocytoma

Answer

Gastric lymphoma, pulmonary fibrosis, adrenal cortical carcinoma

Question 7

Familial retinoblastoma is characterized by which of the following statements?

Accepted Answer

Has autosomal dominant inheritance

Answer

Due to mutations in the RB1 gene

Answer

Less common than sporadic retinoblastoma

Answer

More commonly bilateral

Question 8

A 12-year-old child presented with a maxillary mass, which on further investigation showed the presence of a "starry sky appearance" in the biopsy. All of the following statements are true except:

Accepted Answer

More commonly seen in adults

Answer

This is non-Hodgkin lymphoma

Answer

This condition is due to c-Myc gene activation

Answer

This is Burkitt lymphoma

Question 9

What is the most common initial site for the spread of cancers?

Accepted Answer

Lymph Nodes

Answer

Liver

Answer

Lungs

Answer

Brain

Question 10

Which of the following statements about Psammoma bodies is false?

Accepted Answer

Seen in teratoma

Answer

Contains Calcium deposits

Answer

Concentric whorled appearance

Answer

Seen in meningioma

Neoplasia — MCQs

Neoplasia — MCQs

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