Reproductive Pathology Practice Questions

Q: Ovarian tumors commonly arise from which part of the ovary?

Surface epithelium. **Explanation:** Ovarian tumors are classified based on the cell of origin. The **surface epithelium** (modified mesothelium) is the most common source, accounting for approximately **65–70% of all ovarian tumors** and nearly **90% of all malignant ovarian cancers**. **1. Why Surface Epithelium is Correct:** The surface epithelium undergoes repeated rupture and repair during ovulation. This constant cellular proliferation, combined with the entrapment of epithelial cells into the ovarian stroma (forming inclusion cysts), increases the risk of malignant transformation. Common subtypes include Serous, Mucinous, Endometrioid, and Clear cell tumors. **2. Why Other Options are Incorrect:** * **Germ Cells (Option B):** These arise from the oocytes. While they are the most common ovarian tumors in children and adolescents (e.g., Teratoma, Dysgerminoma), they account for only about 15–20% of all ovarian tumors. * **Stroma of the Ovary (Option C):** Also known as Sex Cord-Stromal tumors (e.g., Fibroma, Granulosa cell tumor, Sertoli-Leydig cell tumor), these arise from the connective tissue or hormone-producing cells. They are relatively rare, accounting for about 5–10% of cases. **High-Yield Clinical Pearls for NEET-PG:** * **Most common benign tumor:** Mature Cystic Teratoma (Dermoid cyst). * **Most common malignant tumor:** Serous Cystadenocarcinoma. * **Most common bilateral tumor:** Serous Cystadenoma/carcinoma. * **Tumor Marker:** CA-125 is the classic marker for epithelial ovarian tumors (especially serous), though it is non-specific. * **Risk Factor:** Nulliparity and early menarche/late menopause increase risk due to "incessant ovulation." Combined Oral Contraceptive Pills (COCPs) are protective.

Q: All of the following are sex-cord tumors, EXCEPT:

Dysgerminoma. **Explanation:** The classification of ovarian tumors is based on the cell of origin. Ovarian tumors are broadly divided into Surface Epithelial tumors, Germ Cell tumors, and Sex Cord-Stromal tumors. **Why Dysgerminoma is the correct answer:** **Dysgerminoma** is a **Germ Cell Tumor (GCT)**, not a sex-cord tumor. It is the most common malignant germ cell tumor of the ovary and is the female counterpart of the testicular seminoma. It typically occurs in young women (2nd and 3rd decades) and is associated with markers like LDH and occasionally hCG. **Analysis of Incorrect Options (Sex Cord-Stromal Tumors):** * **Granulosa cell tumor:** The most common malignant sex cord-stromal tumor. It is known for producing **Estrogen**, leading to precocious puberty in children or postmenopausal bleeding in adults. Histologically, it shows **Call-Exner bodies**. * **Sertoli-Leydig cell tumor:** Also known as Arrhenoblastoma, these are virilizing tumors that produce **Androgens**, leading to hirsutism and defeminization. * **Gynandroblastoma:** A very rare sex cord-stromal tumor that contains a mixture of both Granulosa-Sertoli and Leydig cell components. **NEET-PG High-Yield Pearls:** * **Most common ovarian tumor overall:** Serous Cystadenoma (Surface epithelial). * **Most common Germ Cell Tumor:** Benign Cystic Teratoma (Dermoid cyst). * **Tumor Marker for Dysgerminoma:** **LDH** (highly specific). * **Schiller-Duval bodies:** Pathognomonic for Yolk Sac Tumor (Endodermal Sinus Tumor). * **Reinke Crystals:** Characteristic of Leydig cell tumors. * **Psammoma bodies:** Seen in Serous Cystadenocarcinoma.

Q: What is the most common ovarian tumor in individuals less than 20 years old?

Germ cell tumor. **Explanation:** The distribution of ovarian tumors varies significantly with age. In children and adolescents (individuals <20 years old), **Germ cell tumors (GCTs)** are the most common category, accounting for approximately 60–70% of all ovarian neoplasms in this age group. This is because the ovaries in younger individuals are physiologically dominated by oocytes rather than the surface epithelium. While most GCTs in this demographic are benign (e.g., Mature Cystic Teratoma), the risk of malignancy is higher than in adults; roughly 1/3rd of GCTs in girls under 20 are malignant. **Analysis of Incorrect Options:** * **A. Epithelial tumors:** These are the most common ovarian tumors in **postmenopausal women** and the general population (accounting for 90% of all ovarian cancers). They are rare before puberty. * **C. Metastatic tumors:** Also known as Krukenberg tumors (when from the GI tract), these are more common in older adults and are rarely the primary presentation in adolescents. * **D. Sex cord-stromal tumors:** These (e.g., Granulosa cell tumors) represent only about 5–10% of all ovarian tumors and can occur at any age, but they are far less frequent than GCTs in the under-20 age group. **High-Yield Clinical Pearls for NEET-PG:** * **Most common benign GCT:** Mature Cystic Teratoma (Dermoid cyst). * **Most common malignant GCT:** Dysgerminoma (associated with LDH as a marker). * **Tumor Marker Association:** Always check AFP (Endodermal sinus tumor) and hCG (Choriocarcinoma) in young patients with adnexal masses. * **Management:** In young patients, fertility-sparing surgery (unilateral salpingo-oophorectomy) is the standard of care for malignant GCTs, as they are highly chemosensitive.

Question 1

Which of the following are predisposing factors for Testicular germ cell tumor?

Accepted Answer

Klinefelter's syndrome

Answer

Cryptorchidism

Answer

Testicular feminization syndrome

Answer

Radiation

Question 2

A 4-year-old girl is brought to the physician by her parents who report seeing blood in the child's urine. A CT scan reveals a neoplasm of the urinary bladder. Which of the following is the most likely diagnosis?

Accepted Answer

Embryonal rhabdomyosarcoma

Answer

Angiosarcoma

Answer

Leiomyosarcoma

Answer

Liposarcoma

Question 3

A 60-year-old woman presents with a large breast mass that she first detected 3 months ago. Mammography reveals a well-circumscribed mass measuring 8 cm in diameter. A breast biopsy shows loose fibroconnective tissue with a sarcomatous stroma, abundant mitoses, and nodules and ridges lined by cuboidal epithelial cells. What is the most likely diagnosis?

Accepted Answer

Phyllodes tumor

Answer

Fibroadenoma

Answer

Medullary carcinoma

Answer

Paget disease

Question 4

Which of the following is NOT a testicular tumor marker?

Accepted Answer

CA-125

Answer

Alpha-1 antitrypsin

Answer

Human chorionic gonadotropin (HCG)

Answer

Alpha-fetoprotein (AFP)

Question 5

Ovarian tumors commonly arise from which part of the ovary?

Accepted Answer

Surface epithelium

Answer

Germ cell

Answer

Stroma of the ovary

Answer

None of the above

Question 6

Which of the following cell type(s) secrete prostate-specific antigen (PSA)?

Accepted Answer

Benign and malignant prostate epithelial cells

Answer

Benign prostate epithelial cells only

Answer

Malignant prostate epithelial cells only

Answer

Prostate stromal cells

Question 7

All of the following are sex-cord tumors, EXCEPT:

Accepted Answer

Dysgerminoma

Answer

Granulosa cell tumor

Answer

Sertoli-Leydig cell tumor

Answer

Gynandroblastoma

Question 8

A 22-year-old woman has an abnormal cervical Pap smear. A biopsy is obtained from a suspicious area on the cervix. The pathology report describes changes including loss of normal squamous cell orientation, atypical cells with wrinkled nuclei and perinuclear halos involving the full thickness of the squamous epithelium, and an intact basement membrane. What is the most likely diagnosis?

Accepted Answer

CIN III with koilocytic atypia

Answer

Cervical intraepithelial neoplasia (CIN) I with koilocytic atypia

Answer

CIN II with koilocytic atypia

Answer

Inflammatory atypia secondary to colposcopy artifact

Question 9

What is the most common ovarian tumor in individuals less than 20 years old?

Accepted Answer

Germ cell tumor

Answer

Epithelial tumor

Answer

Metastatic tumor

Answer

Sex cord-stromal tumor

Question 10

A middle-aged man operated for testicular cancer presents with histological examination showing primitive looking 'ugly' cells with abundant mitotic cells. The tumor cells are positive for cytokeratin and CD30. What is the likely type of tumor?

Accepted Answer

Embryonal carcinoma

Answer

Choriocarcinoma

Answer

Yolk sac tumors

Answer

Teratoma

Reproductive Pathology — MCQs

Reproductive Pathology — MCQs

On this page

Practice by Chapter

Want unlimited practice?