Reproductive Pathology Practice Questions

Q: Transitional cell epithelium is seen in which ovarian tumor?

Brenner's tumor. **Explanation:** The correct answer is **Brenner’s Tumor**. This is a surface epithelial-stromal tumor of the ovary characterized by the presence of **transitional cell epithelium** (urothelium), similar to that found in the urinary bladder. Histologically, it features nests of these transitional cells embedded within a dense, fibrous stroma. A classic pathognomonic finding is the **"Coffee Bean" nuclei** (longitudinal nuclear grooves). **Analysis of Incorrect Options:** * **Granulosa Cell Tumor:** A sex cord-stromal tumor characterized by **Call-Exner bodies** (small follicles filled with eosinophilic material) and high estrogen production. * **Endodermal Sinus Tumor (Yolk Sac Tumor):** A germ cell tumor characterized by **Schiller-Duval bodies** (glomeruloid-like structures) and elevated **Alpha-fetoprotein (AFP)** levels. * **Hilus Cell Tumor:** A rare steroid cell tumor (pure Leydig cell tumor) that typically causes virilization and is characterized by the presence of **Reinke’s crystals** in the cytoplasm. **High-Yield Clinical Pearls for NEET-PG:** * **Brenner’s Tumor** is mostly benign and often an incidental finding. * **Walthard Cell Rests:** These are small nests of transitional epithelium found on the fallopian tubes or mesosalpinx, believed to be the precursor to Brenner’s tumors. * **Association:** It is frequently associated with **Mucinous Cystadenomas** in the same or contralateral ovary. * **Markers:** While most are non-secretory, some may rarely produce estrogen, leading to endometrial hyperplasia.

Q: What causes the appearance of mammary skin described as "peau d'orange"?

Lymphatic invasion. **Explanation:** **Peau d’orange** (French for "orange peel skin") is a classic clinical sign of inflammatory breast cancer or advanced underlying malignancy. [1] **Why Lymphatic Invasion is Correct:** The characteristic appearance is caused by the **invasion of dermal lymphatics** by tumor emboli. This leads to lymphatic obstruction and localized **lymphedema**. [1] As the skin swells, the hair follicles remain tethered to the underlying dermis by suspensory ligaments (ligaments of Cooper). This creates a pitted, dimpled appearance where the follicles are depressed relative to the edematous surrounding skin, mimicking the texture of an orange peel. **Analysis of Incorrect Options:** * **A & B (Intraepithelial/Subepidermal carcinoma):** These terms refer to the location of the cancer cells within the skin layers. While cancer cells are present in the dermis in peau d'orange, the *mechanism* of the skin change is mechanical fluid backup (edema), not the mere presence of cells in the epithelium. * **D (Vascular embolization):** While tumor cells can enter blood vessels (hematogenous spread), this typically leads to distant metastasis (e.g., to bone or lungs) rather than localized cutaneous edema and dimpling. **NEET-PG High-Yield Pearls:** * **Clinical Significance:** Peau d’orange is a hallmark of **Inflammatory Breast Cancer**, which is clinically staged as **T4d** (locally advanced). * **Differential Diagnosis:** It can also be seen in severe mastitis, though the presence of a mass or lack of response to antibiotics points toward malignancy. * **Pathology Link:** Always associate "dermal lymphatic obstruction" [1] with "peau d'orange" and "Cooper’s ligaments" with the "pitting/dimpling" effect. **References:** [1] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Liver And Biliary System Disease, pp. 453-454.

Question 1

Transitional cell epithelium is seen in which ovarian tumor?

Accepted Answer

Brenner's tumor

Answer

Granulosa cell tumor

Answer

Endodermal sinus tumor

Answer

Hilus cell tumor

Question 2

What causes the appearance of mammary skin described as "peau d'orange"?

Accepted Answer

Lymphatic invasion

Answer

Intraepithelial carcinoma

Answer

Subepidermal carcinoma

Answer

Vascular embolization

Question 3

A 58-year-old woman has a screening mammogram showing a 0.5-cm irregular area of increased density with scattered microcalcifications in the upper outer quadrant of the left breast. Excisional biopsy shows atypical lobular hyperplasia. She has been on postmenopausal estrogen-progesterone therapy for the past 10 years and has smoked 1 pack of cigarettes per day for the past 35 years. Which of the following is the most significant risk factor for the development of lobular carcinoma in patients with atypical lobular hyperplasia?

Accepted Answer

Atypical cytologic changes

Answer

History of smoking

Answer

Hormone replacement therapy

Answer

Postmenopausal age

Question 4

Which of the following conditions does not typically progress to carcinoma?

Accepted Answer

Bowenoid papulosis

Answer

Bowen's disease

Answer

Leukoplakia

Answer

Erythroplakia

Question 5

Which of the following histological patterns of endometrial carcinoma has the worst prognosis?

Accepted Answer

Clear cell Carcinoma

Answer

Adenoacanthoma

Answer

Adenocarcinoma

Answer

Papillary Carcinoma

Question 6

Nulliparity and late menopause are risk factors for which of the following group of diseases?

Accepted Answer

Endometrial cancer and breast cancer

Answer

Cervical cancer and endometrial hyperplasia

Answer

Cervical cancer and endometrial polyp

Answer

Vulvar cancer and endometrial cancer

Question 7

HPV causes which change in the cervical epithelium?

Accepted Answer

Immobilization of epithelial cells

Answer

Induction of apoptosis

Answer

Induction of necrosis

Answer

Stimulation of telomerase

Question 8

Which of the following histologic types of invasive breast cancer has the best prognosis?

Accepted Answer

Tubular carcinoma

Answer

Medullary carcinoma

Answer

Mucinous carcinoma

Answer

Ductal carcinoma

Question 9

What is the most common malignant testicular neoplasm?

Accepted Answer

Seminoma

Answer

Teratoma

Answer

Choriocarcinoma

Answer

Lymphoma

Question 10

What is a partial mole?

Accepted Answer

Triploid

Answer

Haploid

Answer

Diploid

Answer

Polyploid

Reproductive Pathology — MCQs

Reproductive Pathology — MCQs

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