Reproductive Pathology Practice Questions

Q: Amnion nodosum is characterized by which of the following?

Multiple, small, tan amnionic lesions. **Explanation:** **Amnion nodosum** is a specific pathological condition of the placenta characterized by the presence of multiple, small (1–3 mm), firm, gray-to-yellow/tan nodules on the fetal surface of the amnion. These nodules are composed of deposits of vernix caseosa, desquamated fetal squames, and lanugo hair that have become embedded in the amnionic epithelium. **Why the correct answer is right:** The hallmark of amnion nodosum is the presence of **multiple, small, tan amnionic lesions**. These lesions form due to severe and prolonged **oligohydramnios** (most commonly associated with renal agenesis/Potter sequence or prolonged rupture of membranes). In the absence of sufficient amniotic fluid, the fetal skin rubs directly against the amnion, causing fetal debris to scrape off and aggregate into these characteristic nodules. **Why other options are incorrect:** * **Option A & B:** Amnion nodosum does not involve generalized thickening or redundant folds. While the amnion may appear dull, the pathology is focal and nodular, not a diffuse structural change of the membrane itself. * **Option D:** Fenestrations (holes) in the amniochorion are characteristic of **Amniotic Band Syndrome**, where the rupture of the amnion leads to fibrous bands that can entangle or amputate fetal limbs. **High-Yield Facts for NEET-PG:** * **Clinical Association:** Always associate Amnion nodosum with **severe oligohydramnios**. * **Differential Diagnosis:** Do not confuse it with **Squamous Metaplasia** of the amnion. Squamous metaplasia consists of white, opaque plaques (usually near the umbilical cord insertion) that *cannot* be easily scraped off, whereas amnion nodosum nodules are easily removed. * **Potter Sequence:** If a question mentions amnion nodosum and pulmonary hypoplasia, the underlying cause is likely bilateral renal agenesis.

Q: What is the most frequent epithelial tumor of the ovary?

Papillary serous cystadenoma. **Explanation:** Surface epithelial-stromal tumors are the most common type of ovarian neoplasms, accounting for approximately 65–70% of all ovarian tumors. Among these, **Serous tumors** are the most frequent. 1. **Why A is correct:** Serous tumors represent about 30% of all ovarian neoplasms. **Serous cystadenomas** (specifically the papillary variety) are the most common benign epithelial tumors. They are frequently bilateral (15–25%) and are characterized histologically by psammoma bodies in approximately 30% of cases. 2. **Why B is incorrect:** **Brenner tumors** are uncommon epithelial tumors composed of transitional epithelium (similar to bladder epithelium). They are usually benign and often incidental findings. 3. **Why C is incorrect:** **Endometrioid tumors** account for about 10–15% of ovarian surface epithelial tumors. They are significant because they are frequently malignant and are associated with endometriosis in 15–30% of cases. 4. **Why D is incorrect:** **Mucinous cystadenomas** are the second most common epithelial tumors (approx. 20–25%). They are known for reaching massive sizes and can be associated with *Pseudomyxoma peritonei* if a malignant mucinous tumor ruptures. **High-Yield Clinical Pearls for NEET-PG:** * **Most common ovarian tumor overall:** Benign Cystic Teratoma (Dermoid cyst) in young women; Serous Cystadenoma in the general population. * **Most common malignant ovarian tumor:** Serous Cystadenocarcinoma. * **Psammoma bodies:** Characteristic of Serous tumors and Meningiomas. * **Bilateralism:** Serous tumors are the most likely epithelial tumors to be bilateral. * **Tumor Marker:** CA-125 is the primary marker for monitoring epithelial ovarian cancers.

Q: A 17-year-old female presents with a non-tender, firm, and mobile breast lump. FNAC reveals tightly arranged ductal epithelial cells with dyscohesive bare nuclei. What is the most likely diagnosis?

Fibroadenoma. **Explanation:** The clinical presentation and cytological findings are classic for a **Fibroadenoma**, the most common benign breast tumor in young females (typically <30 years). **Why Fibroadenoma is correct:** 1. **Clinical Presentation:** A firm, non-tender, and highly mobile lump in a 17-year-old is the classic "Breast Mouse" (so-called because it slips away under the fingers). 2. **FNAC Findings:** The presence of **tightly arranged ductal epithelial cells** (often in staghorn or antler-like patterns) along with **dyscohesive bare bipolar nuclei** in the background is pathognomonic. These bare nuclei represent the myoepithelial cells of the stroma. **Why other options are incorrect:** * **DCIS & LCIS:** These are typically seen in older women (post-menopausal). On FNAC, DCIS would show malignant features like pleomorphism and necrosis, while LCIS often lacks the characteristic stromal component and bare nuclei seen here. * **Phyllodes Tumor:** While it shares features with fibroadenoma (biphasic), it usually presents in older age groups (40-50s), grows rapidly, and shows increased stromal cellularity with leaf-like projections and frequent mitoses on histology. **High-Yield Clinical Pearls for NEET-PG:** * **Most common benign tumor of the breast:** Fibroadenoma. * **"Breast Mouse":** Due to high mobility within the breast tissue. * **Giant Fibroadenoma:** Defined as a fibroadenoma >5 cm in size or >500g in weight. * **Management:** Conservative if 35y), and Pathology (FNAC/Core Biopsy).

Question 1

Amnion nodosum is characterized by which of the following?

Accepted Answer

Multiple, small, tan amnionic lesions

Answer

Generalized amnion thickening

Answer

Multiple, redundant folds of amnion

Answer

Multiple, small fenestrations in the amniochorion

Question 2

Dermoid cysts arise from which type of cell?

Accepted Answer

Totipotent cell

Answer

Pluripotent cell

Answer

Ectoderm

Answer

Mesoderm

Question 3

A 62-year-old man presents for an annual physical examination. His PSA level is 12.3 ng/dL, and a subsequent prostatic biopsy reveals adenocarcinoma with a Gleason score of 8. The Gleason score is a measurement of:

Accepted Answer

The likelihood that the cancer will grow and spread

Answer

The grade of the cancer based on its cellular appearance

Answer

The stage of the cancer within the prostate gland

Answer

The number of cancer cells expressing prostate specific antigen (PSA)

Question 4

Which of the following types of Human Papillomavirus (HPV) is least associated with cervical malignancy?

Accepted Answer

Type 42

Answer

Type 16

Answer

Type 31

Answer

Type 33

Question 5

All of the following are germ cell tumors except?

Accepted Answer

Leydig cell tumor

Answer

Seminoma

Answer

Embryonal carcinoma

Answer

Endodermal sinus tumor

Question 6

A 55-year-old nulliparous black woman has a large, fungating tumor projecting from her cervix. A biopsy reveals a background of spindle-shaped cells with over 10 mitoses per high power field. Many of the mitoses have abnormal mitotic spindles. What is the most likely diagnosis?

Accepted Answer

Well-differentiated cervical carcinoma

Answer

Sarcomatous transformation of a uterine leiomyoma

Answer

Malignant mixed mullerian tumor

Answer

Well-differentiated endometrial carcinoma

Question 7

What is the most frequent epithelial tumor of the ovary?

Accepted Answer

Papillary serous cystadenoma

Answer

Brenner tumor

Answer

Endometrioid tumor

Answer

Mucinous cystadenoma

Question 8

A 17-year-old female presents with a non-tender, firm, and mobile breast lump. FNAC reveals tightly arranged ductal epithelial cells with dyscohesive bare nuclei. What is the most likely diagnosis?

Accepted Answer

Fibroadenoma

Answer

Ductal Carcinoma In Situ (DCIS)

Answer

Phyllodes tumor

Answer

Lobular Carcinoma In Situ (LCIS)

Question 9

Ovarian hyperthecosis is characterized by

Accepted Answer

Nests of luteinized theca cells in ovarian stroma.

Answer

Enlarged ovaries.

Answer

A less severe variant of PCOS.

Answer

Less severe hyperandrogenism.

Question 10

Which of the following pathological findings does NOT indicate a malignant phyllodes tumor?

Accepted Answer

Fibrosarcoma

Answer

Liposarcoma

Answer

Rhabdomyosarcoma

Answer

None of the above

Reproductive Pathology — MCQs

Reproductive Pathology — MCQs

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