Mesenchymal tumours

An epidemiologic study is performed to determine risk factors for development of malignant neoplasms. A statistical analysis of pre-existing medical conditions is done. Some pre-existing conditions are observed to precede development of malignant neoplasms, while others do not. Which of the following conditions is most likely to be statistically unrelated to subsequent malignancy?

@Uterine leiomyomas

Endometrial atypical hyperplasia

Chronic alcoholism with hepatic cirrhosis

Cervical squamous dysplasia

Chronic ulcerative colitis

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A macroscopical investigation of operatively removed uterus revealed a tumour with a soft consistence, hemorrhages and necroses. The tumor cut surface reminds ' the fish meat'. Histological research has found an expressed cellular and tissue atypia; there were cells with pathological mitoses figures. What is the most likely diagnosis?

@Sarcoma.

Adenocarcinoma.

Angioma.

Fibroma.

Lipoma.

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Macroscopically the uterine cancer (after operation material) is of soft consistence, with hemorrhages and areas of focal necrosis. It looks like fish meat when incised. At the histological examination the signs of cell and tissue atypism are traced. The cells with pathological mitoses can be also seen. What is your diagnosis?

Adenocarcinoma

@Sarcoma

Angioma

Fibroma

Lipoma

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A 15-year-old young man presented with a tumorous formation in the central site of his wrist bone. The node grew slowly within last 3 years. A histological research of a removed neoplasm revealed mature chondrocytes without mitoses, which randomly located in chondral lacunas. Cartilages of a capsule had different form and the sizes due to variable quantity of chondral cells, between which there were basic substance with liquid layers of a connective tissue. What is the most likely diagnosis?

@Chondroma

Chondroblastoma

Chondrosarcoma

Teratoma

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All the following statements about chondrosarcoma are true EXCEPT that

It is most frequent in middle age or later

The peripheral type can arise from enchondroma

It is common in the pelvic bones

Histologic analysis is of prognostic significance

@It is the second most common malignant bone tumor

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The most common tumor that involves bone is

@A metastatic tumor from an extraosseous site

Osteogenic carcinoma

Multiple myeloma

Chondrosarcoma

A giant cell tumor

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A 50-year-old patient presented to the doctor with a ball-shaped, dense, motionless neoplasm, 2 cm in diameter, under a skin in the right parietal site of his head. A histological research of a removed neoplasm revealed a chaotic osteal beams pattern with a connective tissue between. What is the most likely diagnosis?

@Cancellous osteoma (Osteoma spongiosum)

Compact osteoma (Osteoma durum)

Osteoporosis

Osteomalacia

Osteosarcoma

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Osteosarcoma (osteogenic sarcoma) has an increased incidence in all the following conditions EXCEPT

Paget’s disease

Retinoblastoma

Fibrous dysplasia

@Plasmocytoma

Osteochondromatosis

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At the young woman in'the area of her distal extremity of a femur the tumor, which quickly grew, is removed. Grossly, it had a motley pattern - from white-sulphur to brown-red color and a quaggy consistence. Microscopical investigation revealed the basic tissue component of a tumor presented with osteal and the ossiform structures covered by atypical osteoblasts, with numerous thin-walled vessels and atypical mitoses figures. Make a diagnosis.

@Osteocarcoma

Chondroma

Osteoma

Ewing’s sarcoma

Angiosarcoma

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A 28-year-old man with a history of an elbow bruise 3 years ago presented with a tumorous growth in the area of an epiphysis of a humeral bone. The formation did not have accurate borders. A histological investigation of biopsy material revealed a considerable quantity of polymorphic cells of osteoblastic type with numerous pathological mitoses. Make the presumable diagnosis.

@ Osteosarcoma

Chondrosarcoma

Osteoid-osteoma

Fibrosarcoma

Sinovial sarcoma

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Characteristics of Ewing’s sarcoma include all the following EXCEPT

Primary occurrence prior to age 20

@Primary occurrence in the epiphysis of long bones

Onion-skin pattern on x-ray

Basophilic cells resembling lymphocytes

PAS-positive intracytoplasmic glycogen

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An 11-year-old boy presents with an enlarging, painful lesion that involvers medullary cavity of his left femur. X-rays reveals an irregular, destructive lesion that produced an “onion-skin” periosteal reaction. The lesion is resected surgically, and Histologic sections reveal sheets of uniform small, round, “blue” cells. Which of the following is the most likely diagnosis?

Chondroblastoma

@Ewing’s sarcoma

Fibrosarcoma

Osteoblatoma

Osteogenic sarcoma

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A 16-year-old child presented with a painful softish node in his femur diaphysis. The formation grows quickly with destruction of a spongy layer of a bone. Microscopical investigation revealed monomorphic round cells little bit bigger than mature lymphocytes, with jejunely light cytoplasm which contains glycogen. In some zones these cells form pseudo- rosettes with few mitoses. Between cells there are fibrinous membranes. What is the most likely diagnosis?

@Ewing's sarcoma

Limphoma

Rhabdomyosarcoma

Neuroblastoma

Hemangioma

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A 49-year-old man complains of pain in his left thigh for 3 months. On physical examination his thigh is increased in size, compared to the right. A plain film radiograph reveals the presence of a 15 cm solid mass that does not appear to arise from bone, but it does have infiltrative margins. A biopsy of this mass is taken, and on microscopic examination the mass is composed of highly pleomorphic spindle cells. Name tumor?

Fibroma

Chondroma

Osteoma

@Osteosarcoma

Carcinoma

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In an epidemiologic study, "fallout" from nuclear bomb testing and from nuclear power plant disasters is observed to have released radioactive isotopes into the environment. One of these isotopes is found to be strontium-90. It is observed that the strontium-90 in soils goes into the food chain and eventually contaminates milk products. This contamination is most likely to increase the risk for which of the following neoplasms?

Kaposi's sarcoma of skin

Small cell anaplastic carcinoma of lung

@Osteosarcoma

Nasopharyngeal carcinoma

Endometrial carcinoma

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During an examination of a 25-year-old patient: right half of mandible is spindle-shaped and enlarged, thickened, with a smooth surface. A puncture revealed a liquid of brown colour. Histologically: mononuclear cells, presumably osteoblasts, and giant multinuclear cells with nidi of lacunar resorbtion of bone girders. There are small haemorrhages and grains of haemosiderin. What is the diagnosis?

Giant-cell epulis

Amyloblastoma

Fibrous osteodysplasia

Osteosarcoma

@Osteoblastoclastoma

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4-year-old child presented with a flat red color knot on his neck skin, which turns pale at pressing by glass the knot. What is the most probable diagnosis?

@Hemangioma

Pigmented nevus

Melanoma

Leiomyoma

Lymphangioma

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A 14-year-old healthy girl has a 0.3-cm reddish, slightly raised nodule on the skin of the upper part of her chest found on a routine physical examination. She states that this lesion has been present for years and has not appreciably changed in size or color. Which of the following neoplasms is this nodule most likely to be:

@Hemangioma

Melanoma

Wilms tumor

Lymphoma

Glioma

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A very painful lesion found under the nail of the second finger of the hand is most likely which one of the following lesion of blood vessels or lymphatics?

Kaposi’s sarcoma

@Capillary hemangioma

Glomus tumor angiosarcoma

Cystic hydroma

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Microscopically the tumour of the upper lip is built of multiple small chink-like cavities, the walls of which are covered with endothelium and filled with liquid part of blood and its clots. Make a diagnosis.

Glomus-angioma

Venous hemangioma

Cavernous hemangioma

Haemangiopericytoma

@Capillary hemangioma

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Microscopically: tumour of upper lip, made of numerous slot-like cavities, walls of which is made of flatted endothelia. These cavities are filled with thin blood and clots. Name the diagnosis.

@Capillary haemangioma

Venous haemangioma

Cavernous hemangioma

Hemangiopericytoma

Glomus-angioma

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A 20-year-old man has had a slowly growing reddish nodule on his upper lip. He finally decides to have a surgeon remove it. Microscopically the nodule is composed of benign varying sized tiny blood vessels. What is the most likely diagnosis?

@Capillary hemangioma.

Venous hemangioma.

Cavernous hemangioma.

Hemangiopericytoma.

Glomus-angioma.

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A 17-year-old patient was diagnosed (at the operation) a tumour (4,5 x 5,0 x 3,5cm) on the lower surface of the liver. It has sub serous localization and murrey color. On the incision it is presented by cavities with volumes of blood and thick walls of connective tissue that are covered with one stratum of endothelium. Make a previous diagnosis.

@Cavernous haematoma

Capillary hemangioma

Haemangiopericytoma

Haemangioendothelioma

Lymphangioma

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During surgery in a 17-year-old patient it was revealed the tumour of 4,5х5,0х3,5 sm in size on the lower surface of the liver with subserose localization, of dark-red color. On the section tumour has cavities with marked amount of blood. What is preliminary diagnosis?

Capillar hemangioma

Hemangiopericytoma

Lymphangioma

Hemangioendothelioma

@Cavernous hemangioma

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A 2-year-old girl is being evaluated for progressive swelling of her neck. Physical examination finds a nontender, ill-defined, loculated mass in the left side of her neck. During the workup of this patient, a karyotype reveals that she is monosomic for the X chromosome. Which of the following is the cause of the swelling of this patient’s neck?

Bacillary angiomatosis

@Cystic hygroma

Glomus tumor

Nevus flammeus

Spider angioma

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All the following are the result of melanocytic hyperplasia EXCEPT

@Freckle

Lentigo

Junctionals nevus

Blue nevus

Spitz tumor

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A 35-year-old man present with 0.3-cm flat light brown lesion on his left forearm. The lesion is excised, and microscopy reveal nests of round nevus cells within the lower epidermis is the dermal-epidermal junction. There is no “fusion” present of adjacent nests of nervus cell. Cytologic atypia is not present, nor are nevus cell seen in the superficial or deep dermis. Which of the following is the most likely diagnosis?

Compound nevus

Dysplastic nevus

Halo nevus

@Junctional nevus

Spitz nevus

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The woman on her face skin had a pigmental formation in the form of a nodule which quickly grew. The biopsy is made. Microscopical investigation of biopsy sample revealed fields of spindle- shaped and polymorphic cells which contain a brown pigment. In addition, there were diagnosed numerous mitoses. What is the most likely diagnosis?

@ Melanoma

Nevus

Cancer

Papilloma

Dermatofibroma

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A 46-year-old man gained a bulging black stain on his skin. The stain didn't heal for a long time. Afterwards, the stain became a node, bigger and painful, changed its colour to dark-brown. Histologically: spindle-shaped and polymorphous cells containing brown pigment. What kind of tumour is this?

Basalioma

@Melanoma

Hemangioma

Hematoma

Carcinoid

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An eye of 53-year-old patient, excised at surgery due to neoplasm, presented in pathology department. Gross investigation reveled a 1 x0,4 cm black lesion in the retina. Microscopic appearance of a tumor was characterized by nests of immature cell with eccentric nuclei, prominent macronucleoli and cytoplasm brown pigment. What is the most likely diagnosis?

@Melanoma

Neurinoma

Angiosarcoma

Neuroblastoma

Ganglioneuroblastoma

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A physical investigation of a 60-year-old woman with one year history of a formation on a face revealed a brown skin plaque with irregular form and black impregnations. A histological research of a skin biopsy showed in epidermis and through all derma polymorphic big cells with pathological mitoses, large nucleoli and yellowy-brown pigment in a cytoplasm of many cells. The specified cells grow in a kind of fine groups and also alone. Make a diagnosis.

@Melanoma

Nevus

Papilloma

Xeroderma

Melanosis

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A 75 year old male patient consulted a surgeon about a brown nonhealing ulcer of shin. Examination of biopsy material revealed diffuse growth of polymorphic atypic cells with brown pigment in their cytoplasm. Pearls reaction was negative. There were also a lot of pathological mitoses and foci of tissue necrosis. What is the most probable diagnosis?

Skin cancer

Local hemosiderosis

Trophic ulcer

Intradermal nevus

@Melanoma

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A patient complains on a brown ulcer of leg, that doesn't heal for a long time. During a biopsy: diffuse growth of polymorphous atypic cells. In cytoplasm of those there is a brown pigment. Pearls' reaction is negative. There are a lot of pathological mitoses and nidi of necrosis of the tissue. Name the diagnosis.

Skin cancer

Local haemosiderosis

Intradermal nevus

Trophic ulcer

@Melanoma

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A dark convex macula appeared on the skin of a 46-year-old patient but didn’t disturb him. In course of time it began to enlarge, the pain appeared, the color changed into light brown and a nodule could be palpated. At the histological examination of the removed tissue, spindle and polymorphous cells were revealed, cytoplasm of which had a fulvous pigment. What tumour is meant?

Haematoma

Basaloma

Haemangioma

@Melanoma

Carcinoid

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A 50-year-old woman presented with a pigmented painful skin lesion above the ankle. It had been present for many years but in recent months it had enlarged quite rapidly, its outline got irregularity. Microscopic investigation of a lesion biopsy revealed nests of atypical cells and single cells with eccentric nuclei, prominent macronucleoli and cytoplasmic brown pigment. What is the most likely diagnosis?

@Melanoma

Basal cell carcinoma

Hemangioma.

Haematoma.

Carcinoid.

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A previously healthy 42-year-old man has a skin nodule on his right hand that has become larger and darker with more irregular outlines over the past three months. On physical examination there is a 1.2 cm diameter darkly pigmented and slightly raised nodule on the dorsum of his right hand. No other skin lesions are noted. Several nontender enlarged lymph nodes are palpable in the right axilla. The lesion is excised and microscopic examination shows a neoplasm composed of darkly pigmented polygonal and spindle cells. Which of the following neoplasm’s kind is this one?

Leiomyoma

Rabdomyoma

@Melanoma

Metastatic carcinoma

Basal-cell carcinoma

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The incidence of malignant melanoma of the skin appears to be increasing in the United States. Which of the following is most significant in predicting the clinical behavior following diagnosis?

The degree of pigmentation

@The level and depth

The amount of inflammation

The degree of pleomorphism

The state of nutrition

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An eyeball with tumour like formation was delivered for the histological examination. The formation is located in the vascular tract of the eye with the size 1 x 0,4cm and of black color. Multiple pathological mitoses can be seen in cells. A fulvous pigment is also revealed in the cytoplasm of many cells. What is your diagnosis?

@Melanoma

Neurinoma

Angiosarcoma

Neuroblastoma

Ganglioneuroblastoma

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A 66-year-old woman present with right eye bad vision, ophtalmoscopy revealed a neoplasm of retina which was soon excised, at surgery together with an eye ball. Grossly, a neoplasm was soft, irregular in contour lxl cm in size and had a brown coloring. Under microscope a lesion demonstrated nodular aggregates of infiltrating cells. There cells contained large brown pigment nuclei with chromatin clumped at the periphery of nuclear membrane and prominent nucleoli. Atypical mitoses figures were also revealed. What is most likely diagnosis?

@Melanoma

Schwannoma

Glomus tumor

Paraganglioma

Angiosarcoma

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The most common primary tumor of the heart in adult is the

Rhabdomyoma

Rhabdomyosarcoma

Papillary fibroelastoma

Lipoma

@Myxoma

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A 35-year-old man presents with weight loss, fever, and fatigue. Physical examination finds signs and symptoms of mitral valve disease. Further work-up finds a pedunculated mass in the left atrium. The tumor is resected and histologic sections reveal stellate cells in a loose myxoid background. Which of the following is the most likely diagnosis?

Chordoma

Fibroelastoma

Leiomyoma

@Myxoma

Rhabdomioma

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