Organ-specific tumor

A 60-year-old man with a 90 pack year history of smoking experiences an episode of hemoptysis. A chest radiograph reveals a 5-cm right upper lobe lung mass. A fine needle aspirate of this mass yields cells consistent with small cell anaplastic ("oat cell") carcinoma. On physical examination he has puffiness of the face, some pedal edema, bruises of the skin, and a blood pressure of 165/100-mm Hg. A bone scan shows no metastases. Immunohistochemical staining of the tumor cells is likely to be positive for:

Parathormone related peptide

Erythropoietin

@ACTH

Insulin

Gastrin

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A 32-year-old woman with a history of abortion 8 months earlier presented to the emergency department complaining of uterine bleeding. Examination done by gynecologist revealed a neoplasm of the uterus. Grossly, tumor had a spongy structure with multiple hemorrhages. Microscopically, atypical clear epithelial Langhan's cells and abnormal syncytiotrophoblast cells arranged around maternal blood spaces were detected. What is the most likely diagnosis?

@ Choriocarcinoma

Squamous cell carcinoma without keratinisation

Adenocarcinoma

Fibromyoma

Hydatidiform mole

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A 45-yer-old female examined by her gynecologist due to uterine bleeding. A neoplasm was diagnosed and then removed at surgery department. The uterine lesion presented with huge necrotic and hemorrhagic spongy masses. Microscopic investigation revealed large clear atypical epithelial cells and variety of abnormal dark cells, arranged around material blood spaces. Stroma was not defined. Atypical cells resembled cytotrophoblast and syncytiotrophoblast cells. What is the most likely diagnose?

@Choriocarcinoma

Invasive hydatidiform mole

Adenocarcinoma

Cavernous haemangioma.

Medullary carcinoma

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6 months after delivery a woman had uterine bleeding. Gynecological examination revealed in the uterine cavity a dark-red tissue with multiple cavities that resembled of "sponge". Microscopic examination of the tumour revealed some atypic light epithelial Langhans cells and giant cells of cyncytiotrophoblast in blood lacunas. What tumour is it?

@Chorioepithelioma

Vesicular mole

Squamous cell nonkeratinous carcinoma

Fibromyoma

Adenocarcinoma

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A 39-year-old woman has madescence in the region of mammilla, a small ulcer with inflammatory hyperemia and cutaneous edema. Histologic examination of tissue sampling from this area revealed in the malpighian layer of thickened epidermis atypical cells with light and optically empty cytoplasm, with no intracellular bridges. Such cells were also found in the orifice of big mammal gland ducts. What is the most probable diagnosis?

@ Paget's disease

Intraductal cancer

Epidermoid cancer

Melanocarcinoma

Basal cell carcinoma

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A physical examination of a 39-year-old woman revealed a soaking area by her breast nipple, a superficial ulcer with inflammatory hyperemia and skin edema. A histological research of a biopsy from this area revealed in basal layer of thickened epidermis atypical big cells with light and optically empty cytoplasm, with absence of intercellular bridges. Such cells are found and in the ostium of the big ducts of a gland. What is the most likely diagnosis?

@Paget's desease

Intraductal cancer

Basal cell cancer

Epidermoid carcinoma

Melanoma

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During a routine physical examination, a 49-year-old man is found to have a 2.5-cm “coin lesion” in the upper lobe of his left lung. The lesion is removed surgically, and histologic sections reveal sheets of malignant cells with clear cytoplasm (clear cell carcinoma). Which of the following is the most likely site of origin for this metastatic lung tumor?

Appendix

Breast

@Kidney

Pancreas

Stomach

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A 60-year-old man noticed worsening urinary tract symptoms and thus inquires about screening tests for kidney pathology. Investigation revealed a node 8 cm in diameter at right kidney's apex. After surgery, grossly tumor presented a patchy pattern with hemorrhages and zones of necrosis. Histological study showed large anaplastic tumor cells with abundant foamy cytoplasm and with small central densely staining nucleus. Abnormal mitoses were also found. What is the most likely diagnose?

@ Clear -cell carcinoma

Clear -cell adenoma

Adenocarcinoma

Nephroblastoma

Acidophilic adenoma with malignization

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A 62-year-old man was removed a kidney. At the microscopical examination there was revealed a tumour that looked like a nodule with an approximate diameter 8cm. The tumour tissue is many-coloued with multiple haemorrhage bleedings and necroses when incised. Histologically the tumour consists of light cells that form alveolar and papillar structures. The invasive growth of the tumour is moderate. Many cells have pathological mitoses and hyperchromic nuclei. Diagnose the tumour of the kidney.

@Clear cell cancer

Clear cell adenoma

Adenocarcinoma

Nephroblastoma

Acidophile adenoma with malignancy

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Medical evaluation of a 55-year-old man finds the following laboratory data: increased hematocrit, increased RBC count, increased total red cell mass, normal plasma volume, normal oxygen saturation of hemoglobin, and increased serum erythropoietin. These findings are most characteristic of secondary polycythemia. Which of the following abnormalities is most likely to be present in this individual?

Acute gastroenteritis

Chronic ulcerative colitis

Cyanotic heart disease

Polycythemia rubra vera

@ Renal cell carcinoma

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A 5 5-year-old female is found to have asymptomatic microscopic hematuria. A plain radiograph of the abdomen revealed a neoplasm at her right kidney. A gross investigation of removed kidney revealed a node 8cm in diameter at its upper pole. The cut surface of a tumor presented with multiple hemorrhages and necroses. Histologically, it consists of light cells that form alveolar and papillary structures. The invasive growth of the tumor is moderate. Many cells have hyperchromic nuclei and atypical mitoses figues. What is the most likely diagnosis?

@Renal cell carcinoma.

Clear cell adenoma.

Adenocarcinoma.

Nephroblastoma.

Acidophilic adenoma with malignancy.

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True statements about classic neurofibromatosis (von Recklinghausen’s disease) include all the following EXCEPT

Malignant degeneration may occur

Hamartomas of the iris are very common

@Hemangioblastomas of the brain are associated

Acoustic neuroma is associated

Pheochromacytomas and meningioma are associated

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Examination of a young woman revealed a node-like, soft and elastic homogenous tumour of pinkish-white colour along the acoustic nerve. The tumour contains cell bundles with oval nuclei. Cellular fibrous bundles form rhythmic structures made up by parallel rows of regularly oriented cells arranged in form of a palisade with cell-free homogenous zone (Verocay bodies) between them. What tumour is it?

@Neurinoma

Neuroblastoma

Ganglioneurinoma

Ganglioneuroblastoma

Malignant neurinoma

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Examination of a young woman revealed a tumour up to 3 cm in diameter in form of a knot localized along the acoustic nerve. The tumour is homogenous, soft and elastic, of pink-and-white colour. Microscopically the tumour contains clusters of cells with oval nuclei. Fibrous cell clusters form regular structures made up by parallel rows of regularly oriented cells arranged in form of a palisad e. Zones between the rows of cells are acellular and homogenous (Verocai bodies). What tumour is it?

Ganglioneuroma

Neuroblastoma

Malignant neurinoma

Ganglioneuroblastoma

@Neurinoma

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An elderly man with a 2-year history of right leg amputation presents with 2 cm encapsulated tumor at the area of a past surgical trauma of soft tissue. Histology investigation revealed disordered orientation of mature nerve fiber bundles inter mixed with connective tissue. Higher magnification showed bundles of axons, Schwann cells, fibroblasts and perineurial cells within tumor mass. What is most likely diagnosis?

@Neurinoma

Neurofibroma

Malignant neurinoma

Soft fibroma

Fibrosarcoma

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The man of 45 years has completely lost hearing on the right ear. Physical investigation has not revealed any pathological changes in system of the right acoustic analyzer. The tomography of a brain has revealed a neoplasm, 7 cm in diameter, homogeneous, without precise contours in a site of cerebellopontine angle. Name a neoplasm.

@Neurilemmoma

Gangliocytoma

Astrocytoma

Chorioidal papilloma

Neuroblastoma

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A tumour in a capsule (diameter 2cm) was operative removed from the stump of the lower extremity. Microscopically it consists of spindle monomorphic cells with stick-like nuclei that form palisade structures together with the fibres. What is the most possible tumour?

Neurofibroma

@Benign neurilemmoma

Malignant neurilemmoma

Soft fibroma

Fibrosarcoma

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All the following statements apply to ependymomas EXCEPT that

They are the most common type of intraspinal glioma

@They are most commonly located in the lateral ventricles

Patient may present with headache and papilledema

They may require differentiation from choroid plexus papilloma

Histologic section display rosettes

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True statements about meningiomas include all the following EXCEPT

They usually presents clinically with headaches or seizures

They constitute about 20 percent of primary brain tumors

@They usually display rapid growth

They arise from arachnoid cap cells

They may be multiple in neurofibromatosis type 2

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The tumor of a brain is diagnosed for the patient with neurologic disturbances. During operation the tumor, which looks like the dense node bound to a firm cerebral membrane, is removed. Histological investigation revealed the neoplasm constructed from endothelium-like cells closely adjoining to each other. What is the most likely diagnosis?

@ Meningioma

Glioblastoma

Anaplastic meningeoma

Astrocytoma

Neuroblastoma

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A 63-year-old woman is hospitalized secondary to markedly decreased vision. She has no history of polydipsia or nocturia. Physical examination finds bilateral sluggish light reflexes and a bitemporal hemianopsia. No papilledema is present, and her urine specific gravity is within normal limits. A CT scan of the head finds a suprasellar mass with calcification. Which of the following is the most likely diagnosis?

@Craniopharingioma

Germinoma

Juvenile pilocytic astrocytoma

Medulloblastoma

Meningioma

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The most frequent of all the following intracranial tumors in adults is

Ependymoma

Medulloblastoma

Meningioma

@Glioma

Metastasis

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A 55-year-old woman is suspected of having a brain tumor because on the onset of seizure activity. Computerized tomograms (CT scan) and skull X-rays demonstrate a mass in the right cerebral hemisphere that is markedly calcific. A high index of suspicion should exist for

@Oligodendroglioma

Astrocytoma

Cerebral lymphoma

Metastatic carcinoma

Brown tumor

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A 44-year-old woman present with the new onset of seizures along with increasing frequency of severe headaches. Her medical history is otherwise unremarkable. Physical examination finds bilateral neurologic defects. Work-up reveals a large, ill-defined, necrotic mass that involves both the right and left cerebral cortex. Histologic sections from this lesion reveal a hypercellular tumor with pseudopalisading of tumor cells around large areal of serpentine necrosis. Numerous atypical nuclei and mitoses are seen. This tumor is best classified as what type of high-grade neoplasm?

@Astrocytoma

Lymphoma

Medulloblastoma

Olidodendraglioma

Schwannoma

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A 38-year-old woman has a seizure while shopping and is taken to the hospital. A scan of a brain demonstrated a poorly circumscribed 5 cm tumor at right parietal lobe. A biopsy of this area contains of increased number of glial cell nuclei and an interening feltwork of file cell processes that give the background a fibrillary appearance. Abnormal mitoses and atypical central nervous system cells were absent within biopsy sample. What is the most likely diagnosis?

@Astrocytoma

Oligodendroglioma

Ganglioneuroma

Ependimoma

Chorioid papilloma

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An 8-year-old boy is noted to have a palpable, firm mass in the region of the right neck after he complains of difficulty swallowing. A head CT scan reveals a 7-cm solid soft tissue mass lateral to the esophagus on the right. Further history indicates that this boy was affected by fetal alcohol syndrome and lie does poorly in school. A biopsy of this mass demonstrates pleomorphic spindle cells that are cytokeratin negative, CD45 negative, and vimentin positive. This mass is most likely to be a (an):

Wilms tumor

Rhabdomyosarcoma

@Neuroblastoma

Ewing's sarcoma

Malignant lymphoma

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A 9-year-old boy who had been suffering from a gait disturbance for several weeks was found to have a posterior fossa mass on CT scan. The most likely cause for these findings is

A berry aneurysm

Astrocytoma

@Medulloblastoma

Oligodendroglioma

Pseudotumur cerebri

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A 5-years-old boy presents with projective vomiting and progressive ataxia.

Work-up finds obstructive hydrocephalus due to an infiltrative tumor originating in the cerebellum. Which of the following is the most likely histologic diagnosis for this cerebellar tumor?

Ependimoma

Glioblastoma multiform

@Meduloblastoma

Oligodendroglioma

Schwannoma

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At autopsy a 8-year-old child is found to have a poorly circumscribed tumor of cerebellum. Histologically investigation reveled crowds of small immature cells with hyperchromatic, round-oval nuclei and scant cytoplasm. A few rosettes were also found by pathologist at slide examination. What is the most likely diagnosis in that case?

@Medulloblastoma

Astrocytoma

Metastasis of cancer

Metastasis of sarcoma

Glioblastoma

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The tumour of a brain is diagnosed for the patient with quickly increasing intracranial hypertension. The removed tumor of a parietal -temporal part of brain had a soft consistence and a motley pattern of a cut surface. Histological investigation revealed neoplastic tissue constructed of polymorphic cells with sites of necroses and a hemorrhage. What is the most likely diagnosis?

@Glioblastoma

Oligodendroglioma

Neuroblastoma

Astrocytoma

Meningioma

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Which of the following tumors is characterized by pseudopalisading, necrosis, endoneureal proliferation, hypercellularity, and atypical nuclei?

Schwannoma

Medulloblastoma

Oligodendraglioma

@Glioblastoma multiforme

Ependymoma

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Retinoblastoma, the most common intraocular tumor of children, is associated with all the following EXCEPT

Occurrence in both familial and sporadic patterns

Unilateral and unifocal sporadic tumors

Inactivation of cancer suppressor genes

@Poor prognosis even with treatment

Frequent histologic occurrence of rosettes

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A child is born with a single functional allele of a tumor suppressor gene. At the age of five the remaining normal allele is lost through a point mutation. As a result, the ability to continue the transition from Gl to the S phase of cell cycle is lost. Which of the following neoplasms is most likely to arise via this mechanism:

Infiltrating ductal carcinoma of breast

Small cell anaplastic carcinoma of the lung

@Retinoblastoma of eye

Cerebral astrocytoma

Chronic myeloid leukemia

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