MLT GlobeBasic Pathology: Neoplasia – page 2
120 Basic Pathology MCQs on Neoplasia with answers and explanations.
By which route do breast carcinoma cells typically reach the axillary lymph nodes?
Carcinomas typically spread first via lymphatics to regional nodes; axillary nodes drain most of the breast.
A child with bilateral retinal tumours has a germline loss-of-function mutation in which tumour-suppressor gene?
Retinoblastoma follows Knudson's two-hit model at the RB1 locus on 13q14. PTCH1 is linked to Gorlin syndrome, TP53 to Li-Fraumeni.
A cervical smear shows cells varying in size and shape with dark, coarse nuclear chromatin. These features indicate:
Dysplasia shows pleomorphism, nuclear hyperchromasia, raised N:C ratio and loss of orderly maturation. Metaplasia replaces one normal cell type with another.
Ovarian carcinoma producing numerous tumour nodules on the peritoneal surfaces has spread by:
When tumour penetrates into a natural cavity, cells detach and implant on serosal surfaces (transcoelomic seeding), typical of ovarian cancer.
Every tumour, benign or malignant, is made of which two basic components?
The parenchyma is the proliferating neoplastic cells that determine behaviour; the stroma is connective tissue and vessels that support them.
Basal cell carcinoma of skin and most primary CNS tumours are locally destructive but:
These tumours invade locally, yet distant metastasis is uncommon, an exception to the rule that malignant tumours metastasise.
Loss of uniformity of individual cells and of their architectural orientation in an epithelium, short of invasion, defines:
Dysplasia is disordered growth with pleomorphism and loss of polarity. When it spans full thickness without invasion it is carcinoma in situ.
An ovarian tumour contains skin, hair, teeth, cartilage and gut epithelium. Tissues derived from several germ layers indicate a:
Teratomas arise from totipotent germ cells and contain tissues from more than one germ layer. Hamartomas contain only local tissues.
A malignant tumour arising from fibroblasts, bone or smooth muscle is classified as a:
Malignancies of mesenchymal origin are sarcomas (e.g., fibrosarcoma, osteosarcoma). Carcinomas are epithelial; fibromas are benign.
Which feature unequivocally establishes that a tumour is malignant?
Metastasis (spread to discontinuous sites) is definitive for malignancy. Anaplasia and rapid growth are suggestive but not absolute.
Which gross feature is more typical of a malignant than a benign tumour?
Malignant tumours lack a well-formed capsule and infiltrate surrounding tissue. Benign tumours are often encapsulated and easily enucleated.
The term 'anaplasia' literally means:
Anaplasia ('to form backward') implies loss of differentiation, though tumours actually arise from stem cells rather than dedifferentiation.
Acquired capabilities such as sustained proliferative signalling, evasion of apoptosis and angiogenesis are collectively termed:
Accumulating mutations confer a set of functional capabilities shared by most cancers, known as the hallmarks of cancer.
A tumour cannot grow beyond 1 to 2 mm without which process?
Beyond this size diffusion cannot supply oxygen and nutrients; VEGF-driven new vessel formation sustains growth.
The literal meaning of 'neoplasia' is:
Neoplasia means new growth; an uncontrolled, autonomous proliferation that persists after the initiating stimulus.
Which gross feature most suggests a benign tumour?
Benign tumours tend to be encapsulated and homogeneous. Necrosis, haemorrhage and infiltration are typical of malignancy.
Despite the '-oma' suffix usually indicating a benign tumour, which of these is malignant?
Melanoma, lymphoma, seminoma and mesothelioma are malignant by convention; lipoma, papilloma and adenoma are benign.
Which is the commonest testicular germ cell tumour, noted for its radiosensitivity?
Seminoma accounts for about half of testicular germ cell tumours and responds well to radiotherapy.
Benign and malignant tumours are compared using differentiation/anaplasia, local invasion, metastasis and:
These four features are the classic criteria. Malignant tumours usually grow faster, though growth rate varies widely.
A malignant tumour of glandular epithelium, such as in the colon, is termed:
Carcinomas derive from epithelium of any germ layer; glandular growth defines adenocarcinoma. Adenoma is its benign counterpart.