MLT GlobeBasic Pathology: Neoplasia – page 5
120 Basic Pathology MCQs on Neoplasia with answers and explanations.
Tumour cells bypass the nearest lymph node and first appear in a more distant node of the chain. This is called:
Skip metastases occur when cells travel through lymphatics past proximal nodes to lodge in later ones, so a negative first node does not exclude spread.
Which property most reliably distinguishes a neoplasm from a reactive mass such as a granuloma?
Neoplasia is defined by unregulated, autonomous proliferation. Necrosis and rapid growth also occur in granulomas and abscesses.
A carcinoma arising in the bronchi usually spreads via lymphatics first to which nodes?
Lymphatic spread follows drainage: regional bronchial nodes first, then tracheobronchial and hilar nodes, and later more distant groups.
Which pairing of tumour type with its typical route of spread is correct?
Carcinomas typically metastasise first to lymph nodes, whereas sarcomas favour haematogenous spread, often to lungs.
Xeroderma pigmentosum, with extreme sun sensitivity and early skin cancers, is best described as:
XP patients cannot remove UV-induced pyrimidine dimers because nucleotide excision repair genes are defective; inheritance is autosomal recessive.
Occupational exposure to ethylene oxide, a sterilising gas, is chiefly associated with which malignancy?
Ethylene oxide is an IARC group 1 carcinogen linked mainly to leukaemia/lymphoma. Hepatic angiosarcoma follows vinyl chloride; mesothelioma follows asbestos.
Which gestational trophoblastic lesion is non-invasive and is the usual benign form of trophoblastic proliferation?
A complete or partial mole is an abnormal but non-invasive placental proliferation. Choriocarcinoma is malignant; seminoma is a testicular germ cell tumour.
A lung nodule consists of disorganised but mature cartilage, bronchial epithelium and fat, all native to the lung. It is a:
A hamartoma is a disorganised mass of tissues normally found at that site. A choristoma is normal tissue in an abnormal location.
Liver metastases from colorectal carcinoma usually reach the liver through the:
Haematogenous spread follows venous drainage; bowel tumours drain via the portal vein, so the liver is the first capillary bed encountered.
Apart from metastasis, which feature most reliably separates a malignant tumour from a benign one?
Metastasis is the definitive criterion; next comes progressive infiltration and destruction of adjacent tissue. Mitoses occur in benign tumours too.
A uterine leiomyoma is sharply separated from the myometrium only by a rim of compressed normal muscle. This means it:
Some benign tumours, like leiomyomas, are demarcated by compressed tissue (a pseudocapsule) rather than a true capsule, yet do not invade.
A medulloblastoma produces 'drop metastases' along the spinal canal. This dissemination occurs through:
Tumours entering the ventricles or subarachnoid space shed cells that implant along CSF pathways, a form of cavity seeding.
The weight loss, muscle wasting, anorexia and weakness of advanced cancer (cachexia) are mainly caused by:
Cachexia is driven by cytokines (TNF, IL-1, IL-6) and tumour factors that increase catabolism, not simply by the tumour's caloric demands.
Which is NOT a feature of anaplastic tumour cells?
Anaplastic cells show pleomorphism, hyperchromatic nuclei, loss of polarity and atypical mitoses. Exclusively typical mitoses do not indicate anaplasia.
Cancer cells avoid replicative senescence and become immortal mainly through:
Limitless replicative potential results from telomerase activity that maintains telomere length, preventing senescence.
The word 'tumour' originally described which feature?
Tumour once meant any swelling (a cardinal sign of inflammation); today it is used as a synonym for neoplasm.
Which property is shared by benign and malignant neoplasms and therefore does NOT help tell them apart?
Both benign and malignant tumours are clonal proliferations. Differentiation/anaplasia, invasion and metastasis are the classic distinguishing criteria.
Seminoma is a malignant tumour arising from which cells of the testis?
Seminoma is the commonest testicular germ cell tumour. Leydig and Sertoli cells give rise to sex cord-stromal tumours.
What mainly distinguishes lymphoma from leukaemia?
Both are malignant haematolymphoid neoplasms. Lymphomas present as nodal or extranodal masses; leukaemias widely involve marrow and circulating blood.
The terms differentiation and anaplasia describe which component of a tumour?
Differentiation refers to how closely the neoplastic parenchyma resembles its normal counterpart; stroma is non-neoplastic.