Neoplasia

Topics in this chapter

• Neoplasia Foundations
• Molecular Carcinogenesis and Cell Cycle
• Oncogenic Viruses and HPV
• Tumor-Host Interactions and Paraneoplastic Syndromes
• Molecular Diagnostics and Immunohistochemistry
• Organ-Specific and Hematologic Tumors
• Cancer Spread and Staging

Practice questions

1. Question 1Q-3F9D43

   A 54-year-old chronic smoker presents with a central lung mass. Biopsy reveals small, dark, round-to-oval cells with scanty cytoplasm, finely granular chromatin, and absent nucleoli. Immunohistochemistry is positive for chromogranin and synaptophysin. Which of the following paraneoplastic syndromes is most characteristically associated with this specific tumor?

   1. A.Hypercalcemia due to PTH-related protein secretion
   2. B.Lambert-Eaton myasthenic syndrome due to antibodies against presynaptic voltage-gated calcium channels
   3. C.Polycythemia due to erythropoietin production
   4. D.Hypoglycemia due to insulin-like growth factor secretion
   See the answer and solution
2. Question 2Q-AF98A9

   A 62-year-old male undergoes surgical resection of a colonic polyp. Histopathological examination reveals a pedunculated lesion with malignant glands invading through the muscularis mucosae into the submucosa of the stalk, but the resection margin is clear and there is no lymphovascular invasion. What is the most appropriate next step in management and staging term for this lesion?

   1. A.Total colectomy because any invasion beyond the muscularis mucosae is invasive carcinoma
   2. B.No further surgery required, as it is classified as a pT1 malignant polyp completely excised
   3. C.Adjuvant systemic chemotherapy only, as submucosal invasion equates to node-positive disease
   4. D.Immediate re-excision of the colon segment due to high risk of distant metastasis
   See the answer and solution
3. Question 3Q-D4BB65

   Which of the following classic translocation events is correctly paired with its resulting fusion oncogene and corresponding hematologic malignancy?

   1. A.t(8;14) - MYC/IGH - Chronic Myeloid Leukemia
   2. B.t(9;22) - BCR/ABL1 - Acute Promyelocytic Leukemia
   3. C.t(15;17) - PML/RARA - Acute Promyelocytic Leukemia
   4. D.t(11;14) - BCL2/IGH - Burkitt Lymphoma
   See the answer and solution
4. Question 4Q-23543A

   A researcher is studying the chemical carcinogenesis pathway in a laboratory model. Exposure to an ultimate carcinogen typically leads to direct covalent binding with cellular macromolecules. Which of the following is the primary target for most chemical carcinogens leading to malignant transformation?

   1. A.Cellular membrane phospholipids
   2. B.Nuclear DNA
   3. C.Ribosomal RNA
   4. D.Cytoplasmic structural proteins
   See the answer and solution
5. Question 5Q-BEAB8F

   A 45-year-old woman presents with multiple cutaneous tumors, bilateral hearing loss due to vestibular schwannomas, and multiple meningiomas. Genetic testing reveals a germline mutation in the NF2 gene on chromosome 22q. The product of this gene, merlin, normally functions as which of the following?

   1. A.A receptor tyrosine kinase
   2. B.A cytoplasmic GTPase-activating protein
   3. C.A cytoskeletal-associated tumor suppressor protein connecting membrane proteins to actin filaments
   4. D.A DNA mismatch repair enzyme
   See the answer and solution