100 Pathology Q/A Part 3

201 What is a common genetic finding in Ewing’s sarcoma? 
11;22 translocation 
202 What is a common gross pathological sign seen in Ewing’s sarcoma? 
Characteristic ‘onion-skin’ appearance of bone 
203 What is a common origin of a chondrosarcoma? 
May be of primary origin or from osteochondroma 
204 What is a common sign found on the x-ray of a person with osteosarcoma? 
Codman’s triangle (from elevation of periosteum) 
205 What is a craniopharyngioma? 
Benign childhood tumor. Often confused with pituitary adenoma because both can cause bitemporal hemianopsia. Calcification of the tumor is common. 
206 What is a Ewing’s sarcoma? 
Anaplastic small cell malignant tumor. 
207 What is a giant cell tumor? 
Locally aggressive benign tumor around the distal femur, proximal tibial region. 
208 What is a gross pathological sign of basal cell carcinoma? 
Pearly papules 
209 What is a helpful mnemonic to remember the neoplasm associated with Down’s Syndrome? 
We ALL go DOWN together. 
210 What is a helpful mnemonic to remember the site of metastasis to the brain? 
Lots of Bad Stuff Kills Glia 
211 What is a helpful mnemonic to remember the types of cancer that metastasize to the liver? 
Cancer Sometimes Penetrates Benign Liver 
212 What is a helpful mnemonic to remember what tumors metastasize to bone? 
BLT with a Kosher Pickle 
213 What is a Hemangioblastoma? 
Most often a cerebellar tumor. Associated with von Hippel Lindau syndrome when found with retinoblastoma. 
214 What is a low-grade astrocytoma? 
Diffusely infiltrating glioma. In children, it is most commonly found in the posterior fossa. 
215 What is a medulloblastoma? 
Highly malignant cerebellar tumor. A form of primitive neuroectodermal tumor (PNET). Can compress 4th ventricle causing hydrocephalus 
216 What is a neoplasm associated with actinic keratosis? 
Squamous cell carcinoma of the skin 
217 What is a neoplasm associated with Barrett’s esophagus (chronic GI reflux)? 
Esophageal adenocarcinoma 
218 What is a neoplasm commonly associated with chronic atrophic gastritis, pernicious anemia, and postsurgical gastric remnants? 
Gastric adenocarcinoma 
219 What is an oligodendroglioma? 
A relatively rare, slow growing, benign tumor. 
220 What is CEA (carcinoembryonic antigen)? 
Very nonspecific antigen produced by 70% of colorectal and pancreatic cancers and by gastric and breast carcinoma 
221 What is considered a precursor to squamous cell carcinoma? 
Actinic keratosis 
222 What is considered to be a precursor to malignant melanoma? 
Dysplastic nevus 
223 What is meant by the term tumor grade? 
Histologic appearance of the tumor. Usually graded I-IV based on degree of differentiation and number of mitoses per high-power field. 
224 What is meant by the term tumor stage? 
Based on site an size of primary lesion, spread to regional lymph nodes, and presence of metastases. 
225 What is the characteristic appearance of a giant cell tumor on an x-ray? 
Characteristic ‘double bubble’ or ‘soap bubble’ appearance 
226 What is the common histopathology associated with Ependymomas? 
Characteristic perivascular rosettes. Rod-shaped blepharoblasts (basal ciliary bodies) found near the nucleus. 
227 What is the common histopathology associated with Hemangioblastoma? 
Foamy cells and high vascularity are characteristic. Can produce EPO and lead to polycythemia. 
228 What is the common histopathology associated with medulloblastomas? 
Rosettes or perivascular pseudorosette pattern of cells 
229 What is the common histopathology associated with oligodendrogliomas? 
Fried egg’ appearance of cells in tumor. Often calcified. 
230 What is the common histopathology associated with schwannoma? 
Antoni A=compact palisading nuclei; Antoni B=loose pattern 
231 What is the common histopathology found in Glioblastoma multiforme? 
Pseudopalisading’ tumor cells border central areas of necrosis and hemorrhage 
232 What is the differentiation pattern of normal cells? 
Basal to apical differentiation 
233 What is the histopathology commonly associate with giant cell tumors? 
Spindle-shaped cells with multi-nucleated giant cells. 
234 What is the most common benign bone tumor? 
Osteochondroma 
235 What is the most common location of basal cell carcinoma of the skin? 
Usually found in sun-exposed areas of the body. 
236 What is the most common location of osteosarcoma? 
Commonly found in the metaphysis of long bones 
237 What is the most common organ to ‘send’ metastases? 
The lung is the most common origin of metastases. The breast and stomach are also big sources. 
238 What is the most common organ to receive metastases? 
Adrenal glands. This is due to their rich blood supply. The medulla usually receives metastases first and then the rest of the gland. 
239 What is the most common population to have chondrosarcoma? 
Men age 30-60 years old 
240 What is the most common primary brain tumor? 
Glioblastoma multiforme (grade IV astrocytoma) 
241 What is the most common primary malignant tumor of bone? 
Osteosarcoma 
242 What is the most common type of pituitary adenoma? 
Prolactin secreting 
243 What is the most likely population to have Ewing’s sarcoma? 
Boys under 15 years old. 
244 What is the origin of a craniopharyngioma? 
Derived from the remnants of Rathke’s pouch 
245 What is the origin of a Pituitary adenoma? 
Rathke’s pouch 
246 What is the origin of the Schwannoma? 
Schwann cell origin. Often localized to the 8th cranial nerve (acoustic schwannoma). Bilateral schwannoma found in NF2. 
247 What is the peak incidence of giant cell tumor? 
20-40 years old 
248 What is the peak incidence of osteosarcoma? 
Men 10-20 years old 
249 What is the prognosis for Glioblastoma multiforme? 
Prognosis is grave. Usually only have a year life expectancy. 
250 What is the second most common primary brain tumor? 
Meningioma 
251 What is the third most common primary brain tumor? 
Schwannomas 
252 What neoplasias are associated with a-fetoprotein? 
Hepatocellular carcinoma and nonseminomatous germ cell tumors of the testis. 
253 What neoplasias are associated with B-hCG? 
Hydatidiform moles, Choriocarcinomas, and Gestational trophoblastic tumors. 
254 What neoplasias are associated with CA-125? 
Ovarian and malignant epithelial tumors 
255 What neoplasias are associated with S-100? 
Melanoma, neural tumors, and astrocytomas 
256 What neoplasm is associated with Cirrhosis (due to alcoholism, Hep B, or Hep C) 
Hepatocellular carcinoma 
257 What neoplasm is associated with Dysplastic nevi? 
Malignant melanoma 
258 What neoplasm is associated with Immunodeficiency states? 
Malignant lymphomas 
259 What neoplasm is associated with Plummer-Vinson syndrome (atrophic glossitis, esophageal webs, and anemia; all due to iron deficiency) 
Squamous cell carcinoma of the esophagus 
260 What neoplasm is associated with ulcerative colitis? 
Colonic adenocarcinoma 
261 What oncogene is associated with breast, ovarian, and gastric carcinomas? 
erb-B2 
262 What oncogene is associated with Burkitt’s lymphoma? 
c-myc 
263 What oncogene is associated with colon carcinoma? 
ras 
264 What oncogene is associated with Follicular and undifferentiated lymphomas (inhibits apoptosis)? 
bcl-2 
265 What tumor marker is associated with Prostatic carcinoma? 
PSA (Prostatic acid phosphatase) 
266 What tumor suppressor gene is associated with Retinoblastoma and osteosarcoma? 
Rb gene 
267 What type of metastases are common in the late stages of prostatic adenocarcinoma? 
Osteoblastic metastases in bone 
268 What type of neoplasm is associated with Acanthosis nigricans (hyperpigmentation and epidermal thickening) 
Visceral malignancies (stomach, lung, breast, and uterus) 
269 What type of skin cancer is associated with excessive exposure to sunlight or arsenic exposure? 
Squamous cell carcinoma 
270 Where are chondrosarcomas usually located? 
Pelvis, spine, scapula, humerus, tibia, or femur. 
271 Where are Ewing’s sarcomas most commonly found? 
Diaphysis of long bones, pelvis, scapula, and ribs 
272 Where are Glioblastoma multiformes found? 
Cerebral hemispheres 
273 Where do giant cell tumors most commonly occur? 
At epiphyseal end of long bones 
274 Where do meningiomas most commonly occur? 
Convexities of hemispheres and parasagital region 
275 Where do oligodendrogliomas most often occur? 
Most often found in the frontal lobes 
276 Where do osteochondromas commonly originate? 
Long metaphysis 
277 Where do squamous cell carcinomas most commonly occur? 
Hands and face 
278 Where does prostatic adenocarcinoma most commonly arise? 
From the posterior lobe (peripheral zone) of the prostate gland 
279 Which has more prognostic value: tumor stage or grade? 
Stage 
280 Which is more common: metastasis to bone or primary tumors of bone? 
Metastatic bone tumors are far more common than primary tumors 
281 Which is more common: metastasis to the liver or primary tumors of the liver? 
Metastasis to the liver is more common 
282 Which tumor suppressor gene is associated with most human cancers and the Li-Fraumeni syndrome? 
p53 
283 Which tumor suppressor genes are associated with breast and ovarian cancer? 
BRCA 1 and 2 
284 ___% of African-Americans carry the HbS trait, and ___% have the disease. 
8%; 0.2 
285 ________ = defect of platelet aggregation 
Glanzmann’s thrombasthenia 
286 ________ disease = defect of platelet adhesion 
Bernard-Soulier 
287 _____= activation of coagulation cascade leading to microthrombi and global consumption of platelets, fibrin, and coagulation factors. 
DIC (Disseminated intravascular coagulation) 
288 2 therapies for sickle cell anemia: 
1. Hydroxyurea (increased HbF) 2. bone marrow transplantation 
289 50% of Hodgkin’s cases are associated with which virus? 
EBV 
290 7 causes of normocytic normochromic anemia: 
1. hemorrage 2. enzyme defects (e.g., G6PD deficiency, PK deficiency) 3. RBC membrane defects (e.g., hereditary spherocytosis) 4. Bone Marrow disorders (e.g., aplastic anemia, leukemia) 5. Hemoglobinopathies (e.g., sickle cell) 6. Autoimmune hemolytic anemia 7. Anemia of chronic disease 
291 Antiplatelet antibodies and increased megakaryocytes are seen in ____. 
ITP 
292 Auer rods, myeloblasts, adults = 
AML 
293 bcl-2 activation is associated with which translocation and which lymphomas? 
t(14;18) – Follicular lymphomas 
294 bcr-abl hybrid is associated with which translocation and which leukemia? 
t(9;22) – CML 
295 Blood smear of a Multiple Myeloma patient would show what? 
RBCs stacked like poker chips (rouleau formation) 
296 Burkitt’s lymphoma: ‘______’ appearance associated with what virus? endemic where? 
starry sky’ EBV Africa 
297 c-myc activation is associated with which translocation and which lymphoma? 
t(8;14) – Burkitt’s 
298 Causes of aplastic anemia: 
radiation, benzene, chloramphenicol, alkylating agents, antimetabolites, viral agents (HCV,CMV,EBV, herpes zoster-varicella), Faconi’s anemia, idiopathic (immune-mediated, primary stem cell defect) 
299 Causes of platelet abnormalities: 
ITP, TTP, drugs, DIC 
300 CFU-GM (colony forming unit-granulocyte-monocyte) gives rise to which cells? 
monocytes, neutrophils and basophils 

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