1 | Adenoma | Metastasis

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    Transcribers:  BALMES, BRODITH, DEJAÑO, PALMA , PUGAY Page 1  of 5   1 s  Shifting Exam RECALLS No. Questions Answers/Notes 1 What device is used in rush tissue biopsies to distinguish benign and malignant in rapid biopsy? a. Microrome b. Cryostat c. Tissue aspiration Cryostat 2 The stain containing mercuric chloride and considered one of the best that has ever been devised for light microscopy: a. Zenker's b. Bouin's c. Carnoy's Zenker’s   3 Volume of 10% buffered formalin in relation to specimen A. 5x B. 10x C. 15x D. 20x At least 10 times 4 Fixative agent with picric acid, used for testicular biopsy? Bouin’s fixative   5 6 Tissue submitted for histology must be Must not be more than 3mm thick  and not larger than the dimension of the cassette used 7 Most useful application in renal and tumor pathology a. x-ray microanalysis b. electron microscopy c. flow cytometry d. cytogenetics electron microscopy 8 Used to determine nature of crystalline (foreign body) in tumor? A. Cytogenetics B. Electron microscopy C. Flow cytometry D. Immunohistochemistry Wala sa choices ang sagot     ANSWER: X-ray microanalysis   –  to determine crystalline material (usually foreign body) Rosai and Ackerman’s Surgical Pathology (10 th  Edition) Mosby Elsevier © 2011  9-12 Matching Type Calcium Melanin (Fontana Masson Stain) Hemosiderin Glycogen Amyloid 9 Periodic acid-Schiff Glycogen 10 Perls stain Hemosiderin 11 Von Kossa Stain Calcium 12 Congo red Amyloid 13 14 Tumor marker for primary ovarian tumor a. S-100 b. CEA c. CA-125 d. CK-7 e. TTF-1 CA-125 15 Hmb 45 is the IHC for Melanoma 16-25 AUTOPSY –  no questions 26 Immunomarker to distinguish cutaneous metastasis from lung adenocarcinoma and breast carcinoma a. S-100 b. CEA c. CA-125 d. CK-7 e. TTF-1 TTF-1 27 Metastatic clear cell carcinoma of skin most likely srcinate from? a. Endometrial b. Ovarian c. Lung d. Pancreatic e. Renal In males, the most common sources of metastatic tumor to the skin are lung (25%), large bowel, skin (melanoma), kidney, and upper aerodigestive tract. In females, the breast is by far the most common source (69%), followed by the lung, skin (melanoma), kidney, and ovary. Most cases are multiple and appear as firm, nonulcerated   First Shifting Exam Recalls Transcribers:  BALMES, BRODITH, DEJAÑO, PALMA , PUGAY Page 2  of 5   nodules. When solitary, they may be misdiagnosed as primary skin tumors which is particularly true for renal cell carcinoma . Pero walang sinabi na clear cell sya. Rosai and Ackerman’s Surgical Pathol  ogy (10 th  Edition) Mosby Elsevier © 2011  28 Most common srcin of umbilical node metastasis (Sister Mary Joseph Node) The colloquial term ‘Sister (Mary) Joseph’s nodule’ refers to umbili- cal metastases from malignancies of the female genital tract, usually OVARIAN CARCINOMA Rosai and Ackerman’s Surgical Pathology (10 th  Edition) Mosby Elsevier © 2011  29 Least likely to metastasize in the skin Colorectal CA 30 Which is not true of the following in Sezarry Syndrome associated with cutaneous T-cell lymphoma a. b. c. erythroderma   d. lymphadenoma e. Sary syndrome is a lymphoproliferative disorder usually of CD4- positive T-helper lymphocytes, related to mycosis fungoides and defined by the presence of ERYTHRODERMA, GENERALIZED LYMPHADENOPATHY , and neoplastic T cells in the blood, skin, and lymph nodes. PAS (+), CEREBRIFORM NUCLEUS   Rosai and Ackerman’s Surgical Pathology (10 th  Edition) Mosby Elsevier © 2011  31 Carney complex is a characteristic of which of the following Carney triad: pulmonary condroma, extra-adrenal paraganglioma, and GIST Rosai and Ackerman’s Surgical Pathology (10 th  Edition) Mosby Elsevier © 2011 Carney Complex: with spotty pigmentation of the skin, endocrinopathy, and tumors (endocrine and non-endocrine) Basson (2014) Carney complex. emedicine.medscape.com/article/160000 32 Which microscopic finding would differentiate a spit-nevus from melanoma? a. something about junction b. lack of maturation c. mitosis d. […] e. […] Features that favor a diagnosis of Spitz nevus over one of malignant melanoma are symmetric  shape; sharp lateral demarcation; maturation in depth; arrangement of the spindle cells perpendicularly to the skin surface; presence of tadpole and multinucleated giant cells ; lack of upward epidermal spread (but see above); presence of telangiectasia, edema, and fibrosis; presence of eosinophilic hyaline bodies along the dermoepidermal junction  thought to be made of basement membrane material ( Kamino bodies ); and lack of ulceration. Rosai and Ackerman’s Surgical Pathology (10 th  Edition) Mosby Elsevier © 2011 33-34 35 Which of the following is not a risk factor for melanoma? a. Age >50 yrs old b. pale skin c. xeroderma pigmentosum d. seborrheic keratosis e. ultraviolet light exposure Age >50 yrs old (no age predilection) seborrheic keratosis ( walang sinabi regarding this)  36 Which of the following is NOT a characteristic of a melanoma? a. irregular border b. >4mm width/size c. uniform in color d. >1mm thickness  According sa Robbins and Rosai, Melanoma has varying color from tan brown, to yellow, gray, blue. Hindi ako sure kung ito bay un. Walang naka indicate na specific size and thickness sa book pag melanoma.     37-41 42 Zellballen architecture a. melanoma b. mesothelioma c. neuroblastoma d. paraganglioma e. thymic cancer Paraganglioma  43 44 Predominantly epithelial, spindle cell thymoma resemble morphologically which of the following? a. Lipoma b. Hemangiopericytoma c. Schwannoma Wala sa Rosai     Sa internet naman SCHWANNOMA ang may Spindle shape :] 45 Most common cause of superior vena cava LYMPHOMA     First Shifting Exam Recalls Transcribers:  BALMES, BRODITH, DEJAÑO, PALMA , PUGAY Page 3  of 5   syndrome: a. Acute leukemia b. Fibrosing mediastinitis c. Lymphoma d. Pericardial cyst e. Thymic carcinoma ADULTS: metastatic lung CA and malignant lymphoma CHILDREN: malignant lymphoma and acute leukemia 46-47 48 Immature teratoma in mediastinum is diagnosed as immature a. Bone and cartilage making mesenchyme b. Neuroepithelial c. Squamous epithelial d. Striated Muscle Immature teratoma is defined, as in other sites, as a germ cell tumor similar to mature teratoma but also containing immature epithelial, MESENCHYMAL, or NEURAL ELEMENTS without a component of embryonal carcinoma Rosai and Ackerman’s Surgical Pathology (10 th  Edition) Mosby Elsevier © 2011  49-50 51 Tumor is encapsulated, no LN mets and distant mets a. stage I b. II c. III d. IV Stage I 52 In TNM: T - pleural dissemination, N- no regional lymph node metastasis, M - no distant metastasis a. Stage 0 b. Stage 1 c. Stage 2 d. Stage 3 e. Stage 4 In Masaoka Staging system: Stage IV  (pleural or pericardial dissemination) 53 54 Pericardial cyst is located where in the mediastinum? Pericardial (coelomic) cysts are usually located at the right cardiophrenic angle. Less commonly, they are seen in a suprapericardial position. Rosai and Ackerman’s Surgical Pathology (10 th  Edition) Mosby Elsevier © 2011   from net:  Anterior (and middle) mediastinum 55-57 58 58. True of parafollicular cells a. numerous among adults b. base of the lobes c. Reactive to CEA d. Mesenchymal in srcin Immunoreactive to CEA a - Numerous in infancy and old age; b - Restricted to middle and upper thirds of the lateral lobes; d - Neural crest srcin 59 True of thyroglossal duct cyst a. Located in midline b. Lining epithelium positive with thyroglobulin c. Treatment is medical d. More common in males Usually LOCATED MIDLINE , in the region of the hyoid bone b - lining epithelium is pseudostratified TTF-1 (+), Thyroglobulin (-); c - treatment is surgical; removal; d - no gender predilection 60-63 64 Features of myxedema a. Causes difficulty of breathing b. Hyperactive bowels Causes difficulty of breathing 65 66 True of Follicular thyroid carcinoma a. Encapsulated b. Common in areas dietary deficiency of iodine c. More common in males d. All of the above Common in areas with dietary deficiency of iodine 67 68 Which describes follicular adenoma? ENCAPSULATED , most common thyroid neoplasm, most are euthyroid, benign, increased circulating thyroglobulin 69 True of papillary Thyroid Carcinoma a. More common in men b. Good prognosis in men c. Most common primary malignancy of thyroid Most common primary malignancy of thyroid a –  more common in females b –  good prognosis to everyone, but females have a better prognosis than males Rosai and Ackerman’s Surgical Pathology (10 th  Edition) Mosby Elsevier © 2011     First Shifting Exam Recalls Transcribers:  BALMES, BRODITH, DEJAÑO, PALMA , PUGAY Page 4  of 5   70 Which of the ff is associated with amyloid deposits a. Papillary carcinoma b. Follicular carcinoma c. Medullary carcinoma d. Undifferentiated (Anaplastic) carcinoma Medullary carcinoma 71 Which of the following is a true about salivary gland malignancy a. Malignancy is directly proportional to gland size b. Malignancy is inversely proportional to gland size c. Malignancy is inversely proportional to type of salivary gland d. Malignancy is directly proportional to type of salivary gland Malignancy is inversely proportional to gland size 72 73 Used to distinguish clinically benign and malignant tumors of salivary gland a. Tumor size b. Tumor mobility c. Facial nerve involvement d. None NONE There are no reliable criteria to differentiate benign from malignant lesions on clinical grounds, and histopathologic evaluation is essential. Robbins Basic Pathology (9 th  Edition) Elsevier © 2013 74 75 Most common type of malignancy in minor salivary glands Adenoid cystic carcinoma 76 Most common neoplasm of the salivary a. acinar CA b. mucoepidermoid CA c. pleomorphic adenoma Pleomorphic adenoma 77 Most common malignant salivary gland tumor in children a. Pleomorphic AdenoCA b. Colloid CA c. Mucoepidermoid carcinoma d. Adenoid cystic carcinoma Mucoepidermoid Carcinoma 78 79 Invasive with perineural invasion? Adenoid cystic CA 80 Salivary gland tumor with epithelial cells and rich in mucin? a. Pleomorphic AdenoCA b. Colloid CA c. Mucoepidermoid carcinoma d. Adenoid cystic carcinoma Colloid CA or Mucinous Adenocarcinoma 81 Also known as cystadenoma lymphomatousum papilliferum a. Basal cell adenoma b. Warthin Tumor c. Oncocytic Myoepithelioma d. Oxyphilic carcinoma Warthin Tumor 82 Immunohistochemistry result for primary salivary gland tumor a. CK 7 (-)/ CK 20 (+) b. CK 7 (+)/ CK 20 (-) c. CK 7 (+)/ CK 20 (+) d. CK 7 (-)/ CK 20 (-) CK 7 (+)/ CK 20 (-) 83 What is the most common malignancy of minor salivary lesions? a. Mucoepidermoid cyst b. Pleomorphic adenoma c. Adenoid cystic CA d. Basal cell CA Adenoid cystic CA 84 Foci of mature bone seen in a. Basal cell CA b. Pleiomorphic adenoma c. Oncocytoma d. Mucoepidermoid carcinoma Pleiomorphic adenoma 85 What is the most common primary parotid neoplasm in children? a. Lymphopeithelial-like carcinoma
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