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PathMD Quizes, GU Pathology

GU Pathology – 01

October 29, 2017 peferguson

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1. A 3 year old boy presents with a large abdominal mass consistent with neuroblastoma. All of the following statements regarding this condition are correct, EXCEPT:

Over 80% are detected in children under the age of 4

Hemorrhage, calcification and necrosis are common macroscopic features

Histologically, the most prominent feature is presence of Homer Wright rosettes

It is associated with the Beckwith-Wiedemann syndrome, Hirschsprung's disease and neurofibromatosis

Two characteristic genetic events are loss of a distal region of chromosome 1p and amplification of N-myc oncogene

2. This subtype of prostatic carcinoma overall has a better prognosis than the usual acinar type:

Small cell carcinoma

Mucinous adenocarcinoma

Adenoid basal cell tumor (adenoid cystic tumor)

Signet ring carcinoma

Ductal carcinoma

3. 63 year old male with a history of bilateral ocular MALT lymphoma treated with radiation therapy. He now presents with diffuse pelvic infiltrative process involving the bladder, prostate, seminal vesicles, rectosigmoid, distal ureters, and adjacent muscles. Bladder and prostate biopsies were performed. Based on histology, the process is most consistent with:

Invasive transitional cell carcinoma (urothelial neoplasm)

High-grade lymphoma

Idiopathic retroperitoneal fibrosis

High grade prostatic adenocarcinoma

Recurrent MALT lymphoma

4. The following statements regarding normal prostate are true, EXCEPT:

Lipofuscin pigment helps differentiate seminal vesicle tissue from prostatic glands

Denonvillier's fascia separates the prostate and seminal vesicles from the rectum

Skeletal muscle of the urogenital diaphragm extends into the prostate in its most apical aspect

Large number of neuroendocrine cells are present in prostatic epithelium

Anterior fibromuscular stroma occupies approximately 1/3 of the prostate, contains very few glands and consists of smooth muscle and dense fibrous tissue

5. A 42 yo female presented with hypertension, Cushing's syndrome and virilization. A representative section from her resection specimen is consistent with an adrenal cortical carcinoma. All of the following features are part of diagnostic criteria for this tumor EXCEPT:

Tumor weight

Diffuse growth pattern

Cellular pleomorphism

Tumor necrosis

Vascular invasion

6. All of the following statements are correct regarding this kidney neoplasm, EXCEPT:

Staging is the most important prognostic determinator

90% of the cases occur before the age of 6

Lesions are divided into favorable and unfavorable histology groups based on the degree of anaplasia

It always has three components: undifferentiated blastema, mesenchymal tissue and epithelial tissue

It is associated with Beckwith-Wiedemann and Denys-Drash syndromes

7. All of the following parameters are associated with adverse outcome in prostatic carcinoma, EXCEPT:

Nodal metastases

Involvement of seminal vesicle

Positive surgical margins

Extraprostatic extension

Perineural invasion

8. If seen on a prostate core biopsy this prostatic adenocarcinoma would be best graded as Gleason score =3 for 60%, Gleason score = 4 for 25%, and Gleason score = 5 for 15%. How would the case be scored overall?

Gleason score 4 + 5 = 9/10

Gleason score 3 + 3 = 6/10

Gleason score 3 + 4 = 7/10

Gleason score 3 + 5 = 8/10

Gleason score 5 + 3 = 8/10

9. All of the statements concerning a fibroepithelial polyp of the bladder are true, EXCEPT:

There is a female predominance

It is mostly found in children and young adults

This lesion has no malignant potential

It occurs most commonly at the ureteropelvic junction and upper ureter

It represents a mesenchymal tumor

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