Pathoma Chapter 3: Questions With Correct Solutions
What three features distinguish neoplasia from hyperplasia and repair?
Right Ans - Unregulated, irreversible, and monoclonal
Monoclonal Definition Right Ans - All the (neoplastic) cells are derived
form a single mother cell
How was clonality historically determined? Right Ans - Glucose-6-
phosphate dehydrogenase enzyme isoforms (also androgen receptor
isoforms); both are on the X chromosome
What is the ratio of G6PD isoforms in hyperplasia? Right Ans - Still 1:1
What is the ratio of G6PD isoforms in neoplasia? Right Ans - No longer 1:1;
one isoform will dominate
What is a secondary way clonality can be determined? Right Ans -
Androgen receptor isoforms, which are also on the X chromosome
How is clonality of B lymphocytes determined? Right Ans - Ig light chain
phenotype
What are the two type of light chains that can make up the light chain of Ig?
Right Ans - Kappa and Lambda (each light chain can only have one)
What is the ratio of kappa to lambda light chains in normal lymph nodes?
Right Ans - 3:1
What is the kappa to lambda light chain ratio in hyperplasia? Right Ans -
3:1
What is the kappa to lambda light chain ratio in a neoplastic proliferation (i.e.
lymphoma) Right Ans - 6:1 or reversed to 1:3 (i.e. ratio is no longer 1:3)
Differential diagnosis of enlarged lymph node (3 things) Right Ans - 1.
Metastatic cancer
2. Reactive hyperplasia (infection)
3. Lymphoma
,Two types of neoplasia Right Ans - Benign or malignant
What is the clonality of benign versus malignant neoplasia? Right Ans -
Both are monoclonal
Characteristics (two) of benign neoplasia Right Ans - Remain localized and
do not metastasize
Characteristics (two) of malignant neoplasia Right Ans - Invade locally and
have the potential to metastasize (although they may not metastasize in every
individual patient)
Name two benign tumors of epithelium Right Ans - Adenoma and
papilloma
Name two malignant tumors of epithelium Right Ans - Adenocarcinoma
and papillary carcinoma
What do adenomas/adenocarcinomas produce? Right Ans - Glands
What do papillomas/papillary carcinomas produce? Right Ans - Papillary
fingerlike structures
What is a papillary finger-like structure that characterizes papilloma and
papillary carcinoma? Right Ans - Overgrowth of epithelial cells that
overlies a connective tissue core with a blood vessel in the center
Benign tumor of mesenchymal fat tissue Right Ans - Lipoma (benign tumor
of fat)
Malignant tumor of mesenchymal fat tissue Right Ans - Liposarcoma
(always ends in -sarcoma)
Benign tumor of mesenchymal bone tissue Right Ans - Osteoma
Malignant tumor of mesenchymal bone tissue Right Ans - Osteosarcoma
Benign tumor of mesenchymal cartilagenous tissue Right Ans - Chondroma
, Malignant tumor of mesenchymal cartilagenous tissue Right Ans -
Chondrosarcoma
Benign tumor of mesenchymal blood vessel tissue Right Ans - Angioma
Malignant tumor of mesenchymal blood vessel tissue Right Ans -
Angiosarcoma
Benign tumor of lymphocytes Right Ans - Does not exist
What are the two malignant types of lymphocyte neoplasia? Right Ans -
Lymphoma or leukemia
Benign tumor of melanocytes Right Ans - Nevus (mole)
Malignant tumor of melanocytes Right Ans - Melanoma
What is the second leading cause of death in adults and children? Right Ans
- Cancer
Name the top three causes of death in adults Right Ans - 1. Cardiovascular
disease
2. Cancer
3. Chronic respiratory disease (or cerebrovascular disease)
Name the top three causes of death in children Right Ans - 1. Accidents
2. Cancer
3. Congenital defects
What are the most common cancers by INCIDENCE in adults (excluding
squamous cell carcinoma and basal cell carcinoma of the skin) Right Ans -
1. Breast/prostate
2. Lung
3. Colorectal
What are the most common cancers by MORTALITY in adults Right Ans - 1.
Lung
2. Breast/prostate
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