AP Questions Part 1 Flashcards
1
Q
How many thin prep/automated slides can cytologies read over 24 hours/work day?
A
200 (because don’t need full manual review / spread over small circle on the slide and doesn’t take up the slide) — for regular cyto slides the limit is 100
2
Q
What disease results in accumulation of sphingomyelin in lysosomes in the spleen, liver, lungs, bone marrow, and CNS?
A
Neimann-Pick disease
3
Q
What mutation is seen in lipoblastoma?
A
PLAG1
4
Q
Mutation of hexosaminidase A with accumulation of GM2 ganglioside - what disease? What gene?
A
Tay-Sachs, HEXA gene (Hebrew hex)
5
Q
Paget’s disease of the nipple is positive for what two and negative for what two IHCs?
A
Positive: CK7(cytoplasmic/memb), her2
negative: ER, PR
6
Q
What 4 breast carcinomas have worse prognosis than IDC?
A
Basal-like breast carcinoma, invasive micropapillary carcinoma, metaplastic carcinoma, and her2+ carcinomas
7
Q
What 5 breast carcinomas have better prognosis than IDC?
A
Secretory, medullary, adenoid cystic, tubular, colloid
8
Q
BRCA1/2 increases risk of what 4 cancers?
A
1) breast (including medullary carcinoma)
2) ovary (including serous cystadenocarcinoma and STIC-serous tubal intraepithelial carcinoma; submit entire fallopian tube/ovary for microscopic exam if they have this mutation)
3) colon
4) prostate
9
Q
What 4 disorders is paraganglioma associated with?
A
VHL, NF1, MEN syndromes, and carneys triad
10
Q
What tumors are associated with VHL?
A
- RCC
- pheochromocytoma, paraganglioma
- angioma, hemangioblastoma
- cysts in liver, pancreas, kidneys, epididymis
11
Q
What do plasmacytoid dendritic cells stain + for?
A
CD4, CD123
12
Q
What is the most common cause of nephrotic syndrome in adults?
A
Focal segmental glomerulosclerosis
13
Q
5 features of psoriasis (go from top down)?
A
1) parakeratosis
2) munro microabscesses in the parakeratosis
3) absent granular later
4) Acanthosis
5) dermal chronic inflammation and prominent capillaries
14
Q
Clear cell RCC - what are positive and negative IHC?
1) CD10
2) PAX2
3) vimentin
4) CK7
5) CAIX
6) c-kit
7) AMACR
A
1) CD10+
2) PAX2+
3) vimentin+
4) ck7- *
5) CAIX+ *
6) c-kit-
7) AMACR- *
- the ones different from papillary RCC
15
Q
Papillary RCC - what are positive and negative IHC?
1) CD10
2) PAX2
3) vimentin
4) CK7
5) CAIX
6) c-kit
7) AMACR
A
1) CD10+
2) PAX2+
3) vimentin+
4) CK7+*
5) CAIX-*
6) c-kit-
7) AMACR+*
- the ones different from clear cell RCC
16
Q
Oncocytoma - what are positive and negative IHC?
1) PAX2
2) vimentin
3) CK7
4) c-kit
A
1) PAX2+ *
2) vimentin-
3) CK7- *
4) c-kit+
- the ones different in chromophobe RCC
17
Q
Chromophobe RCC - what are positive and negative IHC?
1) PAX2
2) vimentin
3) CK7
4) c-kit
A
1) PAX2- *
2) vimentin-
3) CK7+ *
4) c-kit+
*the ones different from oncocytoma
18
Q
Three IHC stains for SFT / hemangiopericytoma? Which is most specific?
A
1) CD 34 (will also be + in NF but NF usually also scattered s100+ and doesn’t have thick collagen bands… Schwannoma will be diffuse s100+ but cd34-)
2) STAT6 (most specific)
3) CD99
19
Q
2 mutations to remember for MPNST?
A
1) CDKN2A / CDKN2B
(nerve sheath tumors have a pattern like a CanDy KaNe)
2) PRC2
(Peripheral neRve)
20
Q
IHC for nodular fascitis?
1) CD34
2) SMA
3) s100
A
1) cd34-
2) sma+
3) s100-
21
Q
What is the most common odontogenic tumor?
A
Odontoma
22
Q
What IHC will stain ameloblastoma?
A
CK19
23
Q
Angioimmunoblastic T cell lymphoma vs peripheral T cell lymphoma - how to differentiate by stain?
A
Angioimmunoimmunoblastic: has EBV+ B cells and neoplastic T cells
Peripheral T cell lymphoma: ONLY T cells (CD2,3+)
24
Q
AML with t(8;21) and RUNX1-RUNX1T1 mutation - what maturation do you see and what outcome?
A
Mostly Neutrophilic maturation, favorable outcome (“RUN = fast, like neutrophil acute inflammation and how active you are bc you recovered well”)
25
AML with t(1;22) with RBM15-MKL1 fusion results in what maturation and what staining?
Mostly megakaryocyte lineage (“MKL”= MegaKaryocyte Lineage)
MPO-, TdT-, but CD41+, CD61+, CD42b+ (platelet markers)
26
AML with t(9,11) and KMT2A-MLLT3 fusion have what lineage/features?
Monocytic (“ML=Monocyte Lineage”)
27
AML with t(6;9) and DEK-NUP214 mutation - has what features and what prognosis?
- Basophilia and multilineage dysplasia, TdT expression in half
- Poor prognosis
(“Full DEK of cards”, “NUmerous lineage)
28
What disease shows abnormally large lysosomal granules in leukocytes because of a lysosomal trafficking protein deficiency?
Chediak-Higashi syndrome
29
What is the difference between CGD and MPO deficiency?
1) enzyme deficiency
2) test
3) infections
1) CGD: NAPDH oxidase / MPO: MPO
2) CGD: negative nitroblue tetrazolium test // MPO: positive NBT test
3) CGD: catalase positive organisms // MPO: candida
30
What review is required when HSIL is detected on cyto?
Review of past 5 years pap slides
31
History of itching + lymphoid tissue with paracortical expansion by lymphocytes containing melanin, think…
Dermatopathic lymphadenitis
32
Popcorn cells in lymphoma, think
Nodular lymphocyte predominant Hodgkin lymphoma
33
What increases the specificity of PCR? A) [magnesium ion]
B) inc or dec temperature of what stage
C) what primer length
A) decreasing magnesium ion concentration
B) increasing the temperature of the annealing stage
C) having primer lengths <3000 base pairs
34
How to differentiate epithelioid angiosarcoma and epithelial sarcoma?
INI-1 aka SMARCB1 (will be lost in epithelial sarcoma; retained in angiosarcoma)
35
Difference between alveolar rhabdomyosarcoma and alveolar soft part sarcoma?
Alveolar rhabdomyosarcoma is mostly blue esp at low power (small round blue cell tumor) while alveolar soft part is all pink/rhabdoid cells
36
What findings do you see in lymph node Toxoplasmosis vs autoimmune lymphoproliferative syndrome vs Kimura’s disease?
Toxo: follicular hyperplasia with irregular follicular shapes, monocytoid cells in sinuses, epithelioid histiocytes
Autoimmune: mutations in FAS, paracortical hyperplasia and polyclonal plasmacytosis
Kimura: hyperplasia germinal cels and interfollicular eosinophilia
37
Gyn tumor that is WT1-, ER-, HNF-1-beta+, napsin-A+, with ARID1A loss?
Clear cell carcinoma
(Loss of ARIDness outside = CLEAR)
38
Increased CEA and CA15-3, increased amylase, mass in pancreatic head, think…
Intraductal papillary mucinous neoplasm
(mucinous cystic neoplasms will be in the tail and have low amylase)
(Pancreatic pseudo cyst will have low CEA/CA 15-3)
39
Castleman disease vs Rosai Dorfman disease?
Castleman: vascular variant with hyalinjzed germinal centers with cuffs of histiocytes forming onion skin (lollipop sign); plasma cell variant with follicular hyperplasia and sheets of plasma cells in interfollicular zones
Rosai: emperipoesis (histiocytes eating lymphocytes)
40
B cell lymphoma that is CD10, 19, 20+, CD5-, on chromosome 8?
BurKitts lymphoma (chromosome 8 looks like B, and is c-myc mutation)
41
Mesothelioma: name 4 + IHC and 1 - IHC
+: calretinin, WT1, d2-40, pancytokeratin, survivin
-: BAP1
42
What is the one tumor that will stain Ki67 cytoplasmic and membranous, instead of nuclear? What else is it positive for?
Hyalinizing trabecular tumor
TTF1, thyroglobulin
43
DDIT3(CHOP) and FUS mutation, think…
Myxoid liposarcoma (CHOP, FUSe, and MYX DAT aka DIT)
44
Clear cell sarcoma, think what mutation?
EWSR1-ATF1 fusion
(CLEAR SnARCy EW At The Fair)
45
Gorlin syndrome - what tumors?
1) Brain (medulloblastona, meningioma)
2) Teeth (OKC)
3) Skin (basal cell carcinoma)
4) Fibromas (cardiac and ovarian)
46
Name the disorder associated with TGF-beta mutation?
Lowe-Dietz syndrome (connective tissue disorder — associated with aortic dissection)
Dietz = Dissection
47
What type of Hodgkin’s lymphoma affects women more than men?
Nodular sclerosis classical HL
48
What are the levels of urine and serum phenylalanine in PKU and what are the skin changes?
High in serum, high in urine.
Hypopigmentation
49
What translocation and mutation is seen in NUT carcinoma?
t(15;19) BRD4-NUTM1 fusion
(NUT = NUclear protein in Testes = your “BiRD”)
50
What head and neck tumor has cytoplasmic staining for cyto keratin without significant reactivity for any other markers? What is the frequent mutation?
Sinonasal undifferentiated carcinoma
IDH2 mutation
51
What renal neoplasm is associated with polycythemia?
Metanephric adenoma
52
What is the treatment of choice for CIN2 on cervical biopsy?
LEEP
53
What is adequate by Bethesda standards for a thyroid FNA smear (how many follicles/cells)? OR what 3 other conditions?
- At least 6 groups of follicular cells with at least 10 cells in each group
1) abundant thick colloid
2) abundant inflammation
3) significant atypia
54
What is the mutation for nodular fasciitis?
USP6
(Ups delivers tissue cultures)
55
Cervical Pap smear: 1) increased estrogen (like in obesity) and 2) increased progresterone (like in pregnancy) increases what cells?
1) superficial cells
2) intermediate cells
56
What is the difference on histology between granuloma annulare and rheumatoid nodule?
Both have necrotic granulomas, but GA has Alcian blue+ mucin and RN does not
57
What 4 IHC stains are classic for Merkel cell carcinoma?
+CD56, +CK20, -TTF1, -CD45
58
What is the classic staining by S100, CD68, and CD1a for:
1) Langherhan histiocytosis
2) Rosai Dorfman
3) Xanthogranuloma/Erheim-Chester
1) all 3 +
2) S100, CD68+
3) CD68+
59
What is the mutation for myxoid liposarcoma?
FUS->EWS
(Make a FUS, LotS of EWS)
60
What two subtypes of meningioma are WHO grade iii?
Papillary and rhabdoid
61
What two types of meningioma are grade II?
Clear cell and chordoid
62
Wilms tumor - what is official name and what are the 2 most common mutations and their associations?
Nephroblastoma
1) tp53: anaplasia
2) IGF2: nephrogenic rests
63
What is the other pediatric kidney tumor that may be positive for WT1 and what is the mutation that sets it apart?
Desmoplastic small round cell tumor
ESW-WT1 fusion
64
What 4 IHC markers are specific for HCC?
Hep Par-1, glypican 3, AFP, glutamine synthetase
(Most cytokeratins are negative)
65
What mutation is associated with mucoepidermoid carcinoma?
t(11;19) MECT1-MAML2
(MucoEpidermoid Carcinoma)
66
What is Hand-Schiller-Christian disease and Letterer-Siwe disease?
Multi focal Unisystem and multi focal multi system Langherhan cell histiocytosis, respectively
67
What mutation is associated with invasive lobular and gastric signet ring cell carcinoma?
CDH1 (gene encoding E-cadherin which is why it’s lost)
68
positive FLI-1, think what three groups of tumors?
1) vascular tumors (ie angiosarcoma)
2) Ewing’s/PNET
3) lymphoblastic lymphoma
69
What is a low molecular weight keratin? What are 2 high molecular weight keratins?
LMWK: cam5.2
HMWK: CK5/6, CK903
70
The 3 important positive and 3 negative IHC for Paget’s disease of the nipple?
Positive: Her2, LMWK (cam5.2), ck7
Negative: ER, PR, HMWK (ck903, ck5/6)
71
What is the most common tumor of the pineal gland and what are 3 IHC you can use to prove it?
Germinoma
+ for PLAP, OCT-4, CD117
(Negative for hcg, afp, keratin)
72
3 stains to tell apart mesothelioma from benign mesothelioma cells?
Mesothelioma: Survivin +, EMA+, desmin-
Benign mesos: survivin-, EMA-, desmin+
(The others inc WT1, calretinin, D2-40 are the same)
73
What is the mutation for secretory breast carcinoma?
t(12;15) ETV6-NTRK3 mutation
(sEcreToRy)
74
What is the most common benign tumor in the gallbladder and what stain is positive?
Pyloric gland adenoma
MUC6+ (MUC2 is NEGATIVE)
75
What is the usefulness of HLA-DR in IHC for leukemia?
Differentiate pre-B ALL (where it’s positive) and pre-T ALL (where it’s negative but CD99 and TdT are positive)
76
What is the most common malignancy to arise out of a benign, mature cystic teratoma?
SCC
77
What 3 main things does Birt-Hogg-Dube syndrome entail? What is the mutation?
- pulmonary cysts (Birt = “Burst”), Chromophobe RCC (“chromoHOGG”), fibrofolliculomas of skin (“DUBious FOLLy”)
- autosomal dominant FLCN (folliculin)
78
How to differentiate neuroblastoma and nephroblastoma on H&E?
Homer-Wright pseudorosettes surrounding neuropil (in neuroblastoma)
79
What is the most common Strep micro-organism associated with a) Rheumatic heart disease and b) infective endocarditis?
A) strep pyogenes (group A, beta hemolytic strep)
B) strep viridians
80
3 genetic disorders associated with Wilms tumor?
WAGR syndrome, Beckwidth-Weidemann syndrome, Denys-Drash syndrome
81
What two mutations are common for myxoid liposarcoma?
FUS-DDIT3 or EWSR1-DDIT3
(“EW, FUSe the myxoid and spray it with DDIT”)
82
What is the mutation associated with Ewing’s sarcoma?
EWSR-FLI1
83
Name 3 tumors with ETV6-NTRK3 mutation?
Mammary analogue secretory carcinoma of salivary glands (6 words, for 6), inflammatory myofibroblastic tumor, AML (3 words)
Also: congenital infantile fibrosarcoma, congenital mesoblastic nephroma
84
What mutation is associated with BCC, and what syndrome is associated with multiple BCCs?
- PTCH gene
- Gorlin syndrome (also associated with OKCs and medulloblastoma)
85
Rhabdomyosarcoma - what variants are associated with a poor prognosis and what is the mutation?
Alveolar, anaplastic
PAX3-FOXO1 (think die earlier at age 3 unlike the good prognosis mutation which is PAX7)
86
Rhabdomyosarcoma - what two variants have a favorable prognosis and what is the mutation? What has an intermediate prognosis?
Favorable: spindle cell, botryoid
PAX7-FOXO1 (7 dies older than 3)
Intermediate: embryonal
87
Name the lymphoma for each mutation
1) (8;14)
2) (11;14)
3) (11;18)
4) (14;18)
1) Burkitt
2) Mantle cell
3) MALT (marginal zone) lymphoma
4) follicular
8: c-myc
11: cyclin D1
14: IgH heavy chain
18: bcl-2
88
Muir-Torre syndrome - what tumors associated?
Sebaceous tumors (sebaceous adenoma > keratoacanthoma), colorectal ACA
(Torrid = fat/sebaceous)
89
Cowden syndrome, what tumors? Mutation?
PTEN
- multiple hamartomas, multiple trichilemmoOmas (cows say moo), acral keratoses, breast (moo) and thyroid cancer
90
What tumor do you think of for a mucin-rich brain tumor in a kid in the temporal lobe that has recurrent seizures?
Dysembryonic neuroepithelial tumor
91
What mutations are in MEN-1 vs MEN2a/b?
MEN-1: Menin gene (parathyroid, pituitary, pancreatic, gastrin-producing duodenal carcinoids)
MEN 2b: RET gene (parathyroid & thyroid hyperplasia, pheo, medullary thyroid ca)
MEN 2c: RET (pheo, medullary, marfanoid, mucosal neuromas & ganglioneuromas, thyroid hyperplasia)
92
What is PRogressive multi focal leukoencephalopathy caused by?
JC virus (while BK virus = Bad Kidney = BK virus associated nephropathy)
93
Metaplastic carcinoma of the breast, what is the staining for ER/PR/Her2 and what other stain should you could you remember that’s unique for it?
Triple negative
p63+(because have squamous / sarc/chond differentiation)
94
What is the mutation in Peutz-Jeghers syndrome? What tumors are associated?
STK11
- GI polyps, mucocutaneous pigmentation, sex cord, calcifying Sertoli cell, adenoma malignum
(“Your STicKs and balls [polyps] in PJs”)
95
What is the mutation for GIST with wild type cKIT?
SDHB
(Succinate dehydrogenase)
96
What other 2 IHCs besides CD15 and CD30 stains RS cells in CHL?
Fascin (cytoplasmic) and MUM-1(nuclear)
97
What other 3 IHCs besides CD45 and CD20 stains popcorn cells of nodular lymphocyte predominant HL?
Pax5, oct2, bob1
98
What mutation is commonly seen in salivary duct carcinoma?
ERRB2
99
What 2 mutations are common for WHO grade III meningiomas?
CDKN2A/B
TERT
100
What are the qualifying features of grade II meningiomas?
- brain invasion
-4-19 mitoses/10 HPF
-clear cell/chordoid
Plus
3 of following: necrosis, patternless growth, increased cellularity, increased N/C, prominent nucleoli
101
What is the IHC GCDFP-15 useful for?
Specific for breast origin including EXTRAMAMMARY Pagets, so good for differentiating from gyn tumors
102
What is the X-linked recessive disease associated with eczema, thrombocytopenia, and immune deficiency? What Ig levels are increased / decreased?
Wiskott-Aldrich syndrome
Low IgM, high IgA/IgE
103
What 2 tumors are positive for MUC4 and have the FUS-CREB3L2 translocation?
1) Low grade fibromyxoid sarcoma (more fibrous than myxoid unlike myxofibrosarcoma)
2) sclerosing epithelial fibrosarcomas (looks like invasive lobular breast ca)
104
Frozen codes, what do each mean?
88329-
88331-
88332-
88333-
88334-
88329-path consult during surgery
88331-first tissue block
88332-each additional tissue block
88333-first touch prep
88334-each additional touch prep
105
Cafe au lait spots, fibrous dysplasia, precocious puberty, endocrine dysfunction - what syndrome? What mutation?
McCune Albright, GNAS mutation (McDonalds coffee - cafe au lait, GNASh your teeth - fibrous dysplasia)
106
What 2 mutations are seen with hereditary pancreatitis?
PRSS1 and SPINK1
(Trypsinogen gene and protease gene)
107
Endchondromas and hemangiomas (esp spindle cell) that develop into angiosarcomas, think what syndrome? What mutation?
Maffucci’s syndrome
IDH 1/2
108
Osteomas, epidermoid cysts, fibromas, fibromatosis, GI adenomas, think what syndrome?
Gardner syndrome (gardener deals with fibrous plants with his skin)
109
What mutations are common in smokers vs non smokers for lung adenocarcinoma?
Smokers: KRAS
Non-smokers: EGFR, ALK
110
What syndrome are SMAD4 / BMPR1a mutations seen in?
Juvenile Polyposis
(Some Juveniles get MAD, Pedestrians hit by BuMPeR)
111
What syndrome has the LKB1/STK11 mutation?
Peutz-Jeghers
(Lips Kolored, Bulbs)
Aka mucocutaneous lesions on mouth, hamartomatous polyps)
112
Good prognosis for CLL (5 features)?
One mutation that’s poor prognosis?
Post-germinal center origin, IgVH hypermutation, ZAP70-, CD38-, 13q-
(17p- is poor prognosis)
113
What stain differentiates endometrial stromal sarcoma (when there’s a lot of smooth muscle differentiation) from leiomyosarcoma?
CD10 (+ in ESS)
114
What stains differentiate ovarian and endometrial papillary serous carcinoma?
Ovarian: ER, WT1+
Endometrial: PTEN+
(Both are p16, p53, IMP3+)
115
What white blood cell disease presents with cd34+, cd19+, light chain negative, cd10-, and increased blasts >20%, and what chromosome is the mutation on?
MLL-rearranged ALL
c4q
116
Uniparental disomy - examples?
AngelMAN syndrome (2 paternal copies of 15s)
Prayer-Willi syndrome (2 maternal copies of 15s)
117
What stains differentiate endometrial serous and clear cell carcinoma?
Endometrial serous: p16+
Endometrial clear cell: AMACR, ck7, napsin-A, HNF1-
(Both are p53+)
118
What mutation is present in solid pseudopapillary tumor and what stains will be positive?
CTNNB1 mutation
e-Cadherin, Beta-Catenin, cyclin D1, claudins, ER/PR, trypsin/chymotrypsin
119
What are the types of CD30+ anaplastic large cell lymphoma, and what is the important mutation/risk with it?
1) systemic
2) cutaneous
ALK mutation - better prognosis, more common in kids
120
How long should each of the following be kept:
1) histology slides/blocks
2) cytology slides
3) FNA smears
4) quality control/improvement/prof testing records
1) 10 years
2) 5 years
3) 10 years
4) 2 years (except blood bank - 5 years)
121
What are similarities and differences with the histology of granulosa cell tumor and Brenner tumor?
Both have coffee bean nuclei but brenner tumor is urothelial overall and granulosa cell tumor has call-exner bodies (eosinophilic fluid filled spaces) + hyperestrogenism
122
How would you diagnose abnormal parent-specific imprinting ie with Prader Willi?
DNA methylation assay (looks at imprinting)
123
What stains can be useful in differentiating micro glandular adenosis from invasive carcinoma?
S100, p63 (since it may not have a myoepithelial layer, but this can highlight secretory epithelium)
124
What is the mutation for epithelioid hemangioendothelioma?
WWTR-CAMTA1
125
What kind of cancer is associated with vinyl chloride?
Hepatic angiosarcoma
126
What kind of cancer is associated with woodworking/wood dust and leather working?
Intestinal type adenocarcinoma
127
What kind of cancer is associated with benzene?
Leukemia
128
What kind of cancer is associated with chromium?
Lung
129
What kind of cancers are associated with arsenic?
Skin, bladder, lung, and liver
130
What two inheritances improve sickle cell disease?
Coexisting fetal hemoglobin and ALPHA thalassemia (beta makes it worse)
131
What cancer do sickle cell patients have an increased risk of?
Renal medullary carcinoma
132
What is the difference between hep B, primary biliary cirrhosis, and autoimmune hepatitis on histology?
Hep B: ballooning degeneration, eosinophilic ground glass cytoplasm
PBC: Portal tract inflammation, granulomatous biliary duct destruction
AH: plasma cell portal tract inflammation, emperipoesis, periportal necrosis
133
What is seen in the blood/body fluids after a) pneumothorax? b) pleural trauma/hemothorax?
A) increased IL-5 and eosinophils in pleural fluid
B) increased peripheral blood eosinophils
134
What are the most common tumor type in the posterior mediastinum?
Nerve sheath tumors (ie Schwannoma)
135
What IHC stains are used to differentiate muscularis mucosa and muscularis propria, and what are the associated stages and treatments in bladder carcinoma?
Musc mucosa- vimentin - T1 (BCG tx)
Musc propria - smoothelin - T2 (cystectomy tx)
136
What are 2 stains for the basal layer and 3 stains for the secretory layer of prostate glands?
Basal: CK903, p63
Secretory: PSA, vimentin, EMA
137
What is the mutation for clear cell sarcoma (melanoma of soft parts)?
t(12;22) ATF1-EWS
(whAt The Fuck, not actually a melanoma*)
138
What top 5 cancers metastasize to bone?
Prostate Kancer Likes The Bone
(Prostate, Kidney, Lung, Thyroid, Breast)
139
What are the 4 sarcomas that metastasize by lymphatic route?
Angiosarcoma, clear cell sarcoma, epithelioid sarcoma, rhabdomyosarcoma
140
What are the two tumors seen in a) Mazabraud syndrome and b) Li-Fraumeni?
A) fibrous dysplasia, myxoma of soft tissue
B) sarcomas (especially osteosarcoma and rhabdomyosarcoma)
141
What are the most common mutations for each thyroid carcinoma:
a) papillary
b) follicular
C) medullary
d) anaplastic
a) BRAF V600E
b) RAS > PAX8-PPAR
c) RET
d) p53 > b-catenin
142
What is the most common lymphoma in the colon?
DLBCL (MALT is most common in overall GI tract and in stomach)
143
What is the IHC profile defining DLBCL, activated B cell type? Germinal center type? What has good vs bad prognosis?
Activated B cell type: poor prognosis, CD79a+, MUM1+, GCET1-, BCL6- OR bcl6+ with FOXP1+
Germinal center type: good prognosis, CD10+
144
What are the favorable prognostic factors in ALL:
1) age
2) sex
3) diploidy (hyper or hypo)
4) translocation
5) IHC
1) 1-10 yrs
2) female
3) hyperdiploidy
4) 12;21
5) CD10+
145
How to tell difference between follicular lymphoma and reactive follicular hyperplasia?
Reactive follicular hyperplasia: germinal centers with irregular size and shape, and no nodal effacement (follicles at periphery, medullary/central zone of LN have more sinuses)
Follicular lymphoma: crowding of follicles but have regular size and shape, efface, not polar, + 14;18 IgH-Bcl2
146
How do you differentiate dermatofibrosarcoma protuberans from dermatofibroma?
DFSP: CD34+, FXIIIa -
DF: CD34-, FXIIIa+
147
What is each of the following classification groups for a Medicare patient? A) for inpatient rehab B) for skilled nursing facilities
A) case-mix group
B) resource utilization group
148
What subtype of rhabdomyosarcoma has the worst prognosis?
Alveolar rhabdomyosarcoma
149
What key demographic feature will cause you to think of chondroblastic osteosarcoma vs chondrosarcoma?
Age: osteosarcoma more common in young, chondrosarcoma more common in elderly
150
What is a 1) follicular / dentigerous cyst vs 2) periapical / radicular cyst vs 3) odontogenic keratocyst?
Which one is most common odontogenic cyst?
1) with stratified squamous epithelium
2) stratified squamous epithelium and fibrous capsule with inflammation
3) with parakeratotic epithelium, and hyperchromatic, palisaded basal layer and wavy surface (Gorlin syndrome with BCCs)
*most common: periapical / radicular cyst
