Exam Qs

Question 1

Benign CD34+ neoplasms

Answer 1

Fibroadenoma
Hemangioma
Lymphangioma
Angiofibroma
Spindle cell lipoma
Myofibroblastoma

Question 2

BST neoplasms that typically express keratins

Answer 2

Epithelioid sarcoma
Synovial sarcoma, biphasic
Epithelioid hemangioendothelioma
Myxofibrosarcoma
Epithelioid GIST
DSRCT

Question 3

Indicated for FISH testing in well diff adipocytic neoplasms

Answer 3

Recurrence
Size >10 cm
Retroperitoneal location
Equivocal histologic features

Question 4

Low grade fibromyxoid sarcoma vs myxofibrosarcoma

Answer 4

LGFMS: proximal extremities/trunk, young adults, low grade spindle cells in whorled/short fascicles, alternating fibrous and myxoid areas, Strong diffuse MUC4+, FUS-CREB3 dusion
MFS: Limbs and limb girdles in elderly patients, multinodular architecture w infiltratrive margins, myxoid stroma, variable pleomorphic cells, curvilinear vessles, Aneupolidy

Question 5

Subtypes of kaposi sarcoma and typical population for each

Answer 5

Classic - elderly mediterranean, eastern european, Ashkenazi-Jew, older men
Endemic - HIV neg adults & children in equitorial Africa
AIDS-associated - HIV+
Iatrogenic - solid organ transplant patients

Question 6

Risk factors for angiosarcoma

Answer 6

Radiation
Lymphedema
Implanted foreign material
Li-Fraumeni
Mafucci syndrome
Retinoblastoma syndrome

Question 7

Most common anatomic sites for epithelioid hemangioendothelioma

Answer 7

Soft tissue
Liver
Lung

Question 8

IHC that stains:
Smooth muscle only
Both smooth and skeletal
Skeletal muscle only

Answer 8

Smooth muscle only: Caldesmin, SMMHC
Both smooth and skeletal: MSA, desmin
Skeletal muscle only: Myogenin, MyoD1

Question 9

Clinical and histologic features of synovial sarcoma

Answer 9

Clinical: deep soft tissue of extremities in younger patients
Histo: Biphasic or monophasic. Epithelial component nests, cords, glandular, alveolar, papillary. Spindle component uniform, small, ovoid, “school of fish”, hyperchromatic nuclei, TLE1+

Question 10

DDx SRBCT in 20yo

Answer 10

Ewing sarcoma
Lymphoblastic lymphoma
Small cell osteosarcoma
Desmoplastic small round cell tumor
Mesenchymal chondrosarcoma
Rhabdomyosarcoma

Question 11

Tumors with MDM2 amplification

Answer 11

ALT/WDLS
Dediff liposarcoma
Intimal sarcoma
Low grade central osteosarcoma

Question 12

DDx for giant cell rich bone lesion

Answer 12

Giant cell tumor of bone
ABC
Chondroblastoma
Nonossifying fibroma
Giant cell rich osteosarcoma

Question 13

Benign or malignant disease associated with extramedullary hematopoiesis

Answer 13

Myelofibrosis
Hemolytic anemia
Sickle cell
Hereditary spherocytosis
ITP
Thalassemia

Question 14

Histologic subtypes of leiomyoma

Answer 14

Classica
Epithelioid
FH-deficient
Myxoid
Atypical
Mitotically active
Symplastic

Question 15

Variants of SCC of the H&N

Answer 15

Conventional
Basaloid
Adenosquamous
Papillary
Acantholytic
Lymphoepithelial
Spindled

Question 16

Factors relevant to staging of nephroblastoma

Answer 16

Extrarenal extension
Renal vein invasion
Infiltration of renal sinus
Rupture
Lymph node involvement
Bilaterality

Question 17

Painful skin lesions

Answer 17

Blue nevus
Angiolipoma
Neuroma
Glomus tumor
Eccrine spiradenoma
Leiomyoma

Question 18

EBV-associated lymphomas

Answer 18

Burkitt
PTLD
Hodgkin lymphoma, mixed cellularity
Plasmablastic lymphoma
Extranodal NK/T cell lymphoma, nasal type
Intravascular NK/T cell lymphoma
DLBCL (rarely)

Question 19

Non-hematolymphoid EBV-associated neoplasms

Answer 19

Nasopharyngeal carcinoma
EBV+ gastric CA

Question 20

Infectious agents (other than EBV) and associated lymphomas

Answer 20

HHV8 - primary effusion lymphoma
HP - gastric MALT
Campylobactor jejuni - small bowel MALT
Chlamydia sp. - ocular adenxa MALT
Borrelia sp - skin MALT

Question 21

IHC for
Exaggerated placental site
Placental site nodule
Placental site trophoblastic tumor
Epithelioid trophoblastic tumor

Answer 21

Exaggerated placental site: p63- hPL+ KI67 low
Placental site nodule: p63+ hPL- Ki67 low
Placental site trophoblastic tumor: p63- hPL+ Ki67 high
Epithelioid trophoblastic tumor: p63+ hPL- Ki67 high

Question 22

Skin lesions associated with infectious etiology

Answer 22

Verruca vulgaris - low risk HPV
Kaposi sarcoma - HHV8
Molluscum contagiosum - poxvirus
Merkle cell carcinoma - Merkle cell polyomavirus
Digital papillary adenocarcinoma - HPV42

Question 23

Types of embolism

Answer 23

Thromboembolism
Fat
Air
Amniotic fluid
Septic
Atheroembolism

Question 24

Benign mimics of prostatic adenoCA

Answer 24

Atrophy
Adenosis
Post-radiation/therapy effect
Basal cell hyperplasia
Clear cell cribriform hyperplasia
Nephrogenic adenoma

Question 25

Variant morphologic patterns for conventional prostatic adenoCA

Answer 25

Atrophic Pseudohyperplastic Microcystic Foamy gland Mucinous PIN-like

Question 26

Epiphyseal bone tumors

Answer 26

Giant cell tumor of bone Clear cell chondrosarcoma Chondroblastoma Enchondroma

Question 27

Morphologic patterns in adult granulosa cell tumor

Answer 27

Diffuse Insular Microfollicular Macrofollicular Sarcomatoid Pseudopapillary

Question 28

Meigs syndrome

Answer 28

Ovarian fibroma Ascites Pleural effusion

Question 29

Lymphomas that commonly present as lymphomatous polyposis

Answer 29

DLBCL Extranodal MALT Mantle cell Follicular lymphoma

Question 30

Potter's sequence

Answer 30

Pulmonary hypoplasia Oligohydramnios Twisted skin/limb deformities Twisted face/abnormal facies Extremity deformities Renal agenesis

Question 31

Weiss criteria for adrenal cortical carcinoma

Answer 31

Nuclear grade III/IV >5 mits/50hpf Atypical mits Clear cells <25% of tumor Diffuse architecture >30% Necrosis Venous/sinusoidal/capsular invasion

Question 32

Low risk and high risk subtypes of BCC

Answer 32

Low risk - nodular, nevus of pinkus, superficial, infundibulocystic High risk - micronodular, morpheaform, spindled, infiltrating

Question 33

Four principle histologic growth patterns of HCC

Answer 33

Trabecular Solid Pseudoglandular Macrotrabecular

Question 34

Critical values in anatomical pathology

Answer 34

Crescentic GN Leukocytoclastic vasculitis Fat in endometrial biopsy Herpetic infection in cervical cytology in pregnancy Unexpected malignancy Mesothelial cells or fat in endocardial biopsy Invasive organism in immunocompromised host Transplant rejection

Question 35

Morphologic variants of urothelial CA

Answer 35

Papillary Micropapillary Solid Plasmacytoid Lymphoepithelioma-like Sarcomatoid Nested Squamous

Question 36

Features associated with unfavourable prognosis in neuroblastoma

Answer 36

Age >5y High MKI Clinical stage Less schwannian stroma Nodular architecture MYC-N amplification

Question 37

Benign causes of necrotizing lymphadenitis

Answer 37

TB Kikuchi-Fujimoto disease Cat scratch disease HSV lymphadenitis

Question 38

Common locations for conventional osteosarcoma

Answer 38

Distal femur Proximal Tibia Proximal humerus

Question 39

Radiographic features of osteosarcoma

Answer 39

Medullary and cortical bone destruction Permeative or moth-eaten appearance Periosteal reaction - sunburst or onion-skinned appearane Tumor matrix ossification/calcification Lytic/sclerotic lesion Extraosseus extension

Question 40

Histologic changes in breast carcinoma with partial treatment effect

Answer 40

Decreased cellularity Multiple foci of invasion over a large tumor bed LVI without adjacent tumor Fibrosis adjacent to residual tumor Decreased size of invasive component

Question 41

Types of amyloidosis

Answer 41

AL - primary amyloidosis (immunocyte dyscrasias) AA - secondary (chronic inflammation) AA - familial mediterranean fever ATTR - Systemic senile amyloidosis AB - Senile cerebral (Alzheimer) A Cal - medullary thyroid CA AANF - Isolated atrial amyloidosis

Question 42

DDx cribriform morphology in the prostate

Answer 42

Gleason grade 4 prostate adenoCA Intraductal carcinoma Clear cell cribriform hyperplasia Basal cell hyperplasia Atypical intraductal proliferation Ductal carcinoma

Question 43

Histologic types of neuroblastoma

Answer 43

Neuroblastoma - differentiating, poorly diff, undiff Ganglioneuroblastoma, nodular classic and variant Ganglioneuroblastoma, mixed Ganglioneuroma

Question 44

Algorithm for neuroblastoma diagnosis

Answer 44

Question 45

Gross and microscopic features of Alzheimer's

Answer 45

Gross - cortical atrophy (esp frontal, temporal, parietal lobes) - Hydrocephalus ex vacuo - Medial temporal lobe (hippo, amg, entorrhinal) severe atrophy Micro - Neuritic plaques, neurofibrillary tangles, cerebral amyloid angiopathy

Question 46

Neurochemical changes in Alzheimer's

Answer 46

Increased phosphorylated tau and reduced Abeta in CSF

Question 47

List types of cellular injury

Answer 47

Oxygen deprivation Physical agents Chemical agents and drugs Infectious agents Immunologic reactions Genetic derangements Nutritional imbalances

Question 48

Types of necrosis

Answer 48

Coagulative Liquefactive Gangrenous Caseous Fat Fibrinoid

Question 49

Molecular of TSA

Answer 49

BRAF, KRAS

Question 50

Molecular of SSL

Answer 50

BRAF, CpG-Island Methylation

Question 51

Causes and mechanisms of infectious vasculitis

Answer 51

Pseudomonas, Staph, strep Aspergillus, mucor CMV/HSV Direct - invasion into wall (above do this) Indirect - provoke immune response targeting vessels (TB, HIV, HepB)