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Anatomic Pathology Boards > AP Questions Part 1 > Flashcards

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

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2
Q

What disease results in accumulation of sphingomyelin in lysosomes in the spleen, liver, lungs, bone marrow, and CNS?

A

Neimann-Pick disease

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3
Q

What mutation is seen in lipoblastoma?

A

PLAG1

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4
Q

Mutation of hexosaminidase A with accumulation of GM2 ganglioside - what disease? What gene?

A

Tay-Sachs, HEXA gene (Hebrew hex)

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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

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6
Q

What 4 breast carcinomas have worse prognosis than IDC?

A

Basal-like breast carcinoma, invasive micropapillary carcinoma, metaplastic carcinoma, and her2+ carcinomas

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7
Q

What 5 breast carcinomas have better prognosis than IDC?

A

Secretory, medullary, adenoid cystic, tubular, colloid

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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

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9
Q

What 4 disorders is paraganglioma associated with?

A

VHL, NF1, MEN syndromes, and carneys triad

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10
Q

What tumors are associated with VHL?

A
  • RCC
  • pheochromocytoma, paraganglioma
  • angioma, hemangioblastoma
  • cysts in liver, pancreas, kidneys, epididymis
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11
Q

What do plasmacytoid dendritic cells stain + for?

A

CD4, CD123

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12
Q

What is the most common cause of nephrotic syndrome in adults?

A

Focal segmental glomerulosclerosis

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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

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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
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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
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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
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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

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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

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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)

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20
Q

IHC for nodular fascitis?
1) CD34
2) SMA
3) s100

A

1) cd34-
2) sma+
3) s100-

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21
Q

What is the most common odontogenic tumor?

A

Odontoma

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22
Q

What IHC will stain ameloblastoma?

A

CK19

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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+)

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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”)

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25
Q

AML with t(1;22) with RBM15-MKL1 fusion results in what maturation and what staining?

A

Mostly megakaryocyte lineage (“MKL”= MegaKaryocyte Lineage)

MPO-, TdT-, but CD41+, CD61+, CD42b+ (platelet markers)

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26
Q

AML with t(9,11) and KMT2A-MLLT3 fusion have what lineage/features?

A

Monocytic (“ML=Monocyte Lineage”)

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27
Q

AML with t(6;9) and DEK-NUP214 mutation - has what features and what prognosis?

A
  • Basophilia and multilineage dysplasia, TdT expression in half
  • Poor prognosis
    (“Full DEK of cards”, “NUmerous lineage)
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28
Q

What disease shows abnormally large lysosomal granules in leukocytes because of a lysosomal trafficking protein deficiency?

A

Chediak-Higashi syndrome

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29
Q

What is the difference between CGD and MPO deficiency?
1) enzyme deficiency
2) test
3) infections

A

1) CGD: NAPDH oxidase / MPO: MPO
2) CGD: negative nitroblue tetrazolium test // MPO: positive NBT test
3) CGD: catalase positive organisms // MPO: candida

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30
Q

What review is required when HSIL is detected on cyto?

A

Review of past 5 years pap slides

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31
Q

History of itching + lymphoid tissue with paracortical expansion by lymphocytes containing melanin, think…

A

Dermatopathic lymphadenitis

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32
Q

Popcorn cells in lymphoma, think

A

Nodular lymphocyte predominant Hodgkin lymphoma

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33
Q

What increases the specificity of PCR? A) [magnesium ion]
B) inc or dec temperature of what stage
C) what primer length

A

A) decreasing magnesium ion concentration
B) increasing the temperature of the annealing stage
C) having primer lengths <3000 base pairs

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34
Q

How to differentiate epithelioid angiosarcoma and epithelial sarcoma?

A

INI-1 aka SMARCB1 (will be lost in epithelial sarcoma; retained in angiosarcoma)

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35
Q

Difference between alveolar rhabdomyosarcoma and alveolar soft part sarcoma?

A

Alveolar rhabdomyosarcoma is mostly blue esp at low power (small round blue cell tumor) while alveolar soft part is all pink/rhabdoid cells

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36
Q

What findings do you see in lymph node Toxoplasmosis vs autoimmune lymphoproliferative syndrome vs Kimura’s disease?

A

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

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37
Q

Gyn tumor that is WT1-, ER-, HNF-1-beta+, napsin-A+, with ARID1A loss?

A

Clear cell carcinoma
(Loss of ARIDness outside = CLEAR)

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38
Q

Increased CEA and CA15-3, increased amylase, mass in pancreatic head, think…

A

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)

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39
Q

Castleman disease vs Rosai Dorfman disease?

A

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)

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40
Q

B cell lymphoma that is CD10, 19, 20+, CD5-, on chromosome 8?

A

BurKitts lymphoma (chromosome 8 looks like B, and is c-myc mutation)

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41
Q

Mesothelioma: name 4 + IHC and 1 - IHC

A

+: calretinin, WT1, d2-40, pancytokeratin, survivin
-: BAP1

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42
Q

What is the one tumor that will stain Ki67 cytoplasmic and membranous, instead of nuclear? What else is it positive for?

A

Hyalinizing trabecular tumor
TTF1, thyroglobulin

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43
Q

DDIT3(CHOP) and FUS mutation, think…

A

Myxoid liposarcoma (CHOP, FUSe, and MYX DAT aka DIT)

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44
Q

Clear cell sarcoma, think what mutation?

A

EWSR1-ATF1 fusion
(CLEAR SnARCy EW At The Fair)

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45
Q

Gorlin syndrome - what tumors?

A

1) Brain (medulloblastona, meningioma)
2) Teeth (OKC)
3) Skin (basal cell carcinoma)
4) Fibromas (cardiac and ovarian)

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46
Q

Name the disorder associated with TGF-beta mutation?

A

Lowe-Dietz syndrome (connective tissue disorder — associated with aortic dissection)
Dietz = Dissection

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47
Q

What type of Hodgkin’s lymphoma affects women more than men?

A

Nodular sclerosis classical HL

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48
Q

What are the levels of urine and serum phenylalanine in PKU and what are the skin changes?

A

High in serum, high in urine.
Hypopigmentation

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49
Q

What translocation and mutation is seen in NUT carcinoma?

A

t(15;19) BRD4-NUTM1 fusion
(NUT = NUclear protein in Testes = your “BiRD”)

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50
Q

What head and neck tumor has cytoplasmic staining for cyto keratin without significant reactivity for any other markers? What is the frequent mutation?

A

Sinonasal undifferentiated carcinoma
IDH2 mutation

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51
Q

What renal neoplasm is associated with polycythemia?

A

Metanephric adenoma

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52
Q

What is the treatment of choice for CIN2 on cervical biopsy?

A

LEEP

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53
Q

What is adequate by Bethesda standards for a thyroid FNA smear (how many follicles/cells)? OR what 3 other conditions?

A
  • 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
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54
Q

What is the mutation for nodular fasciitis?

A

USP6
(Ups delivers tissue cultures)

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55
Q

Cervical Pap smear: 1) increased estrogen (like in obesity) and 2) increased progresterone (like in pregnancy) increases what cells?

A

1) superficial cells
2) intermediate cells

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56
Q

What is the difference on histology between granuloma annulare and rheumatoid nodule?

A

Both have necrotic granulomas, but GA has Alcian blue+ mucin and RN does not

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57
Q

What 4 IHC stains are classic for Merkel cell carcinoma?

A

+CD56, +CK20, -TTF1, -CD45

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58
Q

What is the classic staining by S100, CD68, and CD1a for:
1) Langherhan histiocytosis
2) Rosai Dorfman
3) Xanthogranuloma/Erheim-Chester

A

1) all 3 +
2) S100, CD68+
3) CD68+

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59
Q

What is the mutation for myxoid liposarcoma?

A

FUS->EWS
(Make a FUS, LotS of EWS)

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60
Q

What two subtypes of meningioma are WHO grade iii?

A

Papillary and rhabdoid

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61
Q

What two types of meningioma are grade II?

A

Clear cell and chordoid

62
Q

Wilms tumor - what is official name and what are the 2 most common mutations and their associations?

A

Nephroblastoma
1) tp53: anaplasia
2) IGF2: nephrogenic rests

63
Q

What is the other pediatric kidney tumor that may be positive for WT1 and what is the mutation that sets it apart?

A

Desmoplastic small round cell tumor
ESW-WT1 fusion

64
Q

What 4 IHC markers are specific for HCC?

A

Hep Par-1, glypican 3, AFP, glutamine synthetase
(Most cytokeratins are negative)

65
Q

What mutation is associated with mucoepidermoid carcinoma?

A

t(11;19) MECT1-MAML2
(MucoEpidermoid Carcinoma)

66
Q

What is Hand-Schiller-Christian disease and Letterer-Siwe disease?

A

Multi focal Unisystem and multi focal multi system Langherhan cell histiocytosis, respectively

67
Q

What mutation is associated with invasive lobular and gastric signet ring cell carcinoma?

A

CDH1 (gene encoding E-cadherin which is why it’s lost)

68
Q

positive FLI-1, think what three groups of tumors?

A

1) vascular tumors (ie angiosarcoma)
2) Ewing’s/PNET
3) lymphoblastic lymphoma

69
Q

What is a low molecular weight keratin? What are 2 high molecular weight keratins?

A

LMWK: cam5.2
HMWK: CK5/6, CK903

70
Q

The 3 important positive and 3 negative IHC for Paget’s disease of the nipple?

A

Positive: Her2, LMWK (cam5.2), ck7
Negative: ER, PR, HMWK (ck903, ck5/6)

71
Q

What is the most common tumor of the pineal gland and what are 3 IHC you can use to prove it?

A

Germinoma
+ for PLAP, OCT-4, CD117
(Negative for hcg, afp, keratin)

72
Q

3 stains to tell apart mesothelioma from benign mesothelioma cells?

A

Mesothelioma: Survivin +, EMA+, desmin-
Benign mesos: survivin-, EMA-, desmin+
(The others inc WT1, calretinin, D2-40 are the same)

73
Q

What is the mutation for secretory breast carcinoma?

A

t(12;15) ETV6-NTRK3 mutation
(sEcreToRy)

74
Q

What is the most common benign tumor in the gallbladder and what stain is positive?

A

Pyloric gland adenoma
MUC6+ (MUC2 is NEGATIVE)

75
Q

What is the usefulness of HLA-DR in IHC for leukemia?

A

Differentiate pre-B ALL (where it’s positive) and pre-T ALL (where it’s negative but CD99 and TdT are positive)

76
Q

What is the most common malignancy to arise out of a benign, mature cystic teratoma?

A

SCC

77
Q

What 3 main things does Birt-Hogg-Dube syndrome entail? What is the mutation?

A
  • pulmonary cysts (Birt = “Burst”), Chromophobe RCC (“chromoHOGG”), fibrofolliculomas of skin (“DUBious FOLLy”)
  • autosomal dominant FLCN (folliculin)
78
Q

How to differentiate neuroblastoma and nephroblastoma on H&E?

A

Homer-Wright pseudorosettes surrounding neuropil (in neuroblastoma)

79
Q

What is the most common Strep micro-organism associated with a) Rheumatic heart disease and b) infective endocarditis?

A

A) strep pyogenes (group A, beta hemolytic strep)
B) strep viridians

80
Q

3 genetic disorders associated with Wilms tumor?

A

WAGR syndrome, Beckwidth-Weidemann syndrome, Denys-Drash syndrome

81
Q

What two mutations are common for myxoid liposarcoma?

A

FUS-DDIT3 or EWSR1-DDIT3
(“EW, FUSe the myxoid and spray it with DDIT”)

82
Q

What is the mutation associated with Ewing’s sarcoma?

A

EWSR-FLI1

83
Q

Name 3 tumors with ETV6-NTRK3 mutation?

A

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
Q

What mutation is associated with BCC, and what syndrome is associated with multiple BCCs?

A
  • PTCH gene
  • Gorlin syndrome (also associated with OKCs and medulloblastoma)
85
Q

Rhabdomyosarcoma - what variants are associated with a poor prognosis and what is the mutation?

A

Alveolar, anaplastic
PAX3-FOXO1 (think die earlier at age 3 unlike the good prognosis mutation which is PAX7)

86
Q

Rhabdomyosarcoma - what two variants have a favorable prognosis and what is the mutation? What has an intermediate prognosis?

A

Favorable: spindle cell, botryoid
PAX7-FOXO1 (7 dies older than 3)

Intermediate: embryonal

87
Q

Name the lymphoma for each mutation
1) (8;14)
2) (11;14)
3) (11;18)
4) (14;18)

A

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
Q

Muir-Torre syndrome - what tumors associated?

A

Sebaceous tumors (sebaceous adenoma > keratoacanthoma), colorectal ACA
(Torrid = fat/sebaceous)

89
Q

Cowden syndrome, what tumors? Mutation?

A

PTEN
- multiple hamartomas, multiple trichilemmoOmas (cows say moo), acral keratoses, breast (moo) and thyroid cancer

90
Q

What tumor do you think of for a mucin-rich brain tumor in a kid in the temporal lobe that has recurrent seizures?

A

Dysembryonic neuroepithelial tumor

91
Q

What mutations are in MEN-1 vs MEN2a/b?

A

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
Q

What is PRogressive multi focal leukoencephalopathy caused by?

A

JC virus (while BK virus = Bad Kidney = BK virus associated nephropathy)

93
Q

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?

A

Triple negative
p63+(because have squamous / sarc/chond differentiation)

94
Q

What is the mutation in Peutz-Jeghers syndrome? What tumors are associated?

A

STK11
- GI polyps, mucocutaneous pigmentation, sex cord, calcifying Sertoli cell, adenoma malignum
(“Your STicKs and balls [polyps] in PJs”)

95
Q

What is the mutation for GIST with wild type cKIT?

A

SDHB
(Succinate dehydrogenase)

96
Q

What other 2 IHCs besides CD15 and CD30 stains RS cells in CHL?

A

Fascin (cytoplasmic) and MUM-1(nuclear)

97
Q

What other 3 IHCs besides CD45 and CD20 stains popcorn cells of nodular lymphocyte predominant HL?

A

Pax5, oct2, bob1

98
Q

What mutation is commonly seen in salivary duct carcinoma?

A

ERRB2

99
Q

What 2 mutations are common for WHO grade III meningiomas?

A

CDKN2A/B
TERT

100
Q

What are the qualifying features of grade II meningiomas?

A
  • 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
Q

What is the IHC GCDFP-15 useful for?

A

Specific for breast origin including EXTRAMAMMARY Pagets, so good for differentiating from gyn tumors

102
Q

What is the X-linked recessive disease associated with eczema, thrombocytopenia, and immune deficiency? What Ig levels are increased / decreased?

A

Wiskott-Aldrich syndrome
Low IgM, high IgA/IgE

103
Q

What 2 tumors are positive for MUC4 and have the FUS-CREB3L2 translocation?

A

1) Low grade fibromyxoid sarcoma (more fibrous than myxoid unlike myxofibrosarcoma)
2) sclerosing epithelial fibrosarcomas (looks like invasive lobular breast ca)

104
Q

Frozen codes, what do each mean?
88329-
88331-
88332-
88333-
88334-

A

88329-path consult during surgery
88331-first tissue block
88332-each additional tissue block
88333-first touch prep
88334-each additional touch prep

105
Q

Cafe au lait spots, fibrous dysplasia, precocious puberty, endocrine dysfunction - what syndrome? What mutation?

A

McCune Albright, GNAS mutation (McDonalds coffee - cafe au lait, GNASh your teeth - fibrous dysplasia)

106
Q

What 2 mutations are seen with hereditary pancreatitis?

A

PRSS1 and SPINK1
(Trypsinogen gene and protease gene)

107
Q

Endchondromas and hemangiomas (esp spindle cell) that develop into angiosarcomas, think what syndrome? What mutation?

A

Maffucci’s syndrome
IDH 1/2

108
Q

Osteomas, epidermoid cysts, fibromas, fibromatosis, GI adenomas, think what syndrome?

A

Gardner syndrome (gardener deals with fibrous plants with his skin)

109
Q

What mutations are common in smokers vs non smokers for lung adenocarcinoma?

A

Smokers: KRAS
Non-smokers: EGFR, ALK

110
Q

What syndrome are SMAD4 / BMPR1a mutations seen in?

A

Juvenile Polyposis
(Some Juveniles get MAD, Pedestrians hit by BuMPeR)

111
Q

What syndrome has the LKB1/STK11 mutation?

A

Peutz-Jeghers
(Lips Kolored, Bulbs)
Aka mucocutaneous lesions on mouth, hamartomatous polyps)

112
Q

Good prognosis for CLL (5 features)?
One mutation that’s poor prognosis?

A

Post-germinal center origin, IgVH hypermutation, ZAP70-, CD38-, 13q-

(17p- is poor prognosis)

113
Q

What stain differentiates endometrial stromal sarcoma (when there’s a lot of smooth muscle differentiation) from leiomyosarcoma?

A

CD10 (+ in ESS)

114
Q

What stains differentiate ovarian and endometrial papillary serous carcinoma?

A

Ovarian: ER, WT1+
Endometrial: PTEN+

(Both are p16, p53, IMP3+)

115
Q

What white blood cell disease presents with cd34+, cd19+, light chain negative, cd10-, and increased blasts >20%, and what chromosome is the mutation on?

A

MLL-rearranged ALL
c4q

116
Q

Uniparental disomy - examples?

A

AngelMAN syndrome (2 paternal copies of 15s)
Prayer-Willi syndrome (2 maternal copies of 15s)

117
Q

What stains differentiate endometrial serous and clear cell carcinoma?

A

Endometrial serous: p16+
Endometrial clear cell: AMACR, ck7, napsin-A, HNF1-

(Both are p53+)

118
Q

What mutation is present in solid pseudopapillary tumor and what stains will be positive?

A

CTNNB1 mutation
e-Cadherin, Beta-Catenin, cyclin D1, claudins, ER/PR, trypsin/chymotrypsin

119
Q

What are the types of CD30+ anaplastic large cell lymphoma, and what is the important mutation/risk with it?

A

1) systemic
2) cutaneous
ALK mutation - better prognosis, more common in kids

120
Q

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

A

1) 10 years
2) 5 years
3) 10 years
4) 2 years (except blood bank - 5 years)

121
Q

What are similarities and differences with the histology of granulosa cell tumor and Brenner tumor?

A

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
Q

How would you diagnose abnormal parent-specific imprinting ie with Prader Willi?

A

DNA methylation assay (looks at imprinting)

123
Q

What stains can be useful in differentiating micro glandular adenosis from invasive carcinoma?

A

S100, p63 (since it may not have a myoepithelial layer, but this can highlight secretory epithelium)

124
Q

What is the mutation for epithelioid hemangioendothelioma?

A

WWTR-CAMTA1

125
Q

What kind of cancer is associated with vinyl chloride?

A

Hepatic angiosarcoma

126
Q

What kind of cancer is associated with woodworking/wood dust and leather working?

A

Intestinal type adenocarcinoma

127
Q

What kind of cancer is associated with benzene?

A

Leukemia

128
Q

What kind of cancer is associated with chromium?

A

Lung

129
Q

What kind of cancers are associated with arsenic?

A

Skin, bladder, lung, and liver

130
Q

What two inheritances improve sickle cell disease?

A

Coexisting fetal hemoglobin and ALPHA thalassemia (beta makes it worse)

131
Q

What cancer do sickle cell patients have an increased risk of?

A

Renal medullary carcinoma

132
Q

What is the difference between hep B, primary biliary cirrhosis, and autoimmune hepatitis on histology?

A

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
Q

What is seen in the blood/body fluids after a) pneumothorax? b) pleural trauma/hemothorax?

A

A) increased IL-5 and eosinophils in pleural fluid
B) increased peripheral blood eosinophils

134
Q

What are the most common tumor type in the posterior mediastinum?

A

Nerve sheath tumors (ie Schwannoma)

135
Q

What IHC stains are used to differentiate muscularis mucosa and muscularis propria, and what are the associated stages and treatments in bladder carcinoma?

A

Musc mucosa- vimentin - T1 (BCG tx)
Musc propria - smoothelin - T2 (cystectomy tx)

136
Q

What are 2 stains for the basal layer and 3 stains for the secretory layer of prostate glands?

A

Basal: CK903, p63
Secretory: PSA, vimentin, EMA

137
Q

What is the mutation for clear cell sarcoma (melanoma of soft parts)?

A

t(12;22) ATF1-EWS
(whAt The Fuck, not actually a melanoma*)

138
Q

What top 5 cancers metastasize to bone?

A

Prostate Kancer Likes The Bone
(Prostate, Kidney, Lung, Thyroid, Breast)

139
Q

What are the 4 sarcomas that metastasize by lymphatic route?

A

Angiosarcoma, clear cell sarcoma, epithelioid sarcoma, rhabdomyosarcoma

140
Q

What are the two tumors seen in a) Mazabraud syndrome and b) Li-Fraumeni?

A

A) fibrous dysplasia, myxoma of soft tissue
B) sarcomas (especially osteosarcoma and rhabdomyosarcoma)

141
Q

What are the most common mutations for each thyroid carcinoma:
a) papillary
b) follicular
C) medullary
d) anaplastic

A

a) BRAF V600E
b) RAS > PAX8-PPAR
c) RET
d) p53 > b-catenin

142
Q

What is the most common lymphoma in the colon?

A

DLBCL (MALT is most common in overall GI tract and in stomach)

143
Q

What is the IHC profile defining DLBCL, activated B cell type? Germinal center type? What has good vs bad prognosis?

A

Activated B cell type: poor prognosis, CD79a+, MUM1+, GCET1-, BCL6- OR bcl6+ with FOXP1+
Germinal center type: good prognosis, CD10+

144
Q

What are the favorable prognostic factors in ALL:
1) age
2) sex
3) diploidy (hyper or hypo)
4) translocation
5) IHC

A

1) 1-10 yrs
2) female
3) hyperdiploidy
4) 12;21
5) CD10+

145
Q

How to tell difference between follicular lymphoma and reactive follicular hyperplasia?

A

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
Q

How do you differentiate dermatofibrosarcoma protuberans from dermatofibroma?

A

DFSP: CD34+, FXIIIa -
DF: CD34-, FXIIIa+

147
Q

What is each of the following classification groups for a Medicare patient? A) for inpatient rehab B) for skilled nursing facilities

A

A) case-mix group
B) resource utilization group

148
Q

What subtype of rhabdomyosarcoma has the worst prognosis?

A

Alveolar rhabdomyosarcoma

149
Q

What key demographic feature will cause you to think of chondroblastic osteosarcoma vs chondrosarcoma?

A

Age: osteosarcoma more common in young, chondrosarcoma more common in elderly

150
Q

What is a 1) follicular / dentigerous cyst vs 2) periapical / radicular cyst vs 3) odontogenic keratocyst?

Which one is most common odontogenic cyst?

A

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

Anatomic Pathology Boards (3 decks)

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