PDA

View Full Version : PATHOLOGY N* Lymphoproliferative Qs


Roxanita
10-20-2004, 12:31 PM
Q-1)
A 16-year-old boy is brought to the emergency department because of respiratory distress. Examination shows a large mediastinal mass and 3-cm firm cervical lymph nodes bilaterally. Examination of tissue obtained on cervical lymph node biopsy shows small lymphocytes interspersed with binucleate cells with clear chromatin and large eosinophilic nucleoli. The most likely diagnosis is

A) Burkitt's lymphoma

B) diffuse noncleaved cell lymphoma

C) follicular lymphoma

D) Hodgkin's disease

E) lymphoblastic lymphoma



Q-2)
A 65-year-old man with inguinal adenopathy undergoes a lymph node biopsy. Light microscopy shows replacement of nodal tissue by cells that form well-defined, uniform glandular structures. The nuclei are relatively small and nucleoli are inconspicuous. An immunohistochemical stain for prostate-specific antigen is positive. These findings are most consistent with which of the following?

A) High-grade, high-stage neoplasm
B) High-grade, low-stage neoplasm
C) Low-grade, high-stage neoplasm
D) Low-grade, low-stage neoplasm




Q-3)
A 40-year-old woman has a fever and petechiae. Laboratory studies show:
Hemoglobin 9 g/dL
Leukocyte count 5000/mm3
Neutrophils 10%
Lymphocytes 20%
Blasts 70%
Platelet count 20,000/mm3

A peripheral blood smear shows Auer rods. The most likely diagnosis is

A) acute lymphoid leukemia

B) acute myeloid leukemia

C) chronic lymphocytic leukemia

D) chronic myelogenous leukemia

E) leukemoid reaction

Q-4
A 15-year-old girl has had a sore throat and temperatures to 37.7 C (100 F) for 3 days. Physical examination shows erythematous pharyngeal mucosa and cervical lymphadenopathy. Leukocyte count is 12,000/mm3 with 60% lymphocytes. A slide agglutination test is positive for antibodies against Epstein-Barr virus. This virus is most likely to replicate initially in which of the following cells?

A) Peripheral blood B lymphocytes

B) Peripheral blood monocytes

C) Peripheral blood T lymphocytes

D) Pharyngeal B lymphocytes

E) Pharyngeal monocytes

F) Pharyngeal T lymphocytes

Q-5
A 70-year-old woman has increasing weakness, weight loss, generalized lymph node enlargement, and hepatosplenomegaly. Laboratory studies show absolute lymphocytosis with the majority of cells being CD5+. The patient also has a mild antiglobulin-positive hemolytic anemia. Karyotype is normal. Which of the following is the most likely diagnosis?

A) Acute lymphoblastic leukemia

B) Acute promyelocytic leukemia

C) Chronic lymphocytic leukemia

D) Chronic myeloid leukemia

E) Fanconi's anemia

F) Hairy cell leukemia

G) Myelodysplastic syndrome

H) Myeloid metaplasia with myelofibrosis

I) Polycythemia vera

Anonymous
10-22-2004, 09:45 PM
Let's guess the Ans;

1) A : Burkitt's
2) C : LG-HS
3) B : AML
4) D : pharyng. B cells
5) C : CLL

What do U think?

Anonymous
10-26-2004, 11:44 PM
Waiting for the ans pls.

katwal
03-11-2006, 01:57 AM
ans..
binucleate cell in 1 is i think hodgkins lymphoma.
ans 2 is A... ans 3 is D..........ans 4 is A... and ans 5 is c
if anybody knows the ans pls help me out
season

tyrosinase
03-11-2006, 04:49 AM
1. - it describes reed-sternberg cells so its hodgkins lymphoma (A)
2. - it was mentioned that the cells are still well defined so, its low grade, however, there was no mention of any localization so i can't say if its high grade or low grade (therefore, either C or D)
3. - positive for auer rods - then its CML (B)
4. and 5. don't know, still to research on it.

mital82
03-11-2006, 09:37 PM
1.hodkins lymphoma small lymphocyte along with binucleated cell

2.low grade high stage as well defined glandular pattern so grade is low and since prostrate ca has spread to inguinal ln it is high stage.

3.auer rods are in acute promyelocytic leukemia and not chronic leukemia

4kissing disease so obvious it is pharyngeal bcell because it is first trapped there.

5.it is cll as the age is more than 60 and accompanied hemolytic anemia.

a good technique in such questions is to look 1st at age
child around 4 high chances of him having ALL
2.if age more than 60 chances of CLL
3. if around 15 to 60 most common is AML followed by CML

2nd is accompanied syndrome and ps findings
1.auer rods it is aml because auer rods only in immature myelocytes.
2. autoimmune hemolytic anemial cll
3.more mature cells are with chronic leukemias.

regarding burkits and hodkins lymphoma. burkitsss lymphoma lymph node involved are jaw(african) and para aortic(american) plus there are scattered macrophages along with small noncleaved cells.(starry sky appearence.). while in hodkins the mediastinal ln are involved more commonly anterior mediastinal. and there is presence of bilnucleated cells
reed sternberg cells.