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Test Bank for Robbins and Cotran Pathologic Basis of Disease 9th
Edition by Kumar

Chapter 07: Neoplasia

Test Bank

MULTIPLE CHOICE

1. Which of the following tumors occurs most often in the ovary?

2. Chondroma
3. Hemangioma
4. Leiomyoma
5. Transitional cell papilloma
6. Cystadenoma

ANS: E, Cystadenomas, which may contain serous fluid or mucin and are thus called
serous or mucinous cystadenomas, are typically found in the ovary. These benign
tumors have malignant counterparts known as cystadenocarcinomas.

2. Which one of the following carcinomas is locally invasive but rarely forms
metastases in lymph nodes and distant sites?
3. Basal cell carcinoma of the skin
4. Squamous cell carcinoma of the skin
5. Oat cell carcinoma of the lung
6. Transitional cell carcinoma of the urinary bladder
7. Adenocarcinoma of the stomach

ANS: A, Basal cell carcinomas of the skin, the most common malignant tumor in the
human body, is a locally invasive malignant tumor, which, if untreated, could
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ultimately kill the host. However, these tumors are usually diagnosed early and
removed adequately, so that they almost never metastasize.

3. Pseudomyxoma peritonei is a complication of which tumor?

4. Serous cystadenoma of the ovary
5. Mucinous cystadenoma of the ovary
6. Ovarian fibroma
7. Myxoma of the heart
8. Myxosarcoma of the lower extremity

ANS: B, Pseudomyxoma of the ovary usually results from peritoneal seeding of

mucin-secreting tumors of the ovary or the gastrointestinal tract, and most often the
appendix. Although the ovarian tumor is benign, the implants of the tumor cells
seeding the peritoneal cavity can be difficult to eradicate. The cells continue to
secrete mucin and fill the abdominal cavity, colloquially known as jelly-belly.

4. Which mechanism affecting the genes or chromosomes accounts for the

activation of the c-myc protooncogene in Burkitt lymphoma cells?
5. Overexpression
6. Amplification
7. Point mutation
8. Translocation
9. Inactivation of its promotor

ANS: D, Translocation of the c-myc protooncogene from its normal site on

chromosome 8 to chromosome 14 results in the formation of the myc oncogene and
plays a major role in the pathogenesis of Burkitt lymphoma.

5. Homogeneous staining regions (HSR) of chromosome 2p, the site of the N-

myc gene, are adverse prognostic signs if found in neuroblastoma cells. HRS
are evidence of gene
6. deletion
7. amplification
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8. point mutation
9. translocation
10. inversion

ANS: B, Homogeneous staining regions and double minutes are signs of gene
amplification. Amplification of the N-myc oncogene in neuroblastoma cells is a poor
prognostic finding.

6. In which cell function is BRCA1, a gene mutated in women with familial breast
carcinoma, involved?
7. Cell adhesion
8. Growth inhibition
9. Signal transduction
10. Cell surface channel
11. Transcriptional regulation and DNA repair

ANS: E, BRCA1 and BRCA2 are tumor suppressor genes whose true function has not
been fully elucidated. It is thought that they participate in the transcriptional
regulation and interact with proteins that regulate double-strand DNA repair.

7. Germ line mutation of E-cadherin is found in familial cases of

8. lymphoblastic lymphoma
9. Ewing sarcoma
10. neuroblastoma
11. gastric carcinoma
12. seminoma

ANS: D, E-cadherin is a cell-to-cell adhesion molecule that serves to hold many

epithelial cells together. This surface adhesion molecule is often lost in
adenocarcinomas, accounting for the invasive growth of these neoplasms. Germ line
mutation of the E-cadherin gene has been found in families with gastric carcinoma.
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8. Germ line mutation of the Von HippelLindau (VHL) gene is associated with
formation of retinal angiomas and
9. glioblastoma multiforme
10. oligodendroglioma
11. neurinomas
12. ependymomas
13. cerebellar hemangioblastomas

ANS: E, Von HippelLindau syndrome was originally described as a syndrome

comprising angiomas of the retina and hemangioblastomas of the cerebellum. It is
linked to the germ line mutation of the VHL tumor suppressor gene. These patients
are at risk of developing renal cell carcinoma and pheochromocytomas. Mutations of
the VHL gene also have been found in sporadic renal carcinomas unrelated to Von
HippelLindau syndrome.

9. Microsatellite instability, a marker of DNA mismatch repair, is typically found

in
10. hereditary nonpolyposis colon cancer
11. familial adenomatous polyposis coli
12. T-cell lymphoma
13. B-cell lymphoma
14. myelogenous leukemia

ANS: A, Mutations of human DNA mismatch repair genes play a pathogenetic role in
the development of colonic cancers in families with hereditary nonpolyposis colon
cancer (HNPCC). Due to the error in mismatch repair, the microsatellite sequences
(normally fixed for life and the same in every tissue) expand. They account for the
microsatellite instability, a hallmark of all conditions with defective DNA mismatch
repair.

10. Matrix metalloproteinases secreted by tumor cells are important for which
feature of malignant tumors?
11. Desmoplasia
12. Anaplasia
13. Invasiveness
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14. Apoptosis
15. Differentiation

ANS: C, Matrix metalloproteinases, such as type IV collagenase, are important for the
invasive growth of tumor cells. These enzymes degrade the basement membranes
and the extracellular matrix, allowing the tumor cells to penetrate into the tissues,
lymphatics, and blood vessels.

11. Which enzymes in the liver account for the activation of most procarcinogens
into carcinogens?
12. Cytochrome P-450-dependent mono-oxidases
13. Aminotransferases
14. Hydroxylases
15. Glutathione dehydrogenase
16. Caspases

ANS: A, Most of the exogenous procarcinogens are activated into carcinogens in the
liver through the action of microsomal cytochrome P-450dependent mono-
oxidases found in the smooth endoplasmic reticulum of hepatocytes. Susceptibility
to carcinogens is in part determined by the polymorphism of genes that encode
these enzymes.

12. Which is the most common radiation-induced cancer in humans?

13. Thyroid cancer
14. Chronic lymphocytic leukemia
15. Breast cancer
16. Lung cancer
17. Salivary gland carcinoma

ANS: B, Leukemias represent the most common radiation-induced cancer in

humans, closely followed by thyroid cancer, which is the most common malignancy
in young persons.
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13. Helicobacter pylori infection predisposes to formation of gastric tumors, but

the association between the bacterial infection and a gastric tumor is the
strongest for
14. adenocarcinoma of the stomach
15. gastrointestinal stromal tumors
16. marginal zone lymphomas
17. T-cell lymphoma
18. Burkitt lymphoma

ANS: C, The best and strongest evidence links Helicobacter pylori infection with the
onset of mucosa-associated B-cell lymphomas (MALTomas) of the stomach, which
are also known as marginal zone lymphomas. It is thought that H. pylori activates T
cells, which in turn promote polyclonal proliferation of B cells in the gastric mucosa.
In this process, some cells obviously become malignant and give rise to T-cell
independent low-grade monoclonal lymphomas.

14. Clubbing of the digits, periosteal new bone formation on the metatarsals,
metacarpals, and proximal phalanges, and arthritis of adjacent joints is a
paraneoplastic syndrome most often associated with carcinoma of the
15. thyroid
16. larynx
17. bronchi
18. liver
19. stomach

ANS: C, Clubbing of the fingers and related bone and joint changes of the hand and
fingers are signs of hypertrophic osteoarthropathy, which most often occurs in
patients with bronchogenic carcinoma. The pathogenesis of these changes is not
known.

Robbins and Cotran Pathologic Basis of Disease: 9th Edition Test Bank Kumar