ABPath Cytopathology 2

Question 1

On a cervical Pap smear, which cellular feature is most characteristic of a high-grade squamous intraepithelial lesion (HSIL)?

Accepted Answer

Increased nuclear-to-cytoplasmic ratio with hyperchromasia

Answer

Abundant glycogenated cytoplasm

Answer

Perinuclear halos with mild nuclear enlargement

Answer

Prominent cytoplasmic keratinization only

Question 2

A thyroid FNA shows follicular cells with nuclear grooves, powdery chromatin, and intranuclear pseudoinclusions. Which diagnosis is most likely?

Accepted Answer

Papillary thyroid carcinoma

Answer

Medullary carcinoma

Answer

Follicular adenoma

Answer

Hashimoto thyroiditis

Question 3

Which Bethesda System category for thyroid cytology carries the highest risk of malignancy?

Accepted Answer

Malignant (Category VI)

Answer

Atypia of undetermined significance (Category III)

Answer

Benign (Category II)

Answer

Nondiagnostic (Category I)

Question 4

In a serous effusion, which feature best distinguishes reactive mesothelial cells from adenocarcinoma cells?

Accepted Answer

Windows (spaces) between adjacent mesothelial cells

Answer

Presence of psammoma bodies

Answer

Large three-dimensional cell balls

Answer

Sharp community borders with mucin vacuoles

Question 5

Which immunostain is most useful to confirm mesothelial origin of cells in an effusion?

Accepted Answer

Calretinin

Answer

MOC-31

Answer

TTF-1

Answer

CEA

Question 6

A urine cytology specimen shows cells with high N/C ratio, hyperchromatic irregular nuclei, and coarse chromatin. This best fits which Paris System category?

Accepted Answer

High-grade urothelial carcinoma

Answer

Negative for high-grade urothelial carcinoma

Answer

Atypical urothelial cells

Answer

Low-grade urothelial neoplasm

Question 7

Which artifact commonly causes air-drying changes on cytology smears?

Accepted Answer

Delayed fixation of the smear

Answer

Overstaining with hematoxylin

Answer

Excessive alcohol fixation

Answer

Prolonged formalin exposure