BCSE Anatomic and Clinical Pathology 5

Question 1

A 4-year-old child has a large abdominal mass with histology showing triphasic components: blastemal cells, stromal cells, and epithelial cells forming primitive tubules. What is the diagnosis?

Accepted Answer

Wilms tumor (nephroblastoma)

Answer

Wilms tumor is the most common pediatric renal malignancy and is defined by its triphasic histology of blastema, stroma, and epithelium.

Question 2

A patient's cervical Pap smear shows cells with high nuclear-to-cytoplasmic ratio, nuclear hyperchromasia, and irregular chromatin in squamous cells. These findings are classified as HSIL. HSIL corresponds to which histologic diagnosis?

Accepted Answer

CIN 2 or CIN 3

Answer

HSIL (High-grade Squamous Intraepithelial Lesion) on Pap smear corresponds histologically to CIN 2 or CIN 3, indicating significant dysplasia.

Question 3

A 60-year-old female has a lung biopsy showing pink, amorphous alveolar filling material that stains with PAS and is congophilic with apple-green birefringence under polarized light. What is the diagnosis?

Accepted Answer

Alveolar amyloidosis

Answer

Congo red staining with apple-green birefringence under polarized light is diagnostic of amyloid deposition; pulmonary amyloidosis can present as alveolar filling.

Question 4

A 72-year-old man has a splenectomy specimen showing a diffuse infiltration of small lymphoid cells that also fill the splenic red pulp sinusoids and are positive for CD20, CD11c, DBA.44 with TRAP (tartrate-resistant acid phosphatase) staining. What is the diagnosis?

Accepted Answer

Hairy cell leukemia

Answer

Hairy cell leukemia is characterized by B-cells with hairy cytoplasmic projections, CD11c and DBA.44 positivity, TRAP positivity, and infiltration of splenic red pulp.

Question 5

An autopsy on a 55-year-old male with a history of chronic hypertension shows concentric left ventricular wall thickening with a normal or reduced chamber size. What is this change called?

Accepted Answer

Concentric hypertrophy

Answer

Concentric hypertrophy results from pressure overload (as in hypertension), causing sarcomeres to add in parallel, increasing wall thickness while preserving or reducing chamber size.

BCSE - Basic and Clinical Sciences Examination Practice Test

BCSE - Basic and Clinical Sciences Examination Practice Test

BCSE Anatomic and Clinical Pathology 5