CTR Cancer Biology & Pathology 2 — Questions and Answers
Question 1: Which of the following is a defining feature that distinguishes malignant tumors from benign tumors?
- Slow, expansile growth pattern
- Presence of a well-defined fibrous capsule
- Capacity to invade and metastasize to distant sites (Correct answer)
- Close histological resemblance to tissue of origin
Correct answer: Capacity to invade and metastasize to distant sites
The hallmark of malignancy is the ability of tumor cells to invade surrounding tissue and spread (metastasize) to distant organs, which benign tumors cannot do.
Question 2: In ICD-O-3 coding, what does the morphology code represent?
- The primary anatomical site of the tumor
- The histologic cell type and behavior of the neoplasm (Correct answer)
- The clinical stage at time of diagnosis
- The treatment modality selected for the patient
Correct answer: The histologic cell type and behavior of the neoplasm
The ICD-O-3 morphology code is a 5-digit code combining a 4-digit histology code (describing cell type) with a 1-digit behavior code (e.g., /3 for malignant).
Question 3: Triple-negative breast cancer (TNBC) is defined by the absence of which three receptors or proteins?
- HER2, EGFR, and VEGF
- Estrogen receptor (ER), progesterone receptor (PR), and HER2 (Correct answer)
- ER, HER2, and BRCA1 mutation
- PR, BRCA1, and BRCA2 mutation
Correct answer: Estrogen receptor (ER), progesterone receptor (PR), and HER2
Triple-negative breast cancer lacks estrogen receptor, progesterone receptor, and HER2 overexpression, making it ineligible for hormone therapy or HER2-targeted agents.
Question 4: The term 'anaplastic' when describing a tumor indicates:
- Tumor cells are well-differentiated and slow growing
- Tumor cells are highly differentiated with favorable prognosis
- Tumor cells lack differentiation and typically behave aggressively (Correct answer)
- Tumor is confined to the primary site without invasion
Correct answer: Tumor cells lack differentiation and typically behave aggressively
Anaplastic tumors are characterized by a complete loss of differentiation, pleomorphic nuclei, and high mitotic activity, generally correlating with aggressive clinical behavior.
Question 5: Squamous cell carcinoma typically arises from which tissue type?
- Glandular epithelium
- Transitional (urothelial) epithelium
- Stratified squamous epithelium (Correct answer)
- Neuroendocrine cells
Correct answer: Stratified squamous epithelium
Squamous cell carcinoma originates from squamous epithelial cells and is commonly found in the skin, cervix, head and neck, esophagus, and lung.
Question 6: Which pathologic finding indicates that cancer cells have entered blood vessels or lymphatic channels within the tumor specimen?
- Perineural invasion
- Lymphovascular invasion (LVI) (Correct answer)
- Tumor budding
- Extranodal extension
Correct answer: Lymphovascular invasion (LVI)
Lymphovascular invasion (LVI) is documented when cancer cells are identified within vascular or lymphatic spaces, which is associated with increased risk of metastasis and recurrence.
Question 7: A tumor described as 'well-differentiated' most accurately means:
- The tumor has spread to multiple organ systems
- The tumor cells closely resemble the normal cells of the tissue of origin (Correct answer)
- The tumor is ineligible for surgical resection
- The tumor has a high mitotic rate and rapid growth
Correct answer: The tumor cells closely resemble the normal cells of the tissue of origin
Well-differentiated (Grade 1) tumors retain features similar to the normal parent tissue, are typically slower growing, and generally carry a more favorable prognosis.
CTR Cancer Biology & Pathology 2
Which of the following is a defining feature that distinguishes malignant tumors from benign tumors?