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Tumours derived from a mixture of tissues
1. A 55-year-old female is found to have asymptomatic microscopic hematuria. A plain radiograph of the abdomen revealed a neoplasm at her right kidney. A gross investigation of removed kidney revealed a node 8cm in diameter at its upper pole. The cut surface of a tumor presented with multiple hemorrhages and necroses. Histologically, it consists of light cells that form alveolar and papillary structures. The invasive growth of the tumor is moderate. Many cells have hyperchromic nuclei and atypical mitoses figues. What is the most likely diagnosis?
A. *Renal cell carcinoma.
B. Clear cell adenoma.
C. Adenocarcinoma.
D. Nephroblastoma.
E. Acidophilic adenoma with malignancy.
2. A 60-year-old man noticed worsening urinary tract symptoms and thus inquires about screening tests for kidney pathology. Investigation revealed a node 8 cm in diameter at right kidney’s apex. After surgery, grossly tumor presented a patchy pattern with hemorrhages and zones of necrosis. Histological study showed large anaplastic tumor cells with abundant foamy cytoplasm and with small central densely staining nucleus. Abnormal mitoses were also found. What is the most likely diagnose?
A. * Clear -cell carcinoma
B. Clear -cell adenoma
C. Adenocarcinoma
D. Nephroblastoma
E. Acidophilic adenoma with malignization
3. A 45-yer-old female examined by her gynecologist due to uterine bleeding. A neoplasm was diagnosed and then removed at surgery department. The uterine lesion presented with huge necrotic and hemorrhagic spongy masses. Microscopic investigation revealed large clear atypical epithelial cells and variety of abnormal dark cells, arranged around material blood spaces. Stroma was not defined. Atypical cells resembled cytotrophoblast and syncytiotrophoblast cells. What is the most likely diagnose?
A. *Choriocarcinoma
B. Invasive hydatidiform mole
C. Adenocarcinoma
D. Cavernous haemangioma.
E. Medullary carcinoma
4. A 32-year-old woman with a history of abortion 8 months earlier presented to the emergency department complaining of uterine bleeding. Examination done by gynecologist revealed a neoplasm of the uterus. Grossly, tumor had a spongy structure with multiple hemorrhages. Microscopically, atypical clear epithelial Langhan’s cells and abnormal syncytiotrophoblast cells arranged around maternal blood spaces were detected. What is the most likely diagnosis?
A. *Choriocarcinoma
B. Squamous cell carcinoma without keratinisation
C. Adenocarcinoma
D. Fibromyoma
E. Hydatidiform mole
5. A 45-year-old woman presented to oncology with a breast tumor. A biopsy revealed a tissue atypia with stromal predominance over neoplastic parenchyma. Breast ducts and ductules were variable, they had one or two layered epithelium without atypical mitotic activity. The intralobular stroma was dence. What is the most likely diagnosis?
A. *Fibroadenoma
B. Papilloma
C. Non-invasive carcinoma
D. Invasive carcinoma
E. Mastitis
6. The patient on a face skin had a tumorous formation plaque-like form with an ulcer. What is the most likely diagnosis?
A. * Basal cell epithelioma
B. Carcinoid
C. Thecoma
D. Pinealoma
C. Thymoma
7. A physical examination of a 22-year-old woman, with few years’ history of myasthenia, revealed a big tumor at anterior mediastinum. Histologically a tumor consisted of the oblong (spindle-shaped) cells with oval dark nuclei, which form bands and nests and has little Hassall’s bodies. After a surgical removal of a tumor symptoms of a myasthenia have started to disappear progressively. Diagnose a tumor which has etiological and pathogenic connection with a myasthenia.
A. * Thymoma
B. Adenoma of thyroid gland
C. Adenoma of parathyroid gland
D. Paraganglioma
E. Medulloblastoma
8. A 48-year-old man has presented to his physician a plaque-like formation on a neck. Histological investigation of a skin biopsy revealed tumorous cells located as nests, having round and oval form with narrow rim of basophilic cytoplasm. They reminded cells of a skin basal layer. Specify the tumor name.
A. * Basal cell epithelioma
B. Epidermal cancer
C. Hidroadenoma
D. Trichoepithelioma
E. Syringadenoma
9. A physical investigation of a 25-year-old-woman revealed in her breast a dense node 1,0 cm in diameter. A biopsy research showed encapsulated growth of a connective tissue round a basal membrane of a mammary gland ducts. Glandular elements had different diameter, did not form lobes. What is the most likely diagnosis?
A. *Fibroadenama
B. Fibroma
C. Metastasis of a cancer
D. Adenoma
E. Fibrous cancer
10. A physical examination of a 39-year-old woman revealed a soaking area by her breast nipple, a superficial ulcer with inflammatory hyperemia and skin edema. A histological research of a biopsy from this area revealed in basal layer of thickened epidermis atypical big cells with light and optically empty cytoplasm, with absence of intercellular bridges. Such cells are found and in the ostium of the big ducts of a gland. What is the most likely diagnosis?
A. *Paget’s desease
B. Intraductal cancer
C. Basal cell cancer
D. Epidermoid carcinoma
E. Melanoma
11. A 45 year old man consulted a doctor about a plaque-like formation on his neck. Histological examination of a skin bioptate revealed clusters of round and oval tumour cells with a narrow border of basophilic cytoplasm resembling of cells of basal epidermal layer. What tumour is it?
A. *Basal cell carcinoma
B. Hydroadenoma
C. Trichoepithelioma
D. Epidermal cancer
E. Syringoadenoma
12. 6 months after labour a woman had uterine hemorrhage. Gynecological examination of uterine cavity revealed a dark-red tissue with multiple cavities resembling of a "sponge". Microscopic examination of a tumour revealed in blood lacunas atypical light epithelial Langhans cells and giant cells of syncytiotrophoblast. What tumour is it?
A. *Chorioepithelioma
B. Cystic mole
C. Fibromyoma
D. Adenocarcinoma
E. Squamous cell nonkeratinous carcinoma
Mesenchymal (connective tissue) tumors
1. A 30-year-old man has a node on his left leg the skin. Physical investigation revealed dense, mobile tumor, circumscribed by a connective tissue capsule. Grossly it cut section was presented with dense witish fibres. Microscopically the tumor composed of mature fibroblasts and a collagenous stroma. What is the most likely diagnosis?
A. *Fibroma
B. Myoma
C. Histiocytoma
D. Dermatofibroma
E. Desmoid.
2. A 14x6x5 cm neoplasm excised from a retroperitoneum of a 66-year-old woman at surgery department. Microscopic investigation revealed atypical anaplastic cells, which contained round cytoplasmic vacuoles of lipid that scallop the nucleus. The majority of cells were pleomorphic, some of them were round with chromosomal abnormalities. What is the most likely diagnosis?
A. *Liposarcoma
B. Lipoma
C. Myosarcoma
D. Fibrosarcoma
E. Mesothelioma
3. A physical examination of 47-year-old woman of gynecology department revealed that her uterus contained dicrete, firm, white nodules. Histological examination excised lesion demonstrated a tissue atypia of a sample. It presented well-defferentiated mature cells of smooth muscules. What is the most likely diagnosis?
A. *Leiomyoma.
B. Carcinoma of the uterus.
C. Fibromyoma.
D. Chorionepithelioma.
E. Leiomyosarcoma
4. A 20-year-old man has had a slowly growing reddish nodule on his upper lip. He finally decides to have a surgeon remove it. Microscopically the nodule is composed of benign varying sized tiny blood vessels. What is the most likely diagnosis?
A. *Capillary hemangioma.
B. Venous hemangioma.
C. Cavernous hemangioma.
D. Hemangiopericytoma.
E. Glomus-angioma.
5. The patient, a previously dealthy man of 25 years, presented with a painless neoplasm in a soft tissues of his left thigh. Grossly, a tumor had uneven boundaries and on cut section it looked like a fish flesh. Microscopic investigation revealed immature connective tissue cells with pleomorphism, numerous mitotic figures and lymphocyte infiltration at the edge of the tumor. What is the most likely diagnosis?
A. *Fibrosarcoma
B. Myosarcoma
C. Fibroma
D. Carcinoma
E. Myoma
6. A 40-year-old woman presented with a very slowly enlarging subcutaneous mass at the right side of the chest wall. Physical examination revealed a soft lobulated fluctuant swelling, not attached to the skin or underlying muscle. Histologically a neoplasm was well-encapsulated and consisted of mature cells with clear cytoplasm that varied considerably in size. What is the most likely diagnosis?
A. *Lipoma.
B. Fibroma.
C. Hygroma.
D. Papilloma.
E. Hemangioma.
7. A macroscopical investigation of operatively removed uterus revealed a tumour with a soft consistence, hemorrhages and necroses. The tumor cut surface reminds ' the fish meat '. Histological research has found an expressed cellular and tissue atypia; there were cells with pathological mitoses figures. What is the most likely diagnosis?
A. Sarcoma.
B. Adenocarcinoma.
C. Angioma.
D. Fibroma.
E. Lipoma.
8. At the young man in a skin depth the dense, mobile tumour, is defined. A microscopical research revealed chaotically located fascicles of collagen fibers with a small amount of spindle-shaped cells. What tumour is removed?
A. *Dense fibroma.
B. Leiomyoma.
C. Melanoma.
D. Lipoma.
E. Glomus-angioma.
9.A 4-year-old child presented with a flat red color knot on his neck skin, which turns pale at pressing by glass the knot. What is the most probable diagnosis?
А. Hemangioma
B. Pigmented nevus
C. Melanoma
D. Leiomyoma
E. Lymphangioma
10. A 28-year-old man with a history of an elbow bruise 3 years ago presented with a tumorous growth in the area of an epiphysis of a humeral bone. The formation did not have accurate borders. A histological investigation of biopsy material revealed a considerable quantity of polymorphic cells of osteoblastic type with numerous pathological mitoses. Make the presumable diagnosis.
A. *Osteosarcoma
B. Chondrosarcoma
C. Osteoid-osteoma
D. Fibrosarcoma
E. Sinovial sarcoma
11. A 48-year-old man presented to physician with mobile 1, 0 x 0, 7 cm formation under a skin of mandible. It had precise borders, dough-like consistence and slow growth. A histologic research of formation revealed fat tissue cells (lipocytes), which created lobules of different forms and the sizes, divided by thin layers of a connective tissue with vessels. What is the most likely diagnosis?
A. *Lipoma
B. Fibroma
C. Angioma
D. Liposarcoma
E. Fibrosarcoma
12. A 33-year-old woman presented with a tumor-like formation on a white line of her abdomen, which during pregnancy has started to increase in sizes. A histological research revealed that a tumor is constructed of the differentiated connective tissue, in which collagen fibers prevail of cells. What tumor presented in this case?
A. * Desmoid
B. Dense fibroma
C. Fibrosarcoma
D. Soft fibroma
E. Dermatofibroma
13. A 15-year-old young man presented with a tumorous formation in the central site of his wrist bone. The node grew slowly within last 3 years. A histological research of a removed neoplasm revealed mature chondrocytes without mitoses, which randomly located in chondral lacunas. Cartilages of a capsule had different form and the sizes due to variable quantity of chondral cells, between which there were basic substance with liquid layers of a connective tissue. What is the most likely diagnosis?
A. *Chondroma
B. Chondroblastoma
C. Chondrosarcoma
D. Teratoma
E.
14. A 50-year-old patient presented to the doctor with a ball-shaped, dense, motionless neoplasm, 2 cm in diameter, under a skin in the right parietal site of his head. A histological research of a removed neoplasm revealed a chaotic osteal beams pattern with a connective tissue between. What is the most likely diagnosis?
A. *Cancellous osteoma (Osteoma spongiosum)
B. Compact osteoma (Osteoma durum)
C. Osteoporosis
D. Osteomalacia
E. Osteosarcoma
15. At the young woman in the area of her distal extremity of a femur the tumor, which quickly grew, is removed. Grossly, it had a motley pattern – from white-sulphur to brown-red color and a quaggy consistence. Microscopical investigation revealed the basic tissue component of a tumor presented with osteal and the ossiform structures covered by atypical osteoblasts, with numerous thin-walled vessels and atypical mitoses figures. Make a diagnosis.
A. *Osteocarcoma
B. Chondroma
C. Osteoma
D. Саркома Юинга
E. Angiosarcoma
16. A 16-year-old child presented with a painful softish node in his femur diaphysis. The formation grows quickly with destruction of a spongy layer of a bone. Microscopical investigation revealed monomorphic round cells little bit bigger than mature lymphocytes, with jejunely light cytoplasm which contains glycogen. In some zones these cells form pseudo- rosettes with few mitoses. Between cells there are fibrinous membranes. What is the most likely diagnosis?
A. *Ewing’s sarcoma
B. Limphoma
C. Rhabdomyosarcoma
D. Neuroblastoma
E. Hemangioma
17. Examination of a 55 year old woman revealed under the skin of submandibular area a movable slowly growing pasty formation with distinct borders 1,0x0,7 cm large. Histological examination revealed lipocytes that form segments of different forms and sizes separated from each other by thin layers of connective tissue with vessels. What is the most probable diagnosis?
A. *Lipoma
B. Fibroma
C. Liposarcoma
D. Fibrosarcoma
E. Angioma
18. Examination of the anterior abdominal wall of a pregnant woman revealed a tumour-like formation that arose on the spot of a tumour that was removed two years ago. The neoplasm was well-defined, dense, 2x1 cm large. Histological examination revealed that the tumour was composed of differentiated connective tissue with prevailing collagen fibres. What tumour might be suspected?
A. *Desmoid
B. Hibernoma
C. Leiomyoma
D. Fibrosarcoma
E. Lipoma