FREE AIIMS MCQ on 01 January 2017

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 DAILY FREE MCQ CHALLENGE for Medical PG Preparation

Question
A pathologist examines biopsy from a patient presenting with bleeding per rectum with a past history of intussusception for the past 6 months. Histopathology obtained has been shown below. Identify the pathology?


A. Hamartoma
B. Tubulovillous adenoma
C. Adenocarcinoma
D. Juvenile polyposis syndrome

TIPSImportant Question from AIIMS 2015

Answer: B. Tubulovillous adenoma

Explanation :

Adenoma is a benign epithelial tumor arising in epithelium of mucosa (stomach, small intestine and bowel), glands (endocrine and exocrine) and ducts. Here, the microscopic image shows the Tubulovillous adenoma.

Compared to normal colonic epithelium the adenomatous proliferation is characterized by different degrees of cell dysplasia and tubular, villous or tubulo-villous architecture. In tubular component tumor cells proliferate generating tubular shapes, more or less irregular or branched. The villous pattern presents villi – finger-like projections lined by dysplastic epithelium and with thin fibro-vascular core. Passage from tumoral epithelium to normal mucosa is abrupt.

Note:

  • Adenomas themselves are benign, but they are precursors of malignancy.
  • Villous adenomas are more likely to progress to or contain foci of invasive adenocarcinoma than are tubular adenomas.
  • If a villous adenoma is > 4.0 cm in size, the risk of harboring a malignant neoplasm is greatly increased (i.e., > 40%).
Reference: Chapter 14. Gastrointestinal Pathology. In: Kemp WL, Burns DK, Brown TG. eds. Pathology: The Big Picture. Reference link


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