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Round cell tumors

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Q) 12 yr old girl fever diaphyseal femur mass . It is a  Round cell tumor. PAS+VE diastase
sensitive .  AIIMS onco 2020 

A. Ewing's sarcoma 
B. Osteosarcoma
C. Chondroblastoma
D. Chondrosarcoma

Ans a) Ewing

On the basis of round cell pattern tumor classification is 

  1. Diffuse round cell pattern

    1. Ewing's sarcoma

    2. Primitive neuroectodermal tumor (PNET)

    3. Merkel cell carcinoma

    4. Embryonal rhabdomyosarcoma (ERMS)

    5. Small cell carcinoma

    6. Lymphoma

    7. Leukemic infiltrate.

  2. Septate or lobulated round cell pattern

    1. Small round cells are divided by fibrous/fibrovascular septate

    2. Ewing's sarcoma

    3. Alveolar rhabdomyosarcoma (ARMS).

According to size of round cell

  1. Small round cell – Squamous cell carcinoma, PNET, Ewing's sarcoma, melanoma, rhabdomyosarcoma (RMS), Langerhans cell disease, lymphoma, adenocarcinoma, neuroendocrine carcinoma, Merkel cell carcinoma, olfactory neuroblastoma

  2. Large round cell – Squamous cell carcinoma, adenocarcinoma, melanoma, RMS, lymphoid tumors, paraganglioma.

CT colonogrpahy

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Q) Which of the following is not an indication of CT colography

a) Obstructed growth to look for  synchronous lesions
b. Can’t do colonoscopy
c. High risk pt with suspicion of ca colon

d)   50 year old with Average risk

Metastatic NET

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Q) Girl with pain upper abdomen.  CT Abdomen shows  4 X 5 cm mass in segment V  and thickening in ileocecal region. Liver Biopsy shows NET. Next line of management:?

Immunosuppression

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Q) False regarding immunosuppresant medicines ?

a. MMF is a reversible inhibitor of IMD-DH
b. Both Cyclosporine  and tacrolimus inhibit NF-KB and its downstream effects
c. Everolimus acts on FKBP12To inhibit Calcineurin activity
d. ALG are more used in pancreas transplant

Ectopic pancreas

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Q) Not a site of ectopic pancreas
a. Esophagus
b. GB
c. Liver
d. Jejunum

Loss of cell Surface antigen

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Q) Loss of cell surface antigen is a feature of 
A. CIS
B. NO RELATION WITH GRADE
C. LOW GRADE TUMOR
D. HIGH GRADE TUMOR

Ans d High grade

The ABO(H) blood group system consists of terminal oligosaccharide antigens carried by glycoproteins or glycolipids in hematopoietic or epithelial cells 

Their biosynthesis is presumed to be controlled by the ABO(H), Se, H, Le, and X blood group genes .

These antigens are present on normal bladder epithelium of secretor individuals but not on some low-grade and early-stage papillary urothelial carcinomas 

Moreover, initially expressing tumours lose these cell surface antigens upon local recurrence, progression to invasion or metastization 

D 2 gastrectomy

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Q) D2 gastrectomy false statement is ? ( AIIMS 2021) 
a. No benefit in Overall Survival ( OS) 

b. Better Disease free Survival ( DFS) 
c. Recommended to take stomach, omentum, retro peritoneum en masse
d. Can remove spleen or pancreas if involved