AIIMS ONCO 2020

Cowden

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Q) Not seen in cowden syndrome
A. NET
B. Hamartoma
C. CA breast
D. Bowel malignancy

Malignancy risk in CS is significant outside the GI tract. Women have a 50% lifetime risk of developing breast cancer ...............

Read on ..............

Colon Lymphoma

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Q) A 55-year-old male patient presents with chronic abdominal pain, weight loss, and intermittent diarrhea. Colonoscopy reveals a mass in the cecum, and biopsy confirms colonic lymphoma. Which of the following statements is most likely true regarding this condition?

A) Colonic lymphoma is predominantly of T-cell origin
B) It is more common in females
C) The cecum is the most common site of involvement
D) It typically presents in the 3rd and 4th decades of life

C) The cecum is the most common site of involvement

Explanation:

Colonic lymphoma is a rare form of lymphoma that primarily affects the gastrointestinal tract. Among the options provided:

  • A) Colonic lymphoma is predominantly of T-cell origin: This is incorrect. Colonic lymphoma is most commonly of B-cell origin, particularly extranodal marginal zone lymphoma (MALT lymphoma), rather than T-cell lymphoma.
  • B) It is more common in females: This is also incorrect. Colonic lymphoma does not have a strong gender predilection. The incidence is more balanced between males and females.
  • C) The cecum is the most common site of involvement: This is correct. The cecum is the most frequent site of involvement in colonic lymphoma, especially for extranodal B-cell lymphoma, such as MALT lymphoma. It tends to present as a mass-like lesion, often causing symptoms such as abdominal pain and weight loss.
  • D) It typically presents in the 3rd and 4th decades of life: This is incorrect. Colonic lymphoma is more commonly diagnosed in older adults, typically over the age of 50. It is relatively rare in younger individuals.

NO neck

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Q) Treatment of N0 neck in most  head and neck cancers is

a) Elective lymph node dissection

b) Modified radical lymph node dissection

c) Radiotherapy

d) Chemotherapy

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In patients with a clinically negative neck, the incidence of occult metastases varies with the site, size and thickness of the primary tumour.  The high rate of occult cervical metastases (> 20%) in tumours of the lower part of the oral cavity is the main argument in favour of elective treatment of the neck even if it is N0. Several clinical and pathological studies have demonstrated that the pattern of metastatic lymph node metastases occurs in a predictable fashion in patients with oral and oropharyngeal carcinoma.

The risk of metastases increases as one progresses from the anterior to posterior part of the upper aero-digestive tract; from lip (10%) progressing along the tongue (25%), gum (30%), floor of mouth (40%), oropharynx (55%) to hypopharynx (65%). Endophytic tumors, poorly differentiated tumors, and tumors with a greater thickness (tongue and floor of mouth) are more likely to have metastases

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