AIIMS ONCO 2020

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.

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:?

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 

Papillary carcinoma thyroid

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Q) 40 yr old lady 2X 2 Solitarty thyroid nodule left lobe. FNAC shows  classic type of papillary  carcinoma . Usg no neck nodes. Management? ( Questions on Surgical Onco - thyroid) 

A. Total thyroidectomy
B. Total thyroidectomy with Radio active Iodine
C. Total thyroidectomy with central compartment neck dissection
D. Hemithyroidectomy + follow up