Pathology Outlines
December 7, 2013 - Question 2
A 65 year old female with history of hypertension, diabetes and rheumatoid arthritis presents with three months of constipation and rectal bleeding. She initially attributed the bleeding to hemorrhoids, but the symptoms continued to worsen. She has never had a colonoscopy, but states that her mother died of "bad colon cancer." Vital signs are stable, and physical examination is notable only for a palpable rectal mass. Laboratory examination reveals anemia. The patient undergoes colonoscopic biopsy of the lesion. Which of the following histopathologic findings is consistent with the diagnosis seen below?
a. Invasive neoplasm with squamous pearl formation, foci of keratinization and areas of granular necrosis
b. Invasive glandular and tubular structures lined by uniform mucus-producing columnar epithelium
c. Invasive lesion composed of nested, pigmented epithelioid cells exhibiting positivity for S100, HMB-45 and Melan A
d. Dilated, thick-walled submucosal vessels and sinusoidal spaces with adjacent hemorrhage
e. Spindle-shaped cells with large and hyperchromatic nuclei, eosinophilic cytoplasm and positivity for S-100, vimentin, cytokeratin and negative for CEA
Check answer here.
Source: BoardVitals, 12/7/2013
December 7, 2013 - Question 2
A 65 year old female with history of hypertension, diabetes and rheumatoid arthritis presents with three months of constipation and rectal bleeding. She initially attributed the bleeding to hemorrhoids, but the symptoms continued to worsen. She has never had a colonoscopy, but states that her mother died of "bad colon cancer." Vital signs are stable, and physical examination is notable only for a palpable rectal mass. Laboratory examination reveals anemia. The patient undergoes colonoscopic biopsy of the lesion. Which of the following histopathologic findings is consistent with the diagnosis seen below?
a. Invasive neoplasm with squamous pearl formation, foci of keratinization and areas of granular necrosis
b. Invasive glandular and tubular structures lined by uniform mucus-producing columnar epithelium
c. Invasive lesion composed of nested, pigmented epithelioid cells exhibiting positivity for S100, HMB-45 and Melan A
d. Dilated, thick-walled submucosal vessels and sinusoidal spaces with adjacent hemorrhage
e. Spindle-shaped cells with large and hyperchromatic nuclei, eosinophilic cytoplasm and positivity for S-100, vimentin, cytokeratin and negative for CEA
Check answer here.
Source: BoardVitals, 12/7/2013