Pathology Extra Questions

1. A 65-year-old patient presents with a vulvar lesion. The pathology report of the vulvar biopsy is returned with the following description: There is hyperplasia of keratinocytes in the prickle cell layer (stratum spinosum) thickening the epidermis. This is descriptive of which of the following?

2. At an annual examination of a 33-year-old woman, a 3 x 4 mm mass is noted on the lateral aspect of her vagina approximately 3 cm internally from the introitus and at the 3 o’clock position. Which of the following biopsy findings would be most abnormal?

3. Near the external os of the cervix, what is found as a normal transition from columnar epithelium?Near the external os of the cervix, what is found as a normal transition from columnar epithelium?

4. During routine examination, an asymptomatic multiparous patient is found to have a raised 1-cm cyst on her cervix. The area is biopsied and clear mucus is extruded. Histologic examination of the specimen shows a lining of flattened columnar or cuboidal-type cells. With what would this clinical picture be most compatible?

5. On a cytologic specimen, which of the following findings would be most suspicious of herpes virus infection?

6. During the menstrual cycle, the histologic appearance of the endometrium will change significantly. During the first half of the menstrual cycle, the endometrium becomes thicker and rebuilds largely in response to which of the following?

7. During repeat c-section excretances are seen on the ovary and uterine surface. These are biopsied and the report states this as decidualization. What does the term decidualization mean?

8. A 44-year-old G5P5005 patient who is currently using oral contraceptive pills to control menorrhagia had a hysterectomy for uterine enlargement. You suspect adenomyosis by history. Which histological description supports the diagnosis of adenomyosis?

9. A 38-year-old African American woman presents with heavy menses and an enlarged uterus. After an examination the clinical diagnosis is leiomyoma of the uterus. Which of the following best describes this finding?

10. A 47-year-old G0P0 patient presents with history of irregular menses, infertility, and currently increasingly heavy bleeding when it occurs. Her examination is remarkable for obesity, mild hypertension, and a clinical finding consistent with polycystic ovarian syndrome (PCOS). An endometrial biopsy is done and shows endometrial hyperplasia. Which of the following is its best histological description?

11. Although thought to be primarily a conduit between the ovaries and the uterus, the fallopian tubes have been found to have a more prominent role in conception. The same cellular lining that helps in fertility also makes the patient more vulnerable for chronic infection from many of the sexual infectious diseases. Which of the following best describes the normal lining of the fallopian tube?

12. The ovaries are covered by a thin layer of epithelium called germinal epithelium. Why is it called germinal epithelium?

13. The cells in the layers surrounding each oocyte produce ovarian hormones. Which of the following is the correct order of cell layers surrounding an ovarian follicle from the oocyte outward?

14. What is the fate of most of the ovarian follicles that begin to develop at each cycle?

15. Luteinization occurs normally in the ovary during each menstrual cycle. Which of the following best describes this process?

16. An ovary is removed for frozen section pathologic examination. The ovary is enlarged, with small surface excrescences. Pathologic examination reveals numerous cysts lined by serous epithelium with six to eight cell layers piled on top of one another to form the cyst walls. The cells show marked cytologic atypia, and nests of similar cells are present in the ovarian stroma. Round laminated calcium bodies are also seen. What diagnosis does this histologic description indicate?

17. Histologically, the presence of which of the following would determine that an ovarian teratoma is malignant?

18. A 52-year-old patient presents for her annual examination. She denies any problems other than that she has not had an “annual” examination in over 5 years due to cost. During the breast examination she is noted to have dimpling of the skin of the right breast with raising of the arms. What possibility should this sign signify?

19. Histologic examination of the normal breast from a postmenopausal woman as compared to the breast from a premenopausal woman would show which of the following?

20. A patient has a screening mammograph that shows a lesion that is high risk for carcinoma. While waiting for her biopsy to be scheduled she has done some reading on the web regarding breast cancer. She is confused by the number of different types of breast cancer and asks which is the most common pathologic type of breast cancer?

21. A breast biopsy on a 35-year-old woman shows “atypical epithelial hyperplasia confined within the biopsy site.” Which of the following best explains this biopsy finding?

22. A 37-year-old woman complains of a painful lump in her breast. The lump is removed, and microscopic examination of the mass shows “microscopic cysts, papillomatosis, fibrosis, and ductal hyperplasia.” Which of the following is the most likely diagnosis?

23. An asymptomatic 24-year-old college student is found to have a 4-cm, very firm mass in her breast that she has not previously noticed. The mass is mobile, smooth, and nontender in the upper, outer quadrant of her breast. An excision biopsy is performed and shows “a wellcircumscribed, fibrous lesion with glands interspersed throughout the body of the tumor.” Which of the following is the most likely diagnosis?

24. Which of the following pathologic features is most helpful in distinguishing complete hydatidiform mole from normal placenta?