WBR0246: Difference between revisions
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|MainCategory=Pathology | |MainCategory=Pathology | ||
|SubCategory=Gastrointestinal | |SubCategory=Gastrointestinal | ||
|MainCategory=Pathology | |||
|MainCategory=Pathology | |MainCategory=Pathology | ||
|MainCategory=Pathology | |MainCategory=Pathology | ||
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|Prompt=A 62-year-old male presents to the physician's office with complaints of abdominal pain, which has been worsening over the past four months. The dull pain is localized in the epigastric area and persistently increasing in intensity, independently from food intake or change in posture. Upon further questioning, he describes symptoms of increasing fatigue and weight loss. A CT scan displays a mass in the stomach and an endoscopy-guided biopsy of the mass reveals clusters of thin, elongated spindle cells. Which of the following immunohistochemistry findings is most helpful in diagnosing the type of tumor in this patient? | |Prompt=A 62-year-old male presents to the physician's office with complaints of abdominal pain, which has been worsening over the past four months. The dull pain is localized in the epigastric area and persistently increasing in intensity, independently from food intake or change in posture. Upon further questioning, he describes symptoms of increasing fatigue and weight loss. A CT scan displays a mass in the stomach and an endoscopy-guided biopsy of the mass reveals clusters of thin, elongated spindle cells. Which of the following immunohistochemistry findings is most helpful in diagnosing the type of tumor in this patient? | ||
|Explanation=The patient's symptoms of epigastric pain, fatigue, and weight loss, in conjunction with the CT finding of a mass in the stomach, points towards the diagnosis of malignancy. The spindle cells on pathology are often diagnostic for a [[gastrointestinal stromal tumor]] (GIST), which can be confirmed by positive immunohistochemistry for C-kit. | |Explanation=The patient's symptoms of epigastric pain, fatigue, and weight loss, in conjunction with the CT finding of a mass in the stomach, points towards the diagnosis of malignancy. The spindle cells on pathology are often diagnostic for a [[gastrointestinal stromal tumor]] (GIST), which can be confirmed by positive immunohistochemistry for C-kit. | ||
|AnswerA=C-kit | |AnswerA=C-kit | ||
|AnswerAExp= [[C-kit]] oncogene is associated with [[GIST]]. [[C-kit]] gene encodes the human homolog of the proto-oncogene c-kit, also called CD117. | |AnswerAExp=[[C-kit]] oncogene is associated with [[GIST]]. [[C-kit]] gene encodes the human homolog of the proto-oncogene c-kit, also called CD117. | ||
|AnswerB=Ret | |AnswerB=Ret | ||
|AnswerBExp= The [[Ret gene|Ret oncogene]] is often associated with [[MEN|MEN syndrome]], type IIa and IIb. | |AnswerBExp=The [[Ret gene|Ret oncogene]] is often associated with [[MEN|MEN syndrome]], type IIa and IIb. | ||
|AnswerC=Abl | |AnswerC=Abl | ||
|AnswerCExp= The [[Abl gene|Abl oncogene]] is often associated with CML. | |AnswerCExp=The [[Abl gene|Abl oncogene]] is often associated with CML. | ||
|AnswerD=Ras | |AnswerD=Ras | ||
|AnswerDExp= The [[Ras]] oncogene is often associated with colon carcinoma. | |AnswerDExp=The [[Ras]] oncogene is often associated with colon carcinoma. | ||
|AnswerE=C-myc | |AnswerE=C-myc | ||
|AnswerEExp= [[C-myc]] is associated with [[Burkitt's lymphoma]]. | |AnswerEExp=[[C-myc]] is associated with [[Burkitt's lymphoma]]. | ||
|EducationalObjectives=[[C-kit]], also called [[CD 117]], is often associated with [[gastrointestinal stromal tumor]]s (GIST). | |||
|References=First Aid 2014 page 232 | |||
|RightAnswer=A | |RightAnswer=A | ||
|WBRKeyword=Cancer, GIST, Gastrointestinal stromal tumor, Imatinib, Tyrosine kinase inhibitor, Chemotherapy, | |||
|Approved=Yes | |Approved=Yes | ||
}} | }} | ||
Revision as of 02:42, 11 September 2014
| Author | [[PageAuthor::Rim Halaby, M.D. [1], Alison Leibowitz [2] (Reviewed by Alison Leibowitz)]] |
|---|---|
| Exam Type | ExamType::USMLE Step 1 |
| Main Category | MainCategory::Pathology |
| Sub Category | SubCategory::Gastrointestinal |
| Prompt | [[Prompt::A 62-year-old male presents to the physician's office with complaints of abdominal pain, which has been worsening over the past four months. The dull pain is localized in the epigastric area and persistently increasing in intensity, independently from food intake or change in posture. Upon further questioning, he describes symptoms of increasing fatigue and weight loss. A CT scan displays a mass in the stomach and an endoscopy-guided biopsy of the mass reveals clusters of thin, elongated spindle cells. Which of the following immunohistochemistry findings is most helpful in diagnosing the type of tumor in this patient?]] |
| Answer A | AnswerA::C-kit |
| Answer A Explanation | [[AnswerAExp::C-kit oncogene is associated with GIST. C-kit gene encodes the human homolog of the proto-oncogene c-kit, also called CD117.]] |
| Answer B | AnswerB::Ret |
| Answer B Explanation | [[AnswerBExp::The Ret oncogene is often associated with MEN syndrome, type IIa and IIb.]] |
| Answer C | AnswerC::Abl |
| Answer C Explanation | [[AnswerCExp::The Abl oncogene is often associated with CML.]] |
| Answer D | AnswerD::Ras |
| Answer D Explanation | [[AnswerDExp::The Ras oncogene is often associated with colon carcinoma.]] |
| Answer E | AnswerE::C-myc |
| Answer E Explanation | [[AnswerEExp::C-myc is associated with Burkitt's lymphoma.]] |
| Right Answer | RightAnswer::A |
| Explanation | [[Explanation::The patient's symptoms of epigastric pain, fatigue, and weight loss, in conjunction with the CT finding of a mass in the stomach, points towards the diagnosis of malignancy. The spindle cells on pathology are often diagnostic for a gastrointestinal stromal tumor (GIST), which can be confirmed by positive immunohistochemistry for C-kit. Educational Objective: C-kit, also called CD 117, is often associated with gastrointestinal stromal tumors (GIST). |
| Approved | Approved::Yes |
| Keyword | WBRKeyword::Cancer, WBRKeyword::GIST, WBRKeyword::Gastrointestinal stromal tumor, WBRKeyword::Imatinib, WBRKeyword::Tyrosine kinase inhibitor, WBRKeyword::Chemotherapy |
| Linked Question | Linked:: |
| Order in Linked Questions | LinkedOrder:: |