A 50 year old male presents with widespread lymphadenopathy. He has had recent fever and weight loss. A trucut biopsy reveals a malignant tumor with the following phenotype; Cytokeratin negative, CLA positive, CD3 positive, and CD30 positive

Related MCQs

• A 40 year old female presents with mediastinal hilar lymphadenopathy and she has recently noticed slight weight loss and a cough. Staging shows no other evidence of disease. A trucut biopsy reveals a lymphoma showing large cells with mirror image nuclei, lymphocytes, plasma cells and eosinophils. The following phenotype is seen; CD20 positive, CD3 negative, CLA positive, and CD15 positive
• A 29-year-old man was diagnosed with stage II (that is, spread from the primary tumor to retroperitoneal lymph nodes) nonseminomatous germ cell tumor 1 year ago. Treatment included orchiectomy and retroperitoneal lymph node dissection. He now presents with an elevated level of β-human chorionic gonadotropin hormone and multiple pulmonary lesions ranging in size from 0.61 to 3.22 cm. Needle biopsy specimen of the largest lesion reveals a germ cell tumor consistent with the initial diagnosis. He is asymptomatic. What is the best treatment for this patient?
• A 52-year-old woman who is a nonsmoker has a 3-cm right inguinal lymph node.Biopsy specimen shows a poorly differentiated malignancy that is difficult to characterize by light microscopy. The biopsy specimen is negative for leukocyte common antigen, cytokeratin, and estrogen receptors. Which of the following additional tests would best establish the source of this tumor?
• A male patient presented with increasing weight loss and abdominal pain. He had a past history of Coeliac Disease, which up until now was asymptomatic on a gluten free diet. CT of the abdomen revealed a thickened loop of small bowel with a stricture and associated lymphadenopathy. A trucut of the nodes revealed a malignant neoplasm, Diagnosis is:
• 26- A 60-year-old man was diagnosed last year with adenocarcinoma of the lung, and a 4 cm mass lesion was treated with a right lower lobectomy. He now has an abdominal CT scan that reveals scattered hepatic mass lesions and hilar lymphadenopathy. For several weeks, he has had increasing malaise. A urinalysis reveals marked proteinuria, and a 24 hour urine protein collection is 2.7 g/24hr. His serum urea is 30 mmol/L (2.5 - 7.5) with creatinine of 450 µmol/L (60 - 110). A renal biopsy is performed, and there is focal deposition of IgG and C3 with a granular pattern. He is most likely to have which of the following conditions?
• A 55 year old male presents with a history of chronic dyspepsia and with recent weight loss. Investigation by gastroscopy reveals a reduction in specialised gastric glands and the presence of slender giemsa staining filaments on the mucosal surface. In addition a gastric mass is seen. This is composed of large B lymphocytes which are negative for cyclin D1 and BCL2. Monoclonality is identified.
• A 63-year-old man is evaluated because of a several-month history of increasing fatigue and some vague upper abdominal discomfort. His medical history includes gastroesophageal reflux disease, coronary artery disease, and clinical depression, all of which are well controlled with medications. The patient has been working full time. On physical examination, he has mild hepatomegaly. His hemoglobin is 12.2 g/dL, serum alkaline phosphatase level 280 U/L, and serum aspartate aminotransferase level 65 U/L. CT scan of the abdomen and pelvis shows multiple hepatic lesions ranging in size from 1 cm to 4 cm; mesenteric, para-aortic, and paracaval lymphadenopathy, and a colonic mass at the splenic flexure. Colonoscopy reveals a nonobstructing, non bleeding lesion; biopsy shows it to be poorly differentiated adenocarcinoma. Fine- needle aspiration of one of the liver lesions confirms the presence of malignant cells consistent with a primary colon cancer. What is the most appropriate next step in
• A 50-year-old menstruating woman has a 1 .5-cm moderately differentiated breast cancer. The lesion is completely excised, and the margins of the excision are negative. Axillary node sampling shows that she has three positive nodes. The tumor is negative for estrogen and progesterone receptors and is highly positive for HER2. She is otherwise healthy. Her mother had breast cancer at 62 years and was treated by mastectomy; she is alive and healthy at the age of 80 years. The patients sister had breast cancer at 54 years and was treated by breast conservation therapy; 4 years later she died of a recurrence of breast cancer. The patient has seen two different surgeons with opposing viewpoints regarding the best treatment, and she has been reading extensively on the Internet and has become confused about her options. Which of the following represents the best treatment for this patient?
• A 45-year-old woman is evaluated because of a palpable 2-cm right axillary lymph node. The lymph node is completely resected, and histologic study shows adenocarcinoma; hormone receptors are negative. Bilateral mammography is negative, as is MRI of the right breast. CT scans of the chest and abdomen are negative for tumor, and no further lymphadenopathy is detected. Results of bone scan and MRI of the head are also unremarkable. The patient had been previously healthy and has never smoked. Which of the following statements about this patients condition is correct?
• A 68-year-old man presents to his primary care physician for a routine physical examination. The patient‟s medical history is significant for hypertension. The patient is found to have guaiac-positive stools and is subsequently referred for colonoscopy. Colonoscopy reveals a “golf ball”-size, near-obstructing tumor in the descending colon, not admitting the scope. The biopsy is positive for adenocarcinoma of the colon. Which of the following is the next step in the management of this patient?