Question

1. A 39 years old male developed a testicular mass which was removed and was sent for
pathological examination, along with additional studies. Which of the following is the
most compelling evidence that the lesion is malignant:
a. Cells of the mass infiltrate a narrow band of the tuinea albuginea.
b. Two mitosis are found in every (HPF) high power field of microscope.
c. Nuclei are viable in size and tend to stain.
d. X-ray shows 2 round nodules in the left lung field and one in the right, were not
present 2 years ago.
e. The patient is found to be infertile.
2. Which of the following pair does not correctly match the tumor with its causative
agent:
a. Anogenital carcinoma : HPV (Type 16 & 18).
b. Burkitts lymphoma : EBV.
c. Hepatocellular carcinoma : Hepatitis A virus.
d. Carcinoma of stomach : Helicobacter pylori.
e. Squamous cell carcinoma skin : Ultraviolet radiation.

Answer 1

1 a) Cells of the mass infiltrate a narrow band of the tunica albuginea.

Tunica albuginea cysts are the most common extratesticular benign masses, and most of the times are discovered incidentally by the patient. Patients usually present with a firm pinhead - sized palpable mass and rarely present with pain and swelling. The tunica albuginea (TA) forms the fibrous covering of the testis and is itself covered by the serous layer, the tunica vaginalis.

2 c) Hepatocellular carcinoma : Hepatitis A virus.

Hepatocellular carcinoma (HCC) is the most common type of primary liver cancer. Hepatocellular carcinoma occurs most often in people with chronic liver diseases, such as cirrhosis caused by Hepatitis B or Hepatitis C infection.