MCQ Book Questions

Q60962. A 45-year-old woman complains of gradual swelling in her neck of 6 months in duration. Physical examination reveals an enlarged and nodular thyroid gland. A fi ne-needle aspira- tion of a nodule in the left lobe of the thyroid is performed. Cytologic examination of the aspirate shows follicular cells, macrophages, and abundant colloid. What is the appropriate diagnosis?

Q60963. An 85-year-old woman presents with increasing fatigue and weight loss over the past 3 months. A CT scan of the abdo- men reveals a 4-cm retroperitoneal mass. Fine-needle aspira- tion reveals numerous, large, noncleaved dissociated cells. By fl ow cytometry, the cells are positive for CD10, CD19, CD20, IgM, and lambda light chain. Which of the following is the appropriate diagnosis?

Q60964. A 59-year-old man presents with a 3-week history of painless hematuria. Physical examination is unremarkable. Urinalysis shows 2+ hematuria. A CT scan of the abdomen reveals an exophytic mass in the renal pelvis. Cytologic examination of a fi ne-needle aspiration of the renal pelvis is shown in the image. These cells show which of the following patterns of arrangement?

Q60965. A 2-month-old girl is brought to the physician because her parents noticed an enlargement in her abdomen. Physical examination reveals a fl ank mass over the left kidney. Twenty- four–hour urinalysis shows elevated levels of metanephrines. A CT scan of the abdomen reveals an 8-cm suprarenal mass. Fine-needle aspiration of the mass is performed. Cytologic examination of the aspirate would most likely show neoplastic cells with which of the following patterns of arrangement?

Q60966. A 54-year-old man presents with a 4-month history of progressive weight loss. He has smoked three packs of ciga- rettes a day for 30 years. An X-ray fi lm of the chest shows a mass in the right upper lobe. The bronchial brush specimen is shown in the image. Special stains are positive for mucin. Which of the following is the most likely diagnosis?

Q60967. A 55-year-old woman presents with a 4-month history of increasing abdominal girth and pelvic discomfort. Physical examination reveals ascites, and pelvic examination demon- strates an adnexal mass. A blood test for CA-125 is positive. A tap of the ascites returns numerous epithelial cells with pap- illary fronds. A small cluster of cells is shown in the image. Which of the following is the most likely diagnosis?

Q60968. A 35-year-old woman presents after noticing a gradual enlarge- ment of her neck over the past 6 months. Physical examination reveals a diffusely enlarged thyroid gland. Cytologic examina- tion of a fi ne-needle aspirate of the thyroid shows follicular cells and abundant lymphoid cells. Which of the following is the appropriate diagnosis?

Q60969. A 67-year-old man presents with chest wall pain and chronic nonproductive cough. A chest X-ray reveals a pleural-based mass and a large pleural effusion. A sputum sample is shown in the image. Fluid obtained from the left pleural cavity shows numerous single and clustered neoplastic cells. Which of the following is the most likely diagnosis?