A Review of Articles From Last Month's Archives of Pathology & Laboratory Medicine

Archives of Pathology & Laboratory Medicine,  May 2008  

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Listed below are questions based on articles that appeared in last month's edition of the ARCHIVES. Registered continuing medical education participants should answer these questions either online or use the May 2008 answer sheet.

1. When discussing the examination of the bone marrow, which of the following statements is false?

a. an increase in blasts in the context of morphologic dysplasia and prolonged anemia in the absence of growth factor therapy is a very strong indicator of myelodysplastic syndrome

b. distinction between idiopathic thrombocytopenic purpura and other causes of platelet consumption cannot be made on the basis of the bone marrow findings alone

c. a V617F mutation in the JAK2 gene is present in almost all cases of polycythemia vera and in about 50% of cases of essential thrombocythemia and chronic idiopathic myelofibrosis

d. pancytopenic presentation due to primary bone marrow non-Hodgkin or Hodgkin lymphoma is uncommon in the setting of human immunodeficiency virus infection

e. bone marrow examination is becoming less important in distinguishing chronic myeloid leukemia from reactive leukocytosis and other myeloproliferative diseases due to cytogenetic and/or molecular testing of peripheral blood

(from Reactive Versus Neoplastic Bone Marrow-Hasserjian)

2. Histologically, the storiform arrangement of the fibroblasts in nodular fasciitis (NF) is not seen in atypical decubital fibroplasia (ADF), and the dilated capillaries typical of ADF are not a feature of NF. True or False?

(from Pseudosarcomas of Soft Tissue-Rosenberg)

3. For the histologic and cytologic evaluation of thyroid gland nodules, which of the following statements is false?

a. the most important cytologic criterion in distinguishing benign from suspicious thyroid lesions is the cytoarchitecture

b. frozen section is a highly effective method for diagnosing minimally invasive follicular carcinomas or Hu? rthle cell carcinomas

c. fine-needle aspiration is considered the most accurate and cost-effective method for evaluating thyroid nodules

d. microscopic distinction between follicular adenomas and nonneoplastic hyperplastic nodules is not reliable

e. minimum criteria to distinguish a follicular adenoma from an encapsulated variant of papillary thyroid carcinoma are not well defined

(from The Thyroid Gland-Faquin)

4. Although placental infarcts are common, infarcts that make up more than 10% of the placental mass are considered pathologic and may impact the fetal oxygen/nutrient state. True or False?

(from Placental Pathology, a Survival Guide-Roberts)

5. Which of the following statements concerning lymphomas arising in extranodal sites is true?

a. lymphomas that arise in paranasal sinuses are almost always diffuse large B-cell type, whereas most lymphomas arising in the nasal cavity are extranodal natural killer/T-cell lymphomas

b. about 50% of all marginal zone lymphomas have a t(11;18)(q21;q21) translocation; this translocation has not been seen in gastric marginal zone B-cell lymphomas

c. for both primary cutaneous follicle center lymphoma and testicular follicular lymphoma, spread beyond the primary site is common, and patients with these lymphomas have a poor prognosis

d. primary effusion lymphoma affects females much more than males, and patients with this lymphoma have a generally good prognosis

e. patients with enteropathy-type T-cell lymphoma frequently have a palpable mass on physical examination, and peripheral lymphadenopathy is common

(from Extranodal Lymphoma-Ferry)

6. Gastric hyperplastic polyps, which frequently demonstrate malignant transformation, can easily be confused with Me?ne?trier disease due to their similar size. True or False?

(from Gastric Polyps-Park & Lauwers)

Copyright College of American Pathologists May 2008
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