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Question 1
A 58-year-old man with a 15-year history of gastroesophageal reflux disease undergoes surveillance endoscopy for Barrett esophagus. Biopsies of salmon-colored columnar-lined mucosa show crowded glandular architecture, loss of nuclear polarity, marked nuclear pleomorphism with hyperchromasia extending to the mucosal surface, atypical mitotic figures near the luminal surface, and complete absence of surface maturation. Immunohistochemistry for p53 demonstrates strong, diffuse, unequivocal nuclear overexpression in 100% of the atypical epithelial cells. What is the most accurate pathological diagnosis according to current WHO classification criteria?
Correct Answer:
Barrett esophagus with high-grade dysplasia (HGD).
Question 2
An endoscopic mucosal resection (EMR) specimen from the distal esophagus reveals a 1.2 cm ulcerated lesion. Histology demonstrates sheets of malignant polygonal cells with abundant dense eosinophilic cytoplasm, prominent intercellular bridges, and focal keratin pearl formation infiltrating the lamina propria. Immunohistochemistry confirms diffuse strong positivity for p40 and cytokeratin 5/6, while CK7 and CDX2 are completely negative. How should this entity be diagnosed and distinguished from conventional distal esophageal adenocarcinoma?
Correct Answer:
Esophageal squamous cell carcinoma (SCC); distinguished by p40/CK5/6 positivity and keratinization.
Question 3
A total gastrectomy specimen from a 42-year-old woman with a family history of gastric cancer shows diffuse thickening and linitis plastica of the gastric corpus. Microscopic examination reveals non-cohesive, round-to-oval neoplastic cells diffusely infiltrating the muscularis propria as single cells and small loose clusters, with prominent intracytoplasmic mucin vacuoles displacing the nuclei peripherally (signet-ring cell morphology). Glandular/tubular formations are entirely absent. According to the Lauren classification and molecular pathology, which diagnosis and genetic alteration are most characteristic?
Correct Answer:
Diffuse-type gastric adenocarcinoma; associated with germline or somatic CDH1 (E-cadherin) alterations.
Question 4
A diagnostic biopsy of an advanced gastric adenocarcinoma is submitted for predictive biomarker assessment to determine eligibility for targeted trastuzumab therapy. Immunohistochemistry for HER2 (clone 4B5) is performed. Which of the following staining patterns on a biopsy specimen meets the standard diagnostic criteria for HER2-positive (IHC 3+) status in gastric cancer?
Correct Answer:
Strong complete, basolateral, or lateral membranous staining in a cluster of at least 5 contiguous tumor cells, regardless of the overall percentage.
Question 5
Gastric biopsies from a 55-year-old woman with severe vitamin B12 deficiency show complete loss of specialized parietal and chief cells with extensive pseudopyloric and intestinal metaplasia strictly limited to the oxyntic mucosa of the body and fundus. The antral mucosa demonstrates preserved architectural structure with no active inflammation and an increased gastrin-positive G-cell population. Chromogranin A immunohistochemistry reveals linear and micronodular hyperplasia of enterochromaffin-like (ECL) cells in the corpus. What is the diagnosis and the underlying mechanism responsible for the ECL hyperplasia?
Correct Answer:
Autoimmune atrophic gastritis (AAG); hypergastrinemia driven by achlorhydria causes trophic ECL cell stimulation.
Question 1
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Prepare with the Facharzt FMH Pathologie Practice Questions - Facharzt FMH für Pathologie Spécialiste FMH en pathologie Exam practice quiz. This question bank includes 100 questions covering cells, year-old, reveals, nuclear, and diagnosis. Use it to review important concepts, identify knowledge gaps, and build confidence for the related exam, course, or assessment.

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Facharzt FMH Pathologie Practice Questions - Facharzt FMH für Pathologie Spécialiste FMH en pathologie Exam

This practice set contains 100 questions from the matching question bank and focuses on cells, year-old, reveals, nuclear, and diagnosis. Work through each question carefully, review the provided solutions, and revisit topics that need more study before your next attempt.

This is an independent study resource intended for practice and review; it is not an official examination or an endorsement by any organization named in the title.

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