keepgoing
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A 3-year-old child is referred to a major medical center because of an abdominal mass arising from his right adrenal gland. Biopsy of the lesion demonstrates sheets of small cells with hyperchromatic nuclei containing occasional pseudorosettes composed of circles of tumor cells
with central young nerve fibers arising from the tumor cells. Which of the following oncogenes
is associated with this patient's tumor?
A. erb-B2
B. c-myc
C. L-myc
D. N-myc
E. ret
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| doc179
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D
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| jean robert
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D
Explanation from emedicine
"Neuroblastoma is the most common extracranial solid tumor and the most common tumor occurring during infancy. It is an embryonal malignancy of the sympathetic nervous system arising from neuroblasts (pluripotent sympathetic cells). In the developing embryo, these cells invaginate, migrate along the neuraxis, and populate the sympathetic ganglia, adrenal medulla, and other sites.
MYCN is an overexpressed oncogene in neuroblastoma with the amplification of the distal arm of chromosome 2...
The undifferentiated neuroblastomas histologically present as small, round, blue cell tumors with dense nests of cells in a fibrovascular matrix and Homer-Wright pseudorosettes. These pseudorosettes, which are observed in 15-50% of tumor samples, can be described as neuroblasts surrounding eosinophilic neuritic processes. The typical tumor shows small uniform cells with scant cytoplasm and hyperchromatic nuclei. A neuritic process, also called neuropil, is a pathognomonic feature of neuroblastoma cells...
Signs and symptoms of disease vary with site of presentation. Generally, symptoms include abdominal pain, emesis, weight loss, anorexia, fatigue, bone pain, and chronic diarrhea. Hypertension is an uncommon sign of the disease and generally is caused by renal artery compression, not catecholamine excess..."
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| Medusin
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Agree D.
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| Luckyall
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D 
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| new_n_lost
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Yup the Classical Histological Picture n the Pt Age Say all abt A Neuroblastoma HEnce D
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| lq2006
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D
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| keepgoing
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Bravo!!!!!
The correct answer is D. The tumor is a neuroblastoma, which is one of the principal forms of
cancer in children. Neuroblastoma typically occurs before age 5, with many presenting before
age 2. Neuroblastoma can arise from neural crest cells throughout the body, but the adrenal
medulla is the most common site. Homer-Wright pseudorosettes are circles of tumor cells with
central young nerve fibers arising from the tumor cells. The oncogene associated with
neuroblastoma is N-myc.
erb-B2 (choice A) is associated with breast, ovarian, and gastric carcinomas.
c-myc(choice B) is associated with Burkitt's lymphoma.
L-myc(choice C) is associated with small cell carcinoma of the lung.
ret (choice E) is associated with multiple endocrine neoplasia, types II and III.
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