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NBME Free 120 Answers

free120/Block 1/Question#23 (reveal difficulty score)
A 4-year-old boy from Brazil is brought to ...
Apoptosis ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–

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 +6  upvote downvote
submitted by โˆ—bwdc(697)

Endemic Burkitt lymphoma can happen in Brazil as well as Africa (jaw lesion, puffy face). The photomicrograph is demonstrating tingible body macrophages, a type of macrophage containing many phagocytized, apoptotic cells in various states of degradation.

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weenathon  For anyone else who was wondering why a cancer was undergoing apoptosis (classically we think of cancer EVADING apoptosis), apparently it's due to the myc mutation classic in Burkitt Lymphoma. While myc causes the cell to proliferate, it also induces apoptosis - hence the tingible bodies containing apoptotic cells. ( +4
itsalwayslupus  Also just for people who watch boards and beyond or pathoma (I don't remember which exactly it is from), the "stars" in the "starry night" appearance of Burkitt's (what is being shown here) are lighter because the the cells are dying/gone via apoptosis (supposed to be the "holes" in the "night sky" lol). +6
jbrito718  composed of intermediate-sized lymphoid cells with a โ€œstarry skyโ€ appearance due to numerous reactive tingible-body macrophages (phagocytosis of apoptotic tumor cells). There is a characteristic t(8;14) translocation juxtaposing MYC to the immunoglobulin heavy chain locus in most cases. +1

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submitted by โˆ—nwinkelmann(366)

In case anyone is curious about the other terms: I think apoptosis and necroptosis are fairly recognizable, but I had no clue what symptosis, ostosis, and oncosis were. Symptosis = ischemic cell death. Ostosis = bone formation (duh! why didn't I remember that, lol). Oncosis = emaciation.

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amc  correction Oncosis= ischemic cell death Symptosis= emaciation +3
srmtn  oncosis (derived from รณnkos, meaning swelling) was proposed in 1910 by von Reckling-hausen precisely to mean cell death with swelling ostosis: formation of bone symptosis: a gradual wasting away of the body or of any organ or part of the body. +1

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submitted by โˆ—yousif7000(12)

I honestly figured this out by noticing how the spaces are all confined and in well-demarcated borders which are features of apoptosis

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submitted by โˆ—freemanpeng(7)

But i was thinking TUMOR NECROSIS (factor, TNF).And fact that rapid growing tumor alwasy get necrosis due to deficient blood supply(eg. GBM). And Burkitt is definitely rapid growing(High ki-67) Please correct me thx

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