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NBME 21 Answers

nbme21/Block 1/Question#23

A 59-year-old man comes to the physician because of ...

Foci of keratinization

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 +3  upvote downvote
submitted by hyoscyamine(19),

FA pg.372. Squamous cell carcinoma occurs in the upper 2/3 of esophagus whereas adenocarcinoma occurs in the distal 1/3. Since this was in the mid esophagus, its squamous cell carcinoma. Key feature of squamous cell carcinoma is keratin pearls.





 +1  upvote downvote
submitted by thechurchofbobbyhill(1),

Hi- I don't have an explanation for this but I am also curious as to why this was the answer.

drdoom  via @hyoscyamine: FA pg.372. Squamous cell carcinoma occurs in the upper 2/3 of esophagus whereas adenocarcinoma occurs in the distal 1/3. Since this was in the mid esophagus, its squamous cell carcinoma. Key feature of squamous cell carcinoma is keratin pearls. +2  
hyperfukus  idk why my dumbass didn't put foci of keratinization and pearls together lmao +  




 +1  upvote downvote
submitted by meningitis(120),

Squamous and Small cell carcinomas are Sentral (central) and often caused by Smoking

Hilar mass C arising from bronchus; Cavitation; Cigarettes; hyperCalcemia (produces PTHrP). Keratin pearls D and intercellular bridges.

pg 669 2019 FA





 +0  upvote downvote
submitted by est88(11),

I believe its Squamous cell carcinoma. Its centrally located, smoker, and its a hilar mass. Keratin pearls.

cry2mucheveryday  it is a case of esophageal carinoma not lung carcinoma. +2