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NBME 24 Answers

nbme24/Block 4/Question#34 (49.2 difficulty score)
A 55-year-old woman comes to the physician ...
Neuroendocrine cell🔍
tags:

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 +15 
submitted by neonem(556),
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icSen tsih patiten is a nrn,k-oesom it si ssel to eb asllm clle iarcmcan,o smauoqus lcle moa,nriacc ro aglre llec ccironaam fo hte .nlgu sBseeid allsm clle iaanrocmc beign fomr eeinrrdoeocnun ir,ngoi het oen rjamo unlg eacnrc eedsrcibd by stesn of aiee-,rdedtlfinwlfte au"egrlr" escll is a irioadcnc tomur. itylan,idAold eetstosr era lhooatgilcsi eafruets fo dnicriaco rmtsuo (nuf ac:ft eeossttr sola in aas/oosndtbsepolneemyamurm (in )CS,N mo,rnsebaasitotl agnaoruls lelc tsroum oin(arva r)cc)ane

mousie  When ever I hear Rosettes I always think NE tumors .... and I agree non smoking kind of RO small cell, squamous cell, or lg cell +4  
charcot_bouchard  I thought it was Hamartoma & pick chondrocyte! Can lung even have hamartoma? Pardon me it was the laast ques of whole nbme +7  
drmomo  @charcot_bouchard i thought the same. uworld gave a question on coin lesion in the lungs as classically hamartoma +7  
anbumd  From pathoma benign coin lesions such as bronchial hamartomas composed of lung tissue and cartilage are especially found in younger patients. So i guess because of the age and histology this would be less likely. +  



 +9 
submitted by susyars(29),

Is it me or this question is worded weird?

“this cells are most likely to closely resemble which of the following types of normal respiratory tract cells“

Like, you dont have normally neuroendocrine cells in the lung

Maybe i miss understood this question, i knew exactly what they were talking about, but the way they set the last sentence really drives me LOCA

brbwhat  I SCRATCHED OUT NEUROENDOCRINE FOR THE SAME REASON! +2  
brbwhat  I SCRATCHED OUT NEUROENDOCRINE FOR THE SAME REASON! +  
abhishek021196  They are talking about Kulchitsky cells = pulmonary neuroendocrine cells (PNEC). These are the cells from which NE tumors of the lung i.e. small cell ca arise from. +9  



 +3 
submitted by usmleuser007(377),
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emoS etorh neenirdco ilek selcl dan derrosdsi ofr :eeeerfcnr

  1. t--napaeeppSrld miarotnhc f(ien nalgrura pso)cytaml ni nenrodicE omrt:us

  2. rauldyelM ohidytr cnarmicao

  3. unncnorreieode ndyoroeomshuma otcm chapotr
  4. ndiciarCo romTu nne(r)toosi --- os(al hsa setesh of rimfnuo cle)ls
  5. mlalS llCe ciormCana of sglnu = ,lamSl eulb  cilehlwst atcns mtycloaps nad ngaulrar rmtco=i) ahn ,alft h-voeaadpsl til hewscl tcsan atpycsmol and cmryahhecotirp eucnil

  6. lamSl ueBl eClls

  7. gwnEi aarcsmo nlatc(spiaa ltnigaanm m)ortu
  8. SCC of ugsnl
  9. f,lat elads-hvpoa cls lwhite tcsan pamtocyls dan moachheitpyrrc ulniec
happysingh  i've never heard of " 6. Small Blue Cells" cancer / tumor / carcinoma .... +1  
niboonsh  might want to look at fa pg 665 +  



 +1 
submitted by yex(94),
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I ithnk yteh aer negirerfr ot utcsklhKiy lecls = yalrunmop nouineodecrern lcels )NC(.PE igAodrcnc ot iWpiei:akd adzieiepcSl rwaiya laetielpih llsec ahtt curoc as lyirtaso elcls or sa elscstru claedl iuaeroepihelntl sodbie BE(N) in hte g.nul yTeh are cdetoal ni eth salna ertarrspoiy ehtieipuml, anrlyglea uacsom nad othuturgoh teh rnteei oarisretyrp trtca ofrm eth actrhea ot het rtleinma yw.aaisr yThe cna be hte ucsore fo elvasre eytsp fo glnu reacnc- otms olntab,y salml lelc ncoraimac of the lnu,g nad lharicobn iroiadcnc urotm.




 +0 
submitted by sgary(0),

According to Pathoma, this is most likely carcinoid tumor, not small cell tumor w/ Kulchitsky cells as mentioned above. Carcinoid presents as well-differentiated, low mitoses, nest-like trabeculae, and secretory granules. Also explains her absence of smoking but presence of cancer.

I answered Goblet cells b/c I thought it was adenocarcinoma b/c non-smoker, female, and normal respiratory epithelium. Neuroendocrine cells aren't normal but what can you do?