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NBME 24 Answers

nbme24/Block 4/Question#34

A 55-year-old woman comes to the physician for a ...

Neuroendocrine cell

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 +5  upvote downvote
submitted by neonem(227),

Since this patient is a non-smoker, it is less to be small cell carcinoma, squamous cell carcinoma, or large cell carcinoma of the lung. Besides small cell carcinoma being from neuroendocrine origin, the one major lung cancer described by nests of well-differentiated, "regular" cells is a carcinoid tumor. Additionally, rosettes are histological features of carcinoid tumors (fun fact: rosettes also in neuroblastomas/ependymomas (in CNS), retinoblastomas, granulosa cell tumors (ovarian cancer))

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 +2  
charcot_bouchard  I thought it was Hamartoma & pick chondrocyte! Can lung even have hamartoma? Pardon me it was the laast ques of whole nbme +  

 +2  upvote downvote
submitted by usmleuser007(84),

Some other endocrine like cells and disorders for reference:

  1. Salt-and-pepper chromatin (fine granular cytoplasm) in Endocrine tumors:

  2. Medullary thyroid carcinoma

  3. neuroendocrine tumors and pheochromocytoma
  4. Carcinoid Tumor (serotonin) --- (also has sheets of uniform cells)
  5. Small Cell Carcinoma of lungs = Small, blue cells with scant cytoplasm and granular chromatin) = flat, oval-shaped cells with scant cytoplasm and hyperchromatic nuclei

  6. Small Blue Cells

  7. Ewing sarcoma (anaplastic malignant tumor)
  8. SCC of lungs
  9. flat, oval-shaped cells with scant cytoplasm and hyperchromatic nuclei