Listed below are questions based on articles that appeared in last month's edition of the Archives. Registered continuing medical education participants should answer these questions either online or use the November 2007 answer sheet.

  • 1. Among the results of a study that sought to identify potential discrepancies between frozen section diagnosis and the final diagnosis, which of the following statements is false?

    • a. a total of 57 discrepant diagnoses were identified

    • b. the discrepancies significantly impacted patient management in 5% of the cases

    • c. twelve discrepancies involved errors in classification of spindle cell lesions of the central nervous system

    • d. four discrepancies involved errors in the overgrading of tumors

    • e. nine discrepancies involved errors in the diagnosis of central nervous system lymphoma

      (from Frozen Section Discrepancy in the Evaluation of Central Nervous System Tumors—Plesec & Prayson)

  • 2. A recent study that determined the immunohistochemical profiles of primary adenocarcinomas found that none of the pulmonary, ovarian, breast, and pancreatic cases studied were positive for CDX2.

    True or False?

    (from Panels of Immunohistochemical Markers Help Determine Primary Sites of Metastatic Adenocarcinoma—Park et al)

  • 3. A survey to determine whether business and informatics skills were important to pathology practices found which of the following statements to be true?

    • a. 65% of the respondents considered all of the skills listed in the survey (shown in Table 1) as important, very important, or essential

    • b. 25% of respondents agreed that residency training in leadership and management is adequate

    • c. 66% said they would be willing to pay something more for a pathologist with a track record of financial savings in the clinical laboratory

    • d. 15% said that effective public presentation was either not important or slightly important

    • e. when asked to identify the new skills for new pathologists valued by pathology practices, 22% responded informatics and technology

      (from Critical Leadership and Management Skills for Pathology Practice—Brimhall et al)

  • 4. CD34 is expressed by essentially all benign vascular tumors and by more than 90% of hemangioendotheliomas and angiosarcomas.

    True or False?

    (from Best Practices in Diagnostic Immunohistochemistry—Folpe & Cooper)

  • 5. Which of the following statements concerning PTEN is false?

    • a. studies have associated loss of PTEN genetic dosage with a significantly worse survival in adult and childhood high-grade astrocytoma patients

    • b. PTEN is one of the most commonly altered tumor suppressor genes in solid cancers

    • c. unrestricted PIP3 generation caused by loss of PTEN results in unopposed activation of protein kinase B

    • d. the prognostic effect of PTEN loss in a tumor is increased when the loss of PTEN is found in a patient whose tumor does not exhibit an abnormality in the RB1 pathway

    • e. among brain tumors, mutations and allelic deletions affecting PTEN have been linked to progression of astrocytoma to glioblastoma

      (from Second Messenger Systems in Human Gliomas—McLendon et al)

  • 6. When morphologic features of 41 fibroepithelial tumors of the breast were examined, heterologous elements such as osteosarcomatous differentiation were present in 4 cases, all of which were classified as high-grade malignant phyllodes.

    True or False?

    (from Quantification of the Morphologic Features of Fibroepithelial Tumors of the Breast—McKenna et al)