Neoplasia: dysplasia and carcinoma in situ: practice question

A Pathology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

Try it

Pathology · Neoplasia: dysplasia and carcinoma in situ

Sample item

A cervical biopsy from a 34-year-old woman shows squamous epithelium in which atypical cells with high nuclear-to-cytoplasmic ratio and mitoses replace the full thickness of the epithelium. The basement membrane is intact throughout. What is the best description?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Carcinoma in situ (CIN 3)

Carcinoma in situ is full-thickness epithelial dysplasia without breach of the basement membrane. It cannot metastasise because it has not reached lymphatics or vessels, but it is a direct precursor of invasive carcinoma if untreated.

Option by option

  • A. Reactive squamous metaplasia

    Squamous metaplasia is an orderly replacement of columnar by squamous cells without marked nuclear atypia.

  • B. Carcinoma in situ (CIN 3) (correct)

    Full-thickness atypia with an intact basement membrane defines carcinoma in situ.

  • C. Microinvasive squamous carcinoma

    Microinvasion requires tumour cells breaking through the basement membrane into the stroma, which is absent here.

  • D. Mild dysplasia (CIN 1)

    Mild dysplasia confines atypia to the lower third of the epithelium rather than the full thickness.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More Pathology questions

Questions about this Pathology question

What is the answer to this Pathology question?

The best answer is B, Carcinoma in situ (CIN 3). Carcinoma in situ is full-thickness epithelial dysplasia without breach of the basement membrane.

Why is "Reactive squamous metaplasia" not the answer?

Squamous metaplasia is an orderly replacement of columnar by squamous cells without marked nuclear atypia.

Why is "Microinvasive squamous carcinoma" not the answer?

Microinvasion requires tumour cells breaking through the basement membrane into the stroma, which is absent here.

Why is "Mild dysplasia (CIN 1)" not the answer?

Mild dysplasia confines atypia to the lower third of the epithelium rather than the full thickness.

What concept does this question test?

It tests Neoplasia: dysplasia and carcinoma in situ in Pathology. It cannot metastasise because it has not reached lymphatics or vessels, but it is a direct precursor of invasive carcinoma if untreated.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Neoplasia: dysplasia and carcinoma in situ?

Learn each disease as a bundle: cause, key histology, markers, and the clinical hallmark. Then use the flashcards and the other Pathology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.