Neoplasia: neuroblastoma: 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.

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Pathology · Neoplasia: neuroblastoma

Sample item

A 2-year-old child has an abdominal mass crossing the midline, periorbital ecchymoses and opsoclonus-myoclonus. Urinary VMA and HVA are raised. Which finding indicates an adverse prognosis?

AMYCN gene amplificationBAge under 18 months at diagnosisCHigh TrkA expressionDHyperdiploid tumour DNA content

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

The answer and the reasoning

A. MYCN gene amplification

Neuroblastoma arises from sympathetic neuroblasts of the adrenal medulla or sympathetic chain and secretes catecholamines. MYCN amplification is the key adverse genetic marker, correlating with advanced disease and poor survival. Young age, TrkA expression, hyperdiploidy and spontaneous regression are favourable features.

Option by option

A. MYCN gene amplification (correct)
Correct. MYCN amplification signals aggressive disease.
B. Age under 18 months at diagnosis
Age under 18 months is associated with better survival.
C. High TrkA expression
High TrkA expression is associated with a favourable outcome and differentiation.
D. Hyperdiploid tumour DNA content
Hyperdiploidy is a favourable feature, especially in infants.

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.

Questions about this Pathology question

What is the answer to this Pathology question?

The best answer is A, MYCN gene amplification. Neuroblastoma arises from sympathetic neuroblasts of the adrenal medulla or sympathetic chain and secretes catecholamines.

Why is "Age under 18 months at diagnosis" not the answer?

Age under 18 months is associated with better survival.

Why is "High TrkA expression" not the answer?

High TrkA expression is associated with a favourable outcome and differentiation.

Why is "Hyperdiploid tumour DNA content" not the answer?

Hyperdiploidy is a favourable feature, especially in infants.

What concept does this question test?

It tests Neoplasia: neuroblastoma in Pathology. MYCN amplification is the key adverse genetic marker, correlating with advanced disease and poor survival. Young age, TrkA expression, hyperdiploidy and spontaneous regression are favourable features.

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: neuroblastoma?

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.