Neoplasia: solid pseudopapillary neoplasm of the pancreas: 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: solid pseudopapillary neoplasm of the pancreas

Sample item

A 22-year-old woman has a large, well-circumscribed mass in the tail of the pancreas with solid and haemorrhagic cystic areas. Histology shows poorly cohesive monomorphic cells around delicate fibrovascular stalks, and the nuclei stain for beta-catenin. What is the diagnosis?

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

The answer and the reasoning

B. Solid pseudopapillary neoplasm

Solid pseudopapillary neoplasm typically affects young women, forms a large encapsulated mass with solid and cystic haemorrhagic areas and carries CTNNB1 mutations, giving nuclear beta-catenin positivity. It is low-grade and has an excellent prognosis after resection.

Option by option

  • A. Serous cystadenoma

    Serous cystadenoma consists of small glycogen-rich cuboidal cells lining numerous tiny cysts in older women.

  • B. Solid pseudopapillary neoplasm (correct)

    Correct. A young woman, haemorrhagic cystic mass and nuclear beta-catenin point to this neoplasm.

  • C. Ductal adenocarcinoma

    Ductal adenocarcinoma occurs in older patients with infiltrating glands and desmoplastic stroma.

  • D. Insulinoma

    Insulinoma is a small neuroendocrine tumour presenting with hypoglycaemia, not a large cystic mass.

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.

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Questions about this Pathology question

What is the answer to this Pathology question?

The best answer is B, Solid pseudopapillary neoplasm. Solid pseudopapillary neoplasm typically affects young women, forms a large encapsulated mass with solid and cystic haemorrhagic areas and carries CTNNB1 mutations, giving nuclear beta-catenin positivity.

Why is "Serous cystadenoma" not the answer?

Serous cystadenoma consists of small glycogen-rich cuboidal cells lining numerous tiny cysts in older women.

Why is "Ductal adenocarcinoma" not the answer?

Ductal adenocarcinoma occurs in older patients with infiltrating glands and desmoplastic stroma.

Why is "Insulinoma" not the answer?

Insulinoma is a small neuroendocrine tumour presenting with hypoglycaemia, not a large cystic mass.

What concept does this question test?

It tests Neoplasia: solid pseudopapillary neoplasm of the pancreas in Pathology. It is low-grade and has an excellent prognosis after resection.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. 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: solid pseudopapillary neoplasm of the pancreas?

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.