Systemic pathology: oesophageal carcinoma risk factors: 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 · Systemic pathology: oesophageal carcinoma risk factors

Sample item

A 62-year-old man with long-standing reflux has a distal oesophageal tumour that is a gland-forming adenocarcinoma. Compared with squamous carcinoma of the oesophagus, which risk factor is specifically linked to this tumour type?

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

The answer and the reasoning

B. Barrett oesophagus

Oesophageal adenocarcinoma usually arises from Barrett metaplasia, driven by chronic reflux and obesity, at the lower end. Caustic injury, achalasia and post-cricoid webs are risk factors for squamous carcinoma.

Option by option

  • A. Plummer-Vinson web

    Plummer-Vinson syndrome is associated with post-cricoid squamous carcinoma.

  • B. Barrett oesophagus (correct)

    Correct. Barrett metaplasia from chronic reflux is the precursor of distal oesophageal adenocarcinoma.

  • C. Long-standing achalasia

    Achalasia predisposes to squamous carcinoma through chronic stasis and irritation.

  • D. Previous lye stricture

    Lye stricture predisposes to squamous cell carcinoma.

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, Barrett oesophagus. Oesophageal adenocarcinoma usually arises from Barrett metaplasia, driven by chronic reflux and obesity, at the lower end.

Why is "Plummer-Vinson web" not the answer?

Plummer-Vinson syndrome is associated with post-cricoid squamous carcinoma.

Why is "Long-standing achalasia" not the answer?

Achalasia predisposes to squamous carcinoma through chronic stasis and irritation.

Why is "Previous lye stricture" not the answer?

Lye stricture predisposes to squamous cell carcinoma.

What concept does this question test?

It tests Systemic pathology: oesophageal carcinoma risk factors in Pathology. Caustic injury, achalasia and post-cricoid webs are risk factors for squamous carcinoma.

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 Systemic pathology: oesophageal carcinoma risk factors?

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.