Systemic paediatrics: embryonal rhabdomyosarcoma: practice question

A Pediatrics 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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Pediatrics · Systemic paediatrics: embryonal rhabdomyosarcoma

Sample item

A 2-year-old girl has bloody vaginal discharge and a grape-like mass protruding from the introitus. Biopsy shows small round to spindle cells, some with cross-striations. Which markers are expected on immunohistochemistry?

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

The answer and the reasoning

B. Desmin and myogenin

Sarcoma botryoides is the botryoid variant of embryonal rhabdomyosarcoma, arising in the vagina or bladder of young children. Skeletal muscle differentiation is shown by desmin, myogenin and MyoD1 positivity.

Option by option

  • A. S-100 protein and HMB-45

    S-100 and HMB-45 are melanocytic markers, positive in melanoma.

  • B. Desmin and myogenin (correct)

    Correct. Desmin and myogenin show skeletal muscle differentiation in rhabdomyosarcoma.

  • C. Cytokeratin and epithelial membrane antigen

    Cytokeratin and epithelial membrane antigen are epithelial markers, as in carcinoma.

  • D. Chromogranin and neuron-specific enolase

    Chromogranin and neuron-specific enolase are neuroendocrine markers, positive in neuroblastoma.

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 Pediatrics question

What is the answer to this Pediatrics question?

The best answer is B, Desmin and myogenin. Sarcoma botryoides is the botryoid variant of embryonal rhabdomyosarcoma, arising in the vagina or bladder of young children.

Why is "S-100 protein and HMB-45" not the answer?

S-100 and HMB-45 are melanocytic markers, positive in melanoma.

Why is "Cytokeratin and epithelial membrane antigen" not the answer?

Cytokeratin and epithelial membrane antigen are epithelial markers, as in carcinoma.

Why is "Chromogranin and neuron-specific enolase" not the answer?

Chromogranin and neuron-specific enolase are neuroendocrine markers, positive in neuroblastoma.

What concept does this question test?

It tests Systemic paediatrics: embryonal rhabdomyosarcoma in Pediatrics. Skeletal muscle differentiation is shown by desmin, myogenin and MyoD1 positivity.

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 paediatrics: embryonal rhabdomyosarcoma?

Memorise milestones and the vaccine schedule as tables and revise them often. Then use the flashcards and the other Pediatrics 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.