Skin pathology: squamous cell carcinoma: 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 · Skin pathology: squamous cell carcinoma

Sample item

A 70-year-old farmer has a crusted nodule on the dorsum of the hand. Biopsy shows invasive nests of atypical squamous cells with keratin pearls and intercellular bridges. Which lesion is the most likely precursor?

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

The answer and the reasoning

A. Actinic keratosis

Cutaneous squamous cell carcinoma frequently arises from actinic keratosis, a dysplastic lesion on sun-exposed skin caused by UV-induced TP53 mutations and pyrimidine dimers. Keratin pearls and intercellular bridges mark squamous differentiation. Immunosuppressed patients are at higher risk.

Option by option

  • A. Actinic keratosis (correct)

    Correct. Actinic keratosis is the in-situ precursor from chronic sun damage.

  • B. Compound naevus

    A compound naevus is a melanocytic lesion and relates to melanoma, not squamous carcinoma.

  • C. Molluscum contagiosum

    Molluscum contagiosum is a viral infection that is not premalignant.

  • D. Seborrhoeic keratosis

    Seborrhoeic keratosis is a benign lesion with no malignant potential.

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 A, Actinic keratosis. Cutaneous squamous cell carcinoma frequently arises from actinic keratosis, a dysplastic lesion on sun-exposed skin caused by UV-induced TP53 mutations and pyrimidine dimers.

Why is "Compound naevus" not the answer?

A compound naevus is a melanocytic lesion and relates to melanoma, not squamous carcinoma.

Why is "Molluscum contagiosum" not the answer?

Molluscum contagiosum is a viral infection that is not premalignant.

Why is "Seborrhoeic keratosis" not the answer?

Seborrhoeic keratosis is a benign lesion with no malignant potential.

What concept does this question test?

It tests Skin pathology: squamous cell carcinoma in Pathology. Keratin pearls and intercellular bridges mark squamous differentiation. Immunosuppressed patients are at higher risk.

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 Skin pathology: squamous cell carcinoma?

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.