Neoplasia: gastrointestinal stromal tumour: 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: gastrointestinal stromal tumour

Sample item

A 60-year-old man has a gastric submucosal mass. Histology shows spindle cells that are positive for CD117 and DOG1. From which cell does this tumour arise, and which drug is the targeted therapy of choice?

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

The answer and the reasoning

B. Interstitial cells of Cajal; imatinib

Gastrointestinal stromal tumours arise from interstitial cells of Cajal or their precursors, usually through activating mutations of KIT or PDGFRA. Imatinib inhibits these tyrosine kinases and is used in advanced disease and adjuvantly in high-risk resected tumours.

Option by option

  • A. Schwann cells; sunitinib

    Schwannomas are S-100 positive and are not KIT driven.

  • B. Interstitial cells of Cajal; imatinib (correct)

    Cajal cell origin with KIT-driven growth responds to imatinib.

  • C. Smooth muscle of the muscularis propria; surgery only

    Leiomyomas arise from smooth muscle and are desmin positive, whereas this tumour is CD117 positive.

  • D. Gastric neuroendocrine cells; octreotide

    Neuroendocrine tumours express chromogranin and synaptophysin rather than CD117 and DOG1.

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 B, Interstitial cells of Cajal; imatinib. Gastrointestinal stromal tumours arise from interstitial cells of Cajal or their precursors, usually through activating mutations of KIT or PDGFRA.

Why is "Schwann cells; sunitinib" not the answer?

Schwannomas are S-100 positive and are not KIT driven.

Why is "Smooth muscle of the muscularis propria; surgery only" not the answer?

Leiomyomas arise from smooth muscle and are desmin positive, whereas this tumour is CD117 positive.

Why is "Gastric neuroendocrine cells; octreotide" not the answer?

Neuroendocrine tumours express chromogranin and synaptophysin rather than CD117 and DOG1.

What concept does this question test?

It tests Neoplasia: gastrointestinal stromal tumour in Pathology. Imatinib inhibits these tyrosine kinases and is used in advanced disease and adjuvantly in high-risk resected tumours.

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: gastrointestinal stromal tumour?

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.