Bone tumours: physaliphorous cells in chordoma: practice question

A Orthopaedics 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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Orthopaedics · Bone tumours: physaliphorous cells in chordoma

Sample item

A 62-year-old man has a lobulated, destructive midline sacral mass that is bright on T2 weighted MRI. Biopsy shows cords of large cells with abundant vacuolated, bubbly cytoplasm in a myxoid matrix. What are these characteristic cells called?

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

The answer and the reasoning

C. Physaliphorous cells

Physaliphorous (bubbly, vacuolated) cells in a myxoid matrix are the hallmark of chordoma, which arises from notochordal remnants in the sacrococcygeal region or skull base. The cells stain for brachyury and cytokeratin.

Option by option

  • A. Signet-ring cells

    Signet-ring cells are mucin-filled cells of some adenocarcinomas.

  • B. Touton giant cells

    Touton giant cells are seen in xanthomatous lesions and fat necrosis.

  • C. Physaliphorous cells (correct)

    Correct. Vacuolated cells in cords within myxoid matrix identify chordoma.

  • D. Reed-Sternberg cells

    Reed-Sternberg cells are binucleate cells of Hodgkin lymphoma.

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 Orthopaedics question

What is the answer to this Orthopaedics question?

The best answer is C, Physaliphorous cells. Physaliphorous (bubbly, vacuolated) cells in a myxoid matrix are the hallmark of chordoma, which arises from notochordal remnants in the sacrococcygeal region or skull base.

Why is "Signet-ring cells" not the answer?

Signet-ring cells are mucin-filled cells of some adenocarcinomas.

Why is "Touton giant cells" not the answer?

Touton giant cells are seen in xanthomatous lesions and fat necrosis.

Why is "Reed-Sternberg cells" not the answer?

Reed-Sternberg cells are binucleate cells of Hodgkin lymphoma.

What concept does this question test?

It tests Bone tumours: physaliphorous cells in chordoma in Orthopaedics. The cells stain for brachyury and cytokeratin.

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 Bone tumours: physaliphorous cells in chordoma?

Pair each fracture with its classic complication and nerve injured. Then use the flashcards and the other Orthopaedics 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.