Neoplasia: HTLV-1 and adult T-cell leukaemia: 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: HTLV-1 and adult T-cell leukaemia

Sample item

A 45-year-old man from southern Japan has skin lesions, generalised lymphadenopathy, hypercalcaemia and lymphocytes with multilobed 'flower' nuclei. Which oncogenic virus is implicated, acting through its Tax protein?

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

The answer and the reasoning

D. Human T-cell leukaemia virus type 1

HTLV-1 causes adult T-cell leukaemia/lymphoma in a small fraction of carriers after decades. The Tax protein activates NF-kB and other pathways that drive proliferation of CD4+ T cells. Endemic areas include southern Japan and the Caribbean.

Option by option

  • A. Hepatitis C virus

    Hepatitis C is associated with hepatocellular carcinoma and marginal zone lymphoma.

  • B. Human herpesvirus 8

    HHV-8 is the agent of Kaposi sarcoma and primary effusion lymphoma.

  • C. Epstein-Barr virus

    EBV is linked to Burkitt lymphoma and nasopharyngeal carcinoma, not this T-cell neoplasm.

  • D. Human T-cell leukaemia virus type 1 (correct)

    Correct. HTLV-1 Tax drives the clonal expansion of CD4+ T cells.

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 D, Human T-cell leukaemia virus type 1. HTLV-1 causes adult T-cell leukaemia/lymphoma in a small fraction of carriers after decades.

Why is "Hepatitis C virus" not the answer?

Hepatitis C is associated with hepatocellular carcinoma and marginal zone lymphoma.

Why is "Human herpesvirus 8" not the answer?

HHV-8 is the agent of Kaposi sarcoma and primary effusion lymphoma.

Why is "Epstein-Barr virus" not the answer?

EBV is linked to Burkitt lymphoma and nasopharyngeal carcinoma, not this T-cell neoplasm.

What concept does this question test?

It tests Neoplasia: HTLV-1 and adult T-cell leukaemia in Pathology. The Tax protein activates NF-kB and other pathways that drive proliferation of CD4+ T cells. Endemic areas include southern Japan and the Caribbean.

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: HTLV-1 and adult T-cell leukaemia?

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.