Neoplasia: neuroendocrine immunohistochemistry: 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: neuroendocrine immunohistochemistry

Sample item

A bronchial biopsy from a smoker shows sheets of small cells with scant cytoplasm, nuclear moulding and finely granular chromatin. Which immunohistochemical pair best confirms neuroendocrine differentiation?

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

The answer and the reasoning

C. Chromogranin A and synaptophysin

Small cell carcinoma is a high-grade neuroendocrine tumour, which expresses chromogranin, synaptophysin and CD56, along with cytokeratin in a perinuclear dot pattern. Desmin and myogenin label muscle tumours, LCA and CD20 label lymphoma, and GFAP labels glial tumours.

Option by option

  • A. Leucocyte common antigen and CD20

    LCA and CD20 identify haematolymphoid cells and exclude carcinoma.

  • B. Glial fibrillary acidic protein and S-100

    GFAP and S-100 indicate glial or neural crest tumours.

  • C. Chromogranin A and synaptophysin (correct)

    Correct. These are the standard neuroendocrine granule and vesicle markers.

  • D. Desmin and myogenin

    Desmin and myogenin identify skeletal muscle differentiation.

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 C, Chromogranin A and synaptophysin. Small cell carcinoma is a high-grade neuroendocrine tumour, which expresses chromogranin, synaptophysin and CD56, along with cytokeratin in a perinuclear dot pattern.

Why is "Leucocyte common antigen and CD20" not the answer?

LCA and CD20 identify haematolymphoid cells and exclude carcinoma.

Why is "Glial fibrillary acidic protein and S-100" not the answer?

GFAP and S-100 indicate glial or neural crest tumours.

Why is "Desmin and myogenin" not the answer?

Desmin and myogenin identify skeletal muscle differentiation.

What concept does this question test?

It tests Neoplasia: neuroendocrine immunohistochemistry in Pathology. Desmin and myogenin label muscle tumours, LCA and CD20 label lymphoma, and GFAP labels glial 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: neuroendocrine immunohistochemistry?

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.