Neoplasia: Merkel 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 · Neoplasia: Merkel cell carcinoma

Sample item

A 78-year-old man has a rapidly growing painless violaceous nodule on the cheek. Biopsy shows small blue cells with salt-and-pepper chromatin, and cytokeratin 20 stains in a perinuclear dot pattern. Which virus is associated with most cases?

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

The answer and the reasoning

B. Merkel cell polyomavirus

Merkel cell carcinoma is a neuroendocrine skin tumour in elderly or immunosuppressed people, and about 80 percent are associated with clonal integration of Merkel cell polyomavirus. UV damage causes most of the remainder.

Option by option

  • A. Human papillomavirus 6

    HPV 6 causes benign condylomata, not this tumour.

  • B. Merkel cell polyomavirus (correct)

    Correct. Clonally integrated polyomavirus drives most cases.

  • C. Herpes simplex virus

    HSV causes vesicular lesions and is not oncogenic.

  • D. Epstein-Barr virus

    EBV is linked to lymphoma and nasopharyngeal carcinoma.

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, Merkel cell polyomavirus. Merkel cell carcinoma is a neuroendocrine skin tumour in elderly or immunosuppressed people, and about 80 percent are associated with clonal integration of Merkel cell polyomavirus.

Why is "Human papillomavirus 6" not the answer?

HPV 6 causes benign condylomata, not this tumour.

Why is "Herpes simplex virus" not the answer?

HSV causes vesicular lesions and is not oncogenic.

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

EBV is linked to lymphoma and nasopharyngeal carcinoma.

What concept does this question test?

It tests Neoplasia: Merkel cell carcinoma in Pathology. UV damage causes most of the remainder.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. 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: Merkel 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.