Lung tumours: 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 · Lung tumours

Sample item

A heavy smoker has a central hilar mass and a low serum sodium with inappropriately concentrated urine. Biopsy shows small round blue cells with scant cytoplasm, nuclear moulding and crush artefact. What is the most likely diagnosis?

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

The answer and the reasoning

A. Small cell carcinoma

Small cell carcinoma is a neuroendocrine tumour strongly linked to smoking, arising centrally and causing paraneoplastic syndromes such as SIADH and ectopic ACTH. The nuclear moulding, crush artefact and scant cytoplasm are characteristic.

Option by option

  • A. Small cell carcinoma (correct)

    Correct. The central location, neuroendocrine morphology and SIADH point to small cell carcinoma.

  • B. Adenocarcinoma

    Adenocarcinoma is usually peripheral, shows glands or mucin, and is the commonest type in non-smokers.

  • C. Squamous cell carcinoma

    Squamous cell carcinoma is central too but shows keratinisation or intercellular bridges and is linked to hypercalcaemia from PTHrP.

  • D. Large cell carcinoma

    Large cell carcinoma shows large pleomorphic cells with abundant cytoplasm and prominent nucleoli, not small moulded 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 A, Small cell carcinoma. Small cell carcinoma is a neuroendocrine tumour strongly linked to smoking, arising centrally and causing paraneoplastic syndromes such as SIADH and ectopic ACTH.

Why is "Adenocarcinoma" not the answer?

Adenocarcinoma is usually peripheral, shows glands or mucin, and is the commonest type in non-smokers.

Why is "Squamous cell carcinoma" not the answer?

Squamous cell carcinoma is central too but shows keratinisation or intercellular bridges and is linked to hypercalcaemia from PTHrP.

Why is "Large cell carcinoma" not the answer?

Large cell carcinoma shows large pleomorphic cells with abundant cytoplasm and prominent nucleoli, not small moulded cells.

What concept does this question test?

It tests Lung tumours in Pathology. The nuclear moulding, crush artefact and scant cytoplasm are characteristic.

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 Lung tumours?

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.