KMU Past Paper Practice

A 48-year-old man undergoes excision of a painless subcutaneous mass from his upper back. The surgeon describes a soft, yellow, lobulated lesion separated from surrounding tissue by a thin capsule. Which microscopic finding is most consistent with this lesion?

A deep retroperitoneal adipocytic tumour is composed largely of mature fat but also contains scattered enlarged hyperchromatic stromal cells. Which feature most strongly separates it from an ordinary lipoma?

A pathologist identifies a tumour cell containing several clear cytoplasmic vacuoles. The vacuoles push against and indent the nucleus. What does this finding indicate?

A 27-year-old woman develops a small tender mass in the superficial fascia of her arm. Histology shows plump spindle cells in a tissue-culture-like arrangement. Which associated feature would best support the same diagnosis?

A spindle-cell lesion has numerous mitotic figures but lacks marked pleomorphism, atypical mitoses and destructive necrosis. Which interpretation is most appropriate?

A patient has a firm lesion involving the palm that gradually produces flexion deformity of the fingers. The lesion is composed of bland fibroblasts and collagen. Which disease category best fits this presentation?

A 35-year-old woman has a desmoid tumour involving the shoulder girdle. Histology shows long fascicles of uniform spindle cells with abundant collagen. Which biological description is most accurate?

A deep fibroblastic tumour surrounds a major nerve without marked cytological atypia. Which complication is most directly expected from this growth pattern?

A 5-year-old child has a pelvic soft-tissue tumour composed of primitive round cells and larger cells with abundant eosinophilic cytoplasm. Which cell type provides the main diagnostic evidence of differentiation?

A childhood tumour arises beneath the mucosa of the urinary bladder and protrudes into the lumen. Which gross appearance is most likely?

An adolescent has a deep extremity tumour divided into cellular nests by fibrous septa. The cells at the periphery remain attached while those in the centre separate. Which pattern is produced?

A 67-year-old man has a malignant soft-tissue tumour made of bizarre pleomorphic cells showing skeletal-muscle differentiation. Which age-related classification is most appropriate?

A uterine tumour is sharply circumscribed and displays intersecting bundles of uniform spindle cells. Which nuclear shape supports its smooth-muscle origin?

A uterine smooth-muscle tumour has a soft fleshy cut surface with haemorrhage. Microscopy shows marked atypia and atypical mitotic figures. Which additional finding would reinforce the malignant diagnosis?

A woman with multiple uterine leiomyomas reports heavy menstrual bleeding. Which relationship best explains this manifestation?

A malignant spindle-cell tumour arises from the wall of a large blood vessel. The cells have eosinophilic cytoplasm and cigar-shaped nuclei. Which diagnosis is most likely?

A large malignant smooth-muscle tumour contains extensive central necrosis while viable tumour remains at the periphery. Which process best accounts for this distribution?

A deep thigh tumour consists of malignant spindle-shaped fibroblasts producing collagen. The fascicles intersect at acute angles. Which classical architectural description applies?

A spindle-cell tumour is infiltrative and collagen-producing. Which finding would most strongly shift the diagnosis from fibromatosis to fibrosarcoma?

A patient with a high-grade fibrosarcoma later develops several rounded lesions in both lungs. Which pathway most likely produced these secondary deposits?