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Old 06-15-2012
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Question How to confirm malignancy?

During a routine health maintenance examination, a 46-year-old man is found to have an enlarged, nontender supraclavicular lymph node that is palpable on physical examination. The 2-cm node is excised. Histologically, the nodal architecture is effaced by a monomorphous population of small lymphocytes. Which of the following procedures would best confirm that the patient has a malignancy?
(A) Peripheral WBC count and differential cell count
(B) Flow cytometry of nodal tissue for DNA content
(C) Electron microscopy to determine cellular ultrastructure
(D) Southern blot analysis to show monoclonality
(E) Determination of the serum lactate dehydrogenase level
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Old 06-15-2012
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D..........malignant cells show monoclonity
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Old 06-15-2012
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Quote:
Originally Posted by DefeatTheBeast View Post
D..........malignant cells show monoclonity
Not necessarily. If a tumor is not uniform, undifferentiated and of unknown origin then its said to be Polyclonal. BUT the theory is that all cancer cells originate from one precursor cell and therefore monoclonal is the more widely accepted theory unless prove otherwise (which is very hard lol).

But for the USMLE, you're right, malignant cells show monoclonality. So I'd go with D as well.
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Old 06-15-2012
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Default my answer :)

I think it's D

(A) Peripheral WBC count and differential cell count -> it's useful but it's not a definite source for establishing diagnosis of malignancy (we perform bone marrow or node biopsy)
(B) Flow cytometry of nodal tissue for DNA content -> DNA won't tell us whether it's B or T. if they said here 'flow cytometry for CD marker(s)' I would consider this as a possible answer
(C) Electron microscopy to determine cellular ultrastructure -> I haven't heard about cellular structure in leukemia that would allow us to say definitely that it's a malignancy
(D) Southern blot analysis to show monoclonality -that's my choice
(E) Determination of the serum lactate dehydrogenase level - this one I don't know what reason to give to exclude but I'm just not aware of any connection btw this answer and malignancy diagnosis
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Old 06-15-2012
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i would go with
D...
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Old 06-16-2012
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D ?
monoclonal ...tumor
polyclonal. ....hyperplasia
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Old 06-16-2012
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The answer is D.....as explained by H2P....
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