A 55-year-old male presented with a 3.5 cm thyroid mass.
Question 1:
Which of the following best describes the tumor mutation burden (TMB) of papillary thyroid carcinoma (PTC)?
A) High among all cancer types
B) Moderate among all cancer types
C) Lowest among all cancer types
D) Variable depending on the histologic subtype
Answer
Question 2:
Which molecular pathway is most frequently altered in PTC?
A) PI3K/AKT pathway
B) MAPK pathway
C) JAK/STAT pathway
D) WNT/β-catenin pathway
Answer
Question 3:
Which of the following mutations is most common in classic PTC and subtypes with papillary architecture?
A) BRAF p.V600E
B) RAS mutations
C) RET fusions
D) TERT promoter mutations
Answer
Answer: A) BRAF p.V600E
Question 4:
Which histologic subtype of PTC has the highest prevalence of BRAF mutations?
A) Follicular variant PTC
B) Tall cell PTC
C) Oncocytic PTC
D) Warthin-like PTC
Answer
Question 5:
Which chromosomal rearrangement is most commonly associated with radiation-induced solid/trabecular PTC (ST-PTC)?
A) CCDC6::RET
B) NCOA4::RET
C) ETV6::NTRK3
D) PPARG::PAX8
Answer
Question 6:
Which molecular alterations are commonly found in spindle cells of PTC with fibromatosis/fasciitis-like stroma?
A) BRAF p.V600E mutations
B) TERT promoter mutations
C) CTNNB1 (β-catenin) mutations
D) KRAS mutations
Answer
Question 7:
What is the estimated prevalence of TERT promoter mutations in PTC?
A) 1%
B) 5%
C) 10%
D) 20%
Answer
Question 8:
Which RET fusion is the most common in sporadic PTC cases?
A) NCOA4::RET
B) CCDC6::RET
C) ETV6::NTRK3
D) PPARG::RET
Answer
Question 9:
Which molecular alterations are associated with radiation-induced PTC, particularly in children affected by the Chernobyl nuclear accident?
A) BRAF p.V600E mutations
B) TERT promoter mutations
C) NCOA4::RET fusions
D) KRAS mutations
Answer
Question 10:
Which less common mutations and fusions have been reported in PTC?
A) HRAS, KRAS, PPM1D, and CHEK2
B) TP53, RB1, and CDKN2A
C) PTEN, APC, and SMAD4
D) MYC, MDM2, and BRCA1
Answer
Case credit: UCSD Pathology
Author: Wangpan Jackson Shi, MD
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