NBME 21 Foci of keratinization (NBME Answers)

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Retired NBME 21 Answers

nbme21/Block 1/Question#23 (reveal difficulty score)
A 59-year-old man comes to the physician ...
Foci of keratinization 🔍 / 📺 / 🌳 / 📖
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submitted by ∗hyoscyamine(59)

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FA pg.372. Squamous cell carcinoma occurs in the upper 2/3 of esophagus whereas adenocarcinoma occurs in the distal 1/3. Since this was in the mid esophagus, its squamous cell carcinoma. Key feature of squamous cell carcinoma is keratin pearls.

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turtlepenlight can remember it as wearing a pearl necklace (upper 2/3 of throat-ish) +5

baja_blast Patient is also a heavy smoker and drinker. In the absence of GERD this should raise suspicion for SCC of esophagus over Adenocarcinoma. +1

lovebug Is there anyone who can explain about C)Intra-cytoplasmic pigment? what is this?;; +

misrao @lovebug I'm thinking Negri bodies in rabies +

thrawn probably dust-cells (macrophages) +

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submitted by ∗est88(19)

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I believe its Squamous cell carcinoma. Its centrally located, smoker, and its a hilar mass. Keratin pearls.

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cry2mucheveryday it is a case of esophageal carinoma not lung carcinoma. +3

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submitted by ∗meningitis(643)

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Squamous and Small cell carcinomas are Sentral (central) and often caused by Smoking

Hilar mass C arising from bronchus; Cavitation; Cigarettes; hyperCalcemia (produces PTHrP). Keratin pearls D and intercellular bridges.

pg 669 2019 FA

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