NBME 22 Answers : Block 3 : #45 = A 28-year-old man who is seropositive for HIV has ...

NBME 22 Answers

nbme22/Block 3/Question#45

A 28-year-old man who is seropositive for HIV has ...

Slit-like vascular spaces with plump spindle-shaped stromal cells

+5 upvote downvote
submitted by usmleuser007(126),

my list of spindle type cells and conditions:

a. NF-1
b. NF-2 ~ Schwannoma (Antoni A) = Cutaneous neurofibroma ~ high cellularity (w/ palisading patterns with interspersing nuclear-free zones called Verocay bodies
c. Leiomyoma (uterus & esophagus)
d. Mesothelioma (cytokeratin positive)
e. Anaplastic Thyroid cancer (biphasic & along with giant cells)
f. Medullary Thyroid cancer (can also have polygonal cells)
g. Primary cardiac angiosarcoma (malignant vascular spindle cells)
h. Osteosarcoma (bone cancer) (pleomorphic cells)
i. Meningioma
j. Kaposi's Sarcoma (HHV-8) = Slit-like vascular spaces with plump spindle-shaped stromal cells

drdoom @usmleuser007 to make lists display correctly, try using the plus sign (+) for each "bullet point"; that should work +

mcl I love this and I love you +1

usmleuser007 LOL thanks, had to ddo a lot of digging since "spindle cells" are commonly tested +

+2 upvote downvote
submitted by mcl(216),

To expand on this, pathologyoutlines describes the histology of kapowsi sarcoma as "spindle cells forming slits with extravasated red blood cells"

mcl lul i don't know why i spell kaposi like that, my b +1

bubbles This site is super helpful. Thanks for sharing :) +

mcl yesssssss ofc <3 I love path outlines +

usmleuser007 Just realize that spindle cells are similar to the endothelial cells of blood vessels. Anything that have vessel association might have spindle-shaped cells. a. NF-1 b. NF-2 ~ Schwannoma (Antoni A) = Cutaneous neurofibroma ~ high cellularity (w/ palisading patterns with interspersing nuclear-free zones called Verocay bodies c. Leiomyoma (uterus & esophagus) d. Mesothelioma (cytokeratin positive) e. Anaplastic Thyroid cancer (biphasic & along with giant cells) f. Medullary Thyroid cancer (can also have polygonal cells) g. Primary cardiac angiosarcoma (malignant vascular spindle cells) h. Osteosarcoma (bone cancer) (pleomorphic cells) i. Meningioma j. Kaposi's Sarcoma (HHV-8) = Slit-like vascular spaces with plump spindle-shaped stromal cells +1

+1 upvote downvote
submitted by enbeemee(5),

sketchy says that kaposi's has infiltrating lymphocytes, so why would large aggregates of atypical lymphocytes be incorrect?

titanesxvi Bcz I think vascular is the key thing here, whereas atypical lynphocytes would be more of EBV +

-4 upvote downvote
submitted by haliburton(85),

kaposi sarcoma. HHV8. violaceous (purple) lesions. advanced HIV CD4 < 200 (WHO).

yotsubato Yeah thats the easy part. But the histology is whats hard +