My Pathology 2 experience

It’s that time of the year again. I had my Pathology 2 exam today. Professor Tornóczki was my examiner. My topics were:

• Benign and malignant tumors of the stomach
• Tumors and tumor-like lesions of the liver
• Slide: Paget disease of the breast
• Prep: Mixed type testicular germ cell tumor

I loved my prep and slide but hated my theoretical topics. I wanted anything endocrine, IBD, male, female, skin or lung, but noo.. At least I didn’t get soft tissue, kidney or haema.

Benign and malignant tumors of the stomach

I begun talking about the adenocarcinoma. He liked most of what I talked about, but there were multiple questions I couldn’t answer. I said mostly everything written on the paper.

Here are some questions he asked that I couldn’t answer:

• Except for smoking, gastritis and alcohol, what can be carcinogenic for the stomach (EBV)
• Describe the pathogenesis of GIST (had no idea)
• What is the carcinogenic component of H. pylori (CagA)

Tumors and tumor-like lesions of the liver

I begun talking about the hepatocellular carcinoma. He asked what can cause HCC without cirrhosis, I answered fibrolamellar type and aflatoxin. He asked what is characteristic for aflatoxin, to which I didn’t know. Appearently it gives a very characteristic “signature” mutation of the p53 gene (which I wrote on the paper after he said it).

He asked about the benign version of HCC, which I’d forgotten to mention or write.

He asked how one can get multiple echinococcus cysts. I didn’t know, but appearently the parasites can spread through the bile ducts before they die, forming multiple cysts.

We did not talk about cholangiocellular cc, liver abscess or liver cysts (other than the echinococcus).

Testicular mixed tumor

Of course I get the prep that teachers disagree about, and of course my teacher and my examiner disagree about it. I wanted to make it clear that there is a disagreement between teachers about which tumor is which, but he didn’t really let me. He also said that seminomas not rarely have haemorrhage and necrosis. I said that I think the bottom tumor is the seminoma and he disagreed.

I love testicular tumors and wanted to talk about a lot of theory here (as you can see from my paper), but he was only interested in the macroscopy.

I forgot to say that the testicle is enlarged (which is obvious), which I think might have disappointed him a little. I also didn’t know that testicular tumors cause painless enlargement, which is also important (and I’d forgotten).

Paget disease of the breast

Generally okay, however he disagreed that we can’t see the primary tumor in the slide as he showed me some atypical cells in one of the ducts. He also asked what Paget disease can look like, and appearently the answer is eczema (I didn’t know).

Like for the prep he was not interested in any theoretical knowledge here, which was unfortunate for me.

Overall

I got a 3 in the end. I got 3 on 3 of my topics and 4 on one of them, can’t remember which one. The theoretical topics weren’t my best picks and I do believe I could’ve gotten a better grade with better topics, but there were many of his questions that I couldn’t answer. In my opinion he was a little strict when he gave me 3 instead of a 4, but I’m just glad I passed.

He was very nice and his questions were for the most part easy to understand. I answered wrong or “I don’t know” to most of the questions he asked me. I wouldn’t worry if you get him as your examiner.

Good luck with your exams!