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7715 Pathology

A 76-year-old man is admitted to the hospital for evaluation of progressive memory loss and disorientation. The pupils are small but react normally to light. Muscle tone is normal. A lumbar puncture returns clear, colorless CSF under normal pressure. An electroencephalogram shows diffuse slowing. A CT scan of the brain reveals moderate atrophy. Which of the following is the most likely diagnosis?

AAlzheimer disease
BCreutzfeldt-Jakob disease
CGlioblastoma multiforme
DHuntington disease
Pathology
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7718 Pathology

A 36-year-old woman presents with swelling in her neck that she first noticed 3 months ago. She also complains of intermittent watery diarrhea over the same time period. Physical examination reveals a nontender nodule in the left lobe of the thyroid. The patient’s mother died of thyroid cancer 8 years ago. The thyroid nodule is found to be “cold” by radioiodine scintiscan. A needle biopsy of the nodule reveals malignant cells and homogeneous eosinophilic material The tumor in the patient described in Question 38 is removed, and a section stained with Congo red reveals birefringent amyloid stroma. Genetic studies show that this patient has a familial cancer syndrome. In addition to hyperparathyroidism, the patient is advised that she is at risk of developing which of the following neoplastic diseases?

ACraniopharyngioma
BFollicular adenoma of thyroid
CNeuroblastoma
DPheochromocytoma
Pathology
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