Q&A: Benign Vs Malignant Lumps

A lump or swelling is a common presenting problem. A lump may also be found by the examining clinician in the course of routine examination. A methodical approach to history and examination, with particular emphasis on inspection and palpation, is usually important in the correct description and initial diagnosis of a lump. This initial diagnosis will enable a management plan to be formulated and discussed with the patient. Management may range from explanation and reassurance to urgent referral for surgery.

This article is for Medical Students & Professionals

This is a Question & Answer revision article designed for medical students and professionals preparing for the PLAB, MRCP or USMLE examinations. They are based on actual questions from these examinations. You may find the Cancer article more useful, or one of our many articles on Diseases & Conditions, Medical Syndromes, Health & Wellness or Home Remedies.

In this article:
Common causes of lumps
MCQ exam: clinical scenario
MCQ exam: answer
MCQ exam: explanation

Causes of lumps

Generally, lumps fall into one of the following aetiological categories:

• Congenital or acquired.
• Traumatic.
• Inflammatory (acute or chronic).
• Neoplastic (benign or malignant, primary or secondary).
• Other (degenerative, metabolic, parasitic, hormonal disorder).

MCQ exam: clinical scenario

A 52 year old woman notices a lump in her subcutaneous tissue in her arm. The lesion is removed. She is very relieved to learn that the lesion is benign.

Which of the following characteristics in the histology of this lesion would tend to point towards a benign neoplasm rather than a malignant one?

a) Infiltration of the surrounding tissues
b) Metastasis
c) Prominent mitotic figures
d) Anaplasia
e) Well defined encapsulation

MCQ exam: answer

The correct answer is E.

MCQ exam: explanation

A well defined, well demarcated lesion is more characteristic of a benign neoplasm than an malignant neoplasm. Infiltration of the surrounding tissues (choice a) is seen with malignant lesions. Metastasis (choice b) occurs with malignant neoplasms. Prominent mitotic figures (choice c) are seen with a malignancy. Anaplasia (choice d) refers to the characteristic of malignant cells to be poorly differentiated or resemble immature forms.

Reference(s)
1). Patient: Lumps. Available online: https://patient.info/doctor/lumps