Precursor Lesions
Also written as CIN.
One of the following is not true regarding precursor lesions
What our notes say
- One of the following is not true regarding precursor lesions (Oncopathology MCQs: Test Your Knowledge on Cancer Pathology)
- In ~50% of invasive bladder cancers, precursor lesion is not detected at presentation (destroyed by invasive component) (DISORDERS OF THE LOWER URINARY TRACT — Revision Notes)
- Despite its name, MGUS is increasingly recognised as a precursor lesion — symptomatic plasma cell tumour (most commonly myeloma) develops at a rate of 1% per year. (White Cell Disorders — Must-Know Notes)
- Precursor lesions (CIN) confined to epithelium, graded by depth of dysplastic cell involvement (Female & Male Genital Pathology: Ulcers, HPV, Endometriosis, Pre-eclampsia)
- Precursor lesion: high-grade Prostatic Intraepithelial Neoplasia (PIN) (Female & Male Genital Pathology: Ulcers, HPV, Endometriosis, Pre-eclampsia)
- Clinical significance: Represents a precursor lesion with increased risk of progression to esophageal adenocarcinoma via a dysplasia-carcinoma sequence (Gastrointestinal Pathology Exam: H. pylori, Barrett's, Anomalies)
Study material on Precursor Lesions
- Oncopathology MCQs: Test Your Knowledge on Cancer Pathology
- pathology essays
- Female & Male Genital Pathology: Ulcers, HPV, Endometriosis, Pre-eclampsia
Practice questions on Precursor Lesions
Which precursor lesion leads to invasive pancreatic ductal adenocarcinoma?
- PanNET
- PanIN (Pancreatic intraepithelial neoplasia)
- Serous cystadenoma
- Retention cyst
Answer: B. PanINs are the microscopic precursor lesions that progress through stages (1-3) to invasive carcinoma. ---
A middle-aged smoker develops a multifocal warty poorly differentiated vulvar carcinoma. Which precursor lesion is most likely involved?
- Lichen sclerosus with reactive changes
- Lichen simplex chronicus
- Vulvar intraepithelial neoplasia
- Condyloma lata of secondary syphilis
Answer: C. HPV-related vulvar carcinoma in younger women is preceded by VIN. Cigarette smoking and immunodeficiency increase the risk of progression. ---
Which precursor lesion leads to invasive pancreatic ductal adenocarcinoma through sequential mutation accumulation?
- Mucinous cystic neoplasm
- Serous cystadenoma
- Pancreatic intraepithelial neoplasia (PanIN)
- Intraductal papillary mucinous neoplasm
Answer: C. PanIN is the established precursor. Mutations accumulate: KRAS → CDKN2A → TP53 → SMAD4. ---
One of the following is NOT true regarding precursor lesions
- Removal of precursor lesions does not prevent development of cancer
- Squamous dysplasia of bronchial mucosa in smokers is a risk factor for lung cancer
- Squamous metaplasia of bronchial mucosa in smokers is NOT a risk factor
- Endometrial hyperplasia and dysplasia with unopposed oestrogen is risk for endometrial carcinoma
Answer: A. Removal of precursor lesions DOES prevent cancer development. That is the purpose of screening and early intervention. ---