Dysplasia in Ulcerative Colitis
Image Description
Terminology for Dysplasia in Ulcerative Colitis (UC): Biopsies performed during surveillance colonoscopy in patients with UC are reported as negative for dysplasia; indefinite for dysplasia; positive for dysplasia, low-grade; and positive for dysplasia, high-grade.
Biopsies obtained from nodular lesions or mass, plaques, or strictures have often shown dysplasia or cancer. Such lesions have been referred to by the acronym DALM (dysplasia-associated lesion or mass). Based on their endoscopic appearance, they have been further subdivided into adenoma-like DALM and nonadenoma-like DALM.
In 2015, SCENIC International Consensus Statement on the surveillance and management of dysplasia in inflammatory bowel disease issued a statement. The term DALM was replaced by visible dysplasia (dysplasia identified on targeted biopsies from a lesion visualized on colonoscopy) and invisible dysplasia (dysplasia identified on random, non-targeted biopsies of colonic mucosa without a visible lesion). Visible dysplasia was further subdivided into polypoid (protruding ¡Ý2.5 mm above the mucosal surface) and non-polypoid (flat, depressed lesion; or protruding <2.5 mm above the surface).
This biopsy from a raised area found during surveillance colonoscopy in a patient with UC shows tubular adenoma with high-grade dysplasia (visible dysplasia; adenoma-like DALM). Note the crypt abscess at the bottom and crypt distortion. The dysplastic cells lining the crypts have eosinophilic cytoplasm and enlarged hyperchromatic nuclei.
Biopsies obtained from nodular lesions or mass, plaques, or strictures have often shown dysplasia or cancer. Such lesions have been referred to by the acronym DALM (dysplasia-associated lesion or mass). Based on their endoscopic appearance, they have been further subdivided into adenoma-like DALM and nonadenoma-like DALM.
In 2015, SCENIC International Consensus Statement on the surveillance and management of dysplasia in inflammatory bowel disease issued a statement. The term DALM was replaced by visible dysplasia (dysplasia identified on targeted biopsies from a lesion visualized on colonoscopy) and invisible dysplasia (dysplasia identified on random, non-targeted biopsies of colonic mucosa without a visible lesion). Visible dysplasia was further subdivided into polypoid (protruding ¡Ý2.5 mm above the mucosal surface) and non-polypoid (flat, depressed lesion; or protruding <2.5 mm above the surface).
This biopsy from a raised area found during surveillance colonoscopy in a patient with UC shows tubular adenoma with high-grade dysplasia (visible dysplasia; adenoma-like DALM). Note the crypt abscess at the bottom and crypt distortion. The dysplastic cells lining the crypts have eosinophilic cytoplasm and enlarged hyperchromatic nuclei.