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How Dye May Prevent Dying from Cancer: Perceiving Imperceptible Dysplasia in Inflammatory Bowel Disease

  • Sara M. Lewin
  • Kwun Wah Wen
  • Fernando S. Velayos
  • Uma Mahadevan
  • Kendall R. Beck
Multicenter Seminars: IBD (MUSE: IBD)
  • 8 Downloads

Case Presentation

Pre-admission

A 57-year-old man with history of Crohn’s colitis was referred for a second opinion regarding management of high-grade dysplasia found on colonoscopy.

His Crohn’s diagnosis had occurred 2 years prior to referral, when he first complained of an unintentional weight loss of 50 lb over 1 year, abdominal pain, and bloody diarrhea. Esophagogastroduodenoscopy was unremarkable. Colonoscopy demonstrated aphthous-appearing ulcers, post-inflammatory polyps throughout the colon, and edematous, erythematous, and friable colonic mucosa with intervening skip areas of normal mucosa. Random biopsies were taken with cold forceps in the ascending colon, descending colon, and rectum. Random biopsies taken from the ascending colon demonstrated polypoid, low-grade dysplastic adenoma-like lesions whereas biopsies of the descending colon and rectum demonstrated chronic active colitis with ulceration. No granulomata or dysplastic cells were seen; interdepartmental consultants...

Keywords

Inflammatory bowel disease Low-grade dysplasia of the colon High-grade dysplasia of the colon Intramucosal adenocarcinoma Chromoendoscopy 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Sara M. Lewin
    • 1
  • Kwun Wah Wen
    • 2
  • Fernando S. Velayos
    • 3
  • Uma Mahadevan
    • 1
  • Kendall R. Beck
    • 1
  1. 1.Division of Gastroenterology, UCSF Department of MedicineUniversity of CaliforniaSan FranciscoUSA
  2. 2.UCSF Department of PathologyUniversity of CaliforniaSan FranciscoUSA
  3. 3.Department of GastroenterologyKaiser Permanente Medical GroupSan FranciscoUSA

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