How Dye May Prevent Dying from Cancer: Perceiving Imperceptible Dysplasia in Inflammatory Bowel Disease
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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...
KeywordsInflammatory bowel disease Low-grade dysplasia of the colon High-grade dysplasia of the colon Intramucosal adenocarcinoma Chromoendoscopy
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Conflict of interest
The authors declare that they have no conflict of interest.
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