Dysplasia in Inflammatory Bowel Disease

As we all know, chronic inflammatory bowel disease (IBD) presents a risk for dysplasia and subsequent malignancy in patients with long standing disease.The risk for adenocarcinoma increases with a number of factors includingthe linear extent of disease within the bowel,early age at onset of disease,severity of disease and duration of disease.The pathologic reporting of endoscopic biopsy specimens with inflammatory bowel disease must convey the information the clinician needs in a clear and consistent manner in order to properly manage the patient's disease.Every biopsy report should, of course, give an assessment of the disease activity and distribution. In addition, the pathologist must render an opinion on the presence or absence of dysplasia. The "second line" diagnosis must reflect one of three choices regarding dysplasia in the biopsy:1. Negative for dysplasia2. Indefinite for dysplasia3. Positive for dysplasiaLow gradeHigh gradeAgreeing on the terminology is relatively easy. Agreeing on the morphologic presence or absence of dysplasia is another issue.Studies have shown poor interobserver reproducibility with regard to recognizing and diagnosing dysplasia. Low grade dysplasia (LGD), as one might guess, suffers from the worst interobserver variability.The more marked the cytologic changes (high grade dysplasia) the easier it is to recognize and agree upon amongst pathologists.This variability is one reason that many suggest surveillance for LGD. The histologic parameters...
Source: Oncopathology - Category: Cancer & Oncology Tags: Dysplasia in Inflammatory Bowel Disease Source Type: blogs