Abstract
Visible changes associated with dysplasia or carcinoma have been assessed in 62 colectomy specimens from patients with ulcerative colitis. In 34 colectomy specimens with one or more carcinomas, there were 51 visible carcinomas and 65 macroscopic dysplastic lesions; only one carcinoma was found in flat mucosa. Among 28 specimens with microscopic dysplasia but no carcinoma, eight contained no visible dysplastic lesion, and the remaining 20 contained a total of 40 polypoid or elevated dysplastic areas. In 32 operative specimens removed for long-standing chronic colitis without dysplasia or carcinoma, nine contained visible inflammatory polypoid lesions. On radiological or endoscopic examination of the colon in long-standing colitis close attention should be given to the identification and biopsy of polyps, elevated nodular areas or plaques, strictures, and isolated ulcers. It is likely that colectomy specimens with visible polypoid or elevated dysplastic lesions will contain a carcinoma more often than those removed for dysplasia in flat mucosa.
Similar content being viewed by others
References
Dawson IMP, Pryse-Davies J: The development of carcinoma of the large intestine in ulcerative colitis. Br J Surg 47:113–128, 1959
Morson BC, Pang LSG: Rectal biopsy as an aid to cancer control in ulcerative colitis. Gut 8:423–434, 1967
Hulten L, Kewenter J, Ahren C: Precancer and carcinoma in chronic ulcerative colitis. Scand J Gastroenterol 7:663–669, 1972
Fenoglio C, Pascal RR: Adenomatous epithelium, intraepithelial anaplasia and invasive carcinoma in ulcerative colitis. Am J Dig Dis 18:556–562, 1973
Yardley JH, Keren PF: “Precancer” lesions in ulcerative colitis. Cancer 34:835–844, 1974
Cook MG, Goligher JC: Carcinoma and epithelial dysplasia complicating ulcerative colitis. Gastroenterology 68:1127–1136, 1975
Teague RH, Read AE: Polyposis in ulcerative colitis. Gut 16:792–795, 1975
Blackstone MO, Riddell RH, Rogers BHG, Levin B: Dysplasia-associated lesion or mass (DALM) detected by colonoscopy in long-standing ulcerative colitis: An indication for colectomy. Gastroenterology 80:366–374, 1981
Dukes CE: Cancer of the rectum: An analysis of 1000 cases. J Pathol Bacteriol 50:527–539, 1940
Muto T, Bussey HJR, Morson BC: The evolution of cancer of the colon and rectum. Cancer 36:2251–2270, 1975
Dukes CE, Bussey HJR: The spread of rectal cancer and its effect on prognosis. Br J Cancer 12:309–320, 1958
Lennard-Jones JE, Morson BC, Ritchie JK, Shove DC, Williams CB: Cancer in colitis: Assessment of the individual risk by clinical and histological criteria. Gastroenterology 73:1280–1289, 1977
Morson BC, Dawson IMP:In Gastrointestinal Pathology, 2nd ed. Oxford, Blackwell Scientific Publications, 1979
Butt JH, Morson BC: Dysplasia and cancer in inflammatory bowel disease. Gastroenterology 80:865–868, 1981
Goulston SJM, McGovern VJ: The nature of benign strictures in ulcerative colitis. N Engl J Med 281:290–293, 1969
Riddell RH, Goldman H, Ransohoff DF, Appelman H, Fenoglio C, Haggitt R, Yardley JH, Ahren C, Correa P, Hamilton S, Morson BC, Sommers SC: Standardized nomenclature, terminology and criteria for dysplasia in inflammatory bowel disease with recommendations for patient management. Human Pathology. In Press. 1982
Author information
Authors and Affiliations
Additional information
Supported in part by the St. Mark's Hospital Research Foundation, the British Council, and Pharmacia Inc., USA
Rights and permissions
About this article
Cite this article
Butt, J.H., Konishi, F., Morson, B.C. et al. Macroscopic lesions in dysplasia and carcinoma complicating ulcerative colitis. Digest Dis Sci 28, 18–26 (1983). https://doi.org/10.1007/BF01393356
Received:
Revised:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01393356