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Diagnosis of Dysplasia in Ulcerative Colitis by Combined Light Microscopy and Scanning Electron Microscopy

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Inflammatory Bowel Diseases 1986

Part of the book series: Developments in Gastroenterology ((DIGA,volume 8))

Abstract

Patients with longstanding and extensive ulcerative colitis (UC) are at increased risk for the development of colonic carcinoma (1–3). The tumors tend to afflict younger patients and to present at an advanced stage of growth (4–7). To prevent this complication or to detect early lesions, it has been recommended that high risk patients have periodic surveillance by endoscopy and mucosal biopsy to identify epithelial dysplasia (8–12). Alternative terms for dysplasia have included precancer, adenomatous epithelium and precarcinoma (13–15). Dysplasia is defined as a neoplastic transformation and serves as a marker that the patient has or is exceptionally prone to develop a carcinoma (16). The finding of dysplasia, especially when it is associated with a mass lesion or when it persists in repeat biopsies, justifies serious consideration of a total colectomy even when there is no overt carcinoma evident (9,17). Dysplasia is currently identified by the light microscopic (LM) analysis of mucosal biopsies, but difficulties are often encountered in distinguishing dysplasia from the effects of active inflammation on the colonic epithelium (16). To assist in this distinction, we have employed scanning electron microscopy (SEM) with quantitative analyses which can be done in conjunction with standard light microscopy (18,19). This review will provide details of the LM and SEM studies and other techniques used in the diagnosis of epithelial dysplasia.

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Authors and Affiliations

  1. Departments of Pathology and Medicine, Beth Israel Hospital and Harvard Medical School, Boston, MA, USA

    Harvey Goldman (M.D.) & Helen M. Shields (M.D.)

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  1. Harvey Goldman
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  2. Helen M. Shields
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  1. Hadassah University Hospital, Jerusalem, Israel

    Daniel Rachmilewitz

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© 1986 Martinus Nijhoff Publishers

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Goldman, H., Shields, H.M. (1986). Diagnosis of Dysplasia in Ulcerative Colitis by Combined Light Microscopy and Scanning Electron Microscopy. In: Rachmilewitz, D. (eds) Inflammatory Bowel Diseases 1986. Developments in Gastroenterology, vol 8. Springer, Dordrecht. https://doi.org/10.1007/978-94-009-4269-1_12

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  • DOI: https://doi.org/10.1007/978-94-009-4269-1_12

  • Publisher Name: Springer, Dordrecht

  • Print ISBN: 978-94-010-8396-6

  • Online ISBN: 978-94-009-4269-1

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