Microscopic features of colorectal neoplasia in inflammatory bowel diseases.
The risk of developing dysplasia leading to colorectal cancer (CRC) is increased in both ulcerative colitis and Crohn's disease. The prognosis of CRC may be poorer in patients with inflammatory bowel disease (IBD) than in those without IBD. Most CRCs, in general, develop from a dysplastic precursor lesion. The interpretation by the pathologist of the biopsy will guide decision making in clinical practice: colonoscopic surveillance or surgical management. This review summarizes features of dysplasia (or intraepithelial neoplasia) with macroscopic and microscopic characteristics. From an endoscopic (gross) point of view, dysplasia may be classified as flat or elevated (raised); from a histological point of view, dysplasia is separated into 3 distinct categories: negative for dysplasia, indefinite for dysplasia, and positive for dysplasia with low- or high-grade dysplasia. The morphologic criteria for dysplasia are based on a combination of cytologic (nuclear and cytoplasmic) and architectural aberrations of the crypt epithelium. Immunohistochemical and molecular markers for dysplasia are reviewed and may help with dysplasia diagnosis, although diagnosis is essentially based on morphological criteria. The clinical, epidemiologic, and pathologic characteristics of IBD-related cancers are, in many aspects, different from those that occur sporadically in the general population. Herein, we summarize macroscopic and microscopic features of IBD-related colorectal carcinoma.
Aude Bressenot, Virginie Cahn, Department of pathology, University Hospital of Nancy, 54500 Vandoeuvre-lès-Nancy, France.
Aude
A
Bressenot
Aude Bressenot, Virginie Cahn, Department of pathology, University Hospital of Nancy, 54500 Vandoeuvre-lès-Nancy, France.
Virginie
V
Cahn
Aude Bressenot, Virginie Cahn, Department of pathology, University Hospital of Nancy, 54500 Vandoeuvre-lès-Nancy, France.
Silvio
S
Danese
Aude Bressenot, Virginie Cahn, Department of pathology, University Hospital of Nancy, 54500 Vandoeuvre-lès-Nancy, France.
Laurent
L
Peyrin-Biroulet
D001706:Biopsy; D002277:Carcinoma / Q000150:complications / Q000473:pathology; D002471:Cell Transformation, Neoplastic / Q000473:pathology; D003093:Colitis, Ulcerative / Q000150:complications / Q000473:pathology; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000150:complications* / Q000473:pathology*; D003424:Crohn Disease / Q000150:complications / Q000473:pathology; D018450:Disease Progression; D006801:Humans; D007150:Immunohistochemistry; D007249:Inflammation; D015212:Inflammatory Bowel Diseases / Q000150:complications* / Q000473:pathology*; D007410:Intestinal Diseases / Q000473:pathology*; D011379:Prognosis; D012307:Risk Factors
Colorectal cancer; Dysplasia; Inflammatory bowel disease; Microscopic features