Endoscopic and pathological aspects of colitis-associated dysplasia

Fiona D M van Schaik, G. Johan A Offerhaus, Marguerite E I Schipper, Peter D. Siersema, Frank P. Vleggaar, Bas Oldenburg

Research output: Contribution to journalArticlepeer-review


The risk of developing colorectal cancer in patients with colitis-associated dysplasia is considerable. Surveillance programs in patients with ulcerative colitis and Crohn's disease aim to detect dysplastic lesions early and rely heavily on taking random biopsy samples along the length of the colon. Diagnosing dysplasia can be difficult because of the heterogenous endoscopic appearance of dysplasia and the poor interobserver agreement among pathologists when grading dysplasia. Colitis-associated dysplasia may present as a dysplasia-associated lesion or mass (DALM), which may be indistinguishable from a sporadic adenoma in non-colitic tissue, or may arise in flat mucosa of endoscopically normal appearance. Information about the endoscopic appearance, the colonic distribution and the histopathological grade of colitis-associated dysplasia is required to define the optimal treatment. This Review summarizes the endoscopic and histopathological features of colitis-associated dysplasia and the requirements for optimal interaction between endoscopists and pathologists, with the aim of reducing the uncertainties in the diagnosis of dysplastic lesions and improving the management of colitis-associated dysplasia.

Original languageEnglish (US)
Pages (from-to)671-678
Number of pages8
JournalNature Reviews Gastroenterology and Hepatology
Issue number11
StatePublished - 2009
Externally publishedYes

ASJC Scopus subject areas

  • Gastroenterology
  • Hepatology


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