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. 1990 Dec;31(12):1382–1386. doi: 10.1136/gut.31.12.1382

Rectal mucosal dysplasia in Crohn's disease.

B I Korelitz 1, G Y Lauwers 1, S C Sommers 1
PMCID: PMC1378761  PMID: 2265778

Abstract

Serial sections of 812 rectal biopsy specimens from 356 Crohn's disease patients were analysed for mucosal epithelial dysplasia. Dysplasia was found in 18 patients (5%), with four showing dysplasia on repeat biopsy specimen. In these 22 biopsy specimens the dysplasia was mild in 13, moderate in nine, and severe in none. Subsequently, three patients (17%) developed neoplasms including carcinoma in two and an adenomatous polyp in one. In colectomy specimens which showed dysplasia, significantly more dysplastic changes were found in seven patients who underwent colonic resection than in 10 others who underwent operation but had no prior dysplasia (p less than 0.001). Thirteen patients still have their rectum in situ and remain at risk of developing colonic cancer. Four carcinomas developed in patients with Crohn's disease who did not have dysplasia on rectal biopsy specimen.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Castellano T. J., Frank M. S., Brandt L. J., Mahadevia P. Metachronous carcinoma complicating Crohn's disease. Arch Intern Med. 1981 Jul;141(8):1074–1075. [PubMed] [Google Scholar]
  2. Cooper D. J., Weinstein M. A., Korelitz B. I. Complications of Crohn's disease predisposing to dysplasia and cancer of the intestinal tract: considerations of a surveillance program. J Clin Gastroenterol. 1984 Jun;6(3):217–224. [PubMed] [Google Scholar]
  3. Craft C. F., Mendelsohn G., Cooper H. S., Yardley J. H. Colonic "precancer" in Crohn's disease. Gastroenterology. 1981 Mar;80(3):578–584. [PubMed] [Google Scholar]
  4. Fochios S. E., Korelitz B. I. The role of sigmoidoscopy and rectal biopsy in diagnosis and management of inflammatory bowel disease: personal experience. Am J Gastroenterol. 1988 Feb;83(2):114–119. [PubMed] [Google Scholar]
  5. Fochios S. E., Sommers S. C., Korelitz B. I. Sigmoidoscopy and biopsy in surveillance for cancer in ulcerative colitis. J Clin Gastroenterol. 1986 Jun;8(3 Pt 1):249–254. doi: 10.1097/00004836-198606000-00009. [DOI] [PubMed] [Google Scholar]
  6. Greenstein A. J., Sachar D. B., Smith H., Janowitz H. D., Aufses A. H., Jr A comparison of cancer risk in Crohn's disease and ulcerative colitis. Cancer. 1981 Dec 15;48(12):2742–2745. doi: 10.1002/1097-0142(19811215)48:12<2742::aid-cncr2820481231>3.0.co;2-p. [DOI] [PubMed] [Google Scholar]
  7. Gyde S. N., Prior P., Macartney J. C., Thompson H., Waterhouse J. A., Allan R. N. Malignancy in Crohn's disease. Gut. 1980 Dec;21(12):1024–1029. doi: 10.1136/gut.21.12.1024. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Hamilton S. R. Colorectal carcinoma in patients with Crohn's disease. Gastroenterology. 1985 Aug;89(2):398–407. doi: 10.1016/0016-5085(85)90343-9. [DOI] [PubMed] [Google Scholar]
  9. Korelitz B. I. Carcinoma of the intestinal tract in Crohn's disease: results of a survey conducted by the National Foundation for Ileitis and colitis. Am J Gastroenterol. 1983 Jan;78(1):44–46. [PubMed] [Google Scholar]
  10. Morson B. C., Pang L. S. Rectal biopsy as an aid to cancer control in ulcerative colitis. Gut. 1967 Oct;8(5):423–434. doi: 10.1136/gut.8.5.423. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Morson B. C. Rectal biopsy in inflammatory bowel disease. N Engl J Med. 1972 Dec 28;287(26):1337–1339. doi: 10.1056/NEJM197212282872607. [DOI] [PubMed] [Google Scholar]
  12. Myrvold H. E., Kock N. G., Ahrén C. Rectal biopsy and precancer in ulcerative colitis. Gut. 1974 Apr;15(4):301–304. doi: 10.1136/gut.15.4.301. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Nugent F. W., Haggit R. C., Colcher H., Kutteruf G. C. Malignant potential of chronic ulcerative colitis. Preliminary report. Gastroenterology. 1979 Jan;76(1):1–5. [PubMed] [Google Scholar]
  14. Riddell R. H., Goldman H., Ransohoff D. F., Appelman H. D., Fenoglio C. M., Haggitt R. C., Ahren C., Correa P., Hamilton S. R., Morson B. C. Dysplasia in inflammatory bowel disease: standardized classification with provisional clinical applications. Hum Pathol. 1983 Nov;14(11):931–968. doi: 10.1016/s0046-8177(83)80175-0. [DOI] [PubMed] [Google Scholar]
  15. Riddell R. H., Morson B. C. Value of sigmoidoscopy and biopsy in detection of carcinoma and premalignant change in ulcerative colitis. Gut. 1979 Jul;20(7):575–580. doi: 10.1136/gut.20.7.575. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Shamsuddin A. K., Phillips R. M. Preneoplastic and neoplastic changes in colonic mucosa in Crohn's disease. Arch Pathol Lab Med. 1981 Jun;105(6):283–286. [PubMed] [Google Scholar]
  17. Shorter R. G. Risks of intestinal cancer in Crohn's disease. Dis Colon Rectum. 1983 Oct;26(10):686–689. doi: 10.1007/BF02553347. [DOI] [PubMed] [Google Scholar]
  18. Simpson S., Traube J., Riddell R. H. The histologic appearance of dysplasia (precarcinomatous change) in Crohn's disease of the small and large intestine. Gastroenterology. 1981 Sep;81(3):492–501. [PubMed] [Google Scholar]
  19. Traube J., Simpson S., Riddell R. H., Levin B., Kirsner J. B. Crohn's disease and adenocarcinoma of the bowel. Dig Dis Sci. 1980 Dec;25(12):939–944. doi: 10.1007/BF01308045. [DOI] [PubMed] [Google Scholar]
  20. Warren R., Barwick K. W. Crohn's colitis with carcinoma and dysplasia. Report of a case and review of 100 small and large bowel resections for Crohn's disease to detect incidence of dysplasia. Am J Surg Pathol. 1983 Mar;7(2):151–159. [PubMed] [Google Scholar]
  21. Weedon D. D., Shorter R. G., Ilstrup D. M., Huizenga K. A., Taylor W. F. Crohn's disease and cancer. N Engl J Med. 1973 Nov 22;289(21):1099–1103. doi: 10.1056/NEJM197311222892101. [DOI] [PubMed] [Google Scholar]

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