Table 3.

Terminology for reporting findings in surveillance colonic biopsy of inflammatory bowel disease patients

Location of biopsy	Endoscopic finding	Pathologic diagnosis	Implications
Outside of colitis region	Polyp or sessile lesions	Sporadic adenoma, hyperplastic polyp, or sessile serrated polyp	Complete removal with routine IBD annual surveillance
Inside of colitis region	Polyp (resectable)	Polypoid LGD or HGD	Complete removal with intensified surveillance
	Polyp (unresectable) on conventional colonoscopy	Polypoid LGD or HGD (should be confirmed by another GI pathologist)	IBD expert referral with chromoendoscopy or colonoscopy of high resolution: Resectable LGD or resectable HGD: complete removal with intensified surveillance Unresectable LGD: colectomy indicated Unresectable HGD: colectomy
	Visible but unresectable mass/lesion (elevated, flat, depressed) or invisible on conventional colonoscopy	LGD, HGD, or invasive adenocarcinoma (should be confirmed by another GI pathologist)	Focal LGD: intensified surveillance or referral to an IBD center for a repeat colonoscopy with high resolution and/or chromoendoscopy or colectomy (depending on clinical and endoscopic suspicion) HGD: colectomy Invasive adenocarcinoma: colectomy
	Sessile lesion	Sessile serrated polyp	Complete removal with routine IBD annual surveillance

IBD, inflammatory bowel disease; LGD, low-grade dysplasia; HGD, high-grade dysplasia.