Non‐conventional dysplasia in inflammatory bowel disease is more frequently associated with advanced neoplasia and aneuploidy than conventional dysplasia

Aims Several different non‐conventional morphological patterns of epithelial dysplasia have been recently described in inflammatory bowel disease (IBD), but there is limited information regarding their clinicopathological and molecular features, as well as potential risk for high‐grade dysplasia (HG...

Full description

Saved in:
Bibliographic Details
Published in:Histopathology 2021-05, Vol.78 (6), p.814-830
Main Authors: Lee, Hannah, Rabinovitch, Peter S, Mattis, Aras N, Lauwers, Gregory Y, Choi, Won‐Tak
Format: Article
Language:English
Subjects:
Adenoma
Aneuploidy
Biopsy
Cell differentiation
colorectal cancer
Colorectal carcinoma
DNA flow cytometry
Dysplasia
Flow cytometry
Genomic instability
Inflammatory bowel disease
Inflammatory bowel diseases
Intestine
Lesions
Morphology
Tumors
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Aims Several different non‐conventional morphological patterns of epithelial dysplasia have been recently described in inflammatory bowel disease (IBD), but there is limited information regarding their clinicopathological and molecular features, as well as potential risk for high‐grade dysplasia (HGD) or colorectal cancer (CRC) compared with conventional dysplasia developing in IBD. Methods and results A total of 317 dysplastic lesions from 168 IBD patients were analysed. All lesions were re‐reviewed and subtyped as either conventional [including tubular adenoma‐like (n = 183) and tubulovillous/villous adenoma‐like (n = 56)] or non‐conventional dysplasia [including dysplasia with increased Paneth cell differentiation (DPD, n = 40), crypt cell dysplasia (CCD, n = 14), goblet cell deficient (GCD, n = 10), hypermucinous (n = 7), sessile serrated lesion (SSL)‐like (n = 4) and traditional serrated adenoma (TSA)‐like (n = 3)]. DNA flow cytometry was performed on 70 low‐grade conventional (n = 24) and non‐conventional (n = 46) dysplastic biopsies to determine their malignant potential and molecular pathways to HGD or CRC. Eleven sporadic tubular adenomas with low‐grade dysplasia (LGD) were utilised as controls. Seventy‐eight non‐conventional dysplastic lesions were identified in 56 (33%) of the 168 patients, whereas 239 conventional dysplastic lesions were identified in 149 (89%) patients. Although both non‐conventional and conventional dysplasias were most often graded as LGD at diagnosis (83% and 84%, respectively), non‐conventional dysplasia (38%) was more likely to develop HGD or CRC in the same colonic segment than conventional dysplasia (19%) on follow‐up (P 
ISSN:0309-0167
1365-2559
DOI:10.1111/his.14298