GIT Case dysplasia in IBD.

1. GIT Case:
Dysplasia prevention in IBD
Dr.Mohamed Al-Shekhani
December 2012

2. :History
• 40 years old man presented with BPR.
• Colonoscopy revealed endoscopic findings of
chronic pan ulcerative colitis with 3 polyps ; 2 in
the sigmoid colon & one in the splenic flexture,
biopsies taken from the polypoid lesions & the
colon as recommended.
• He had H/O BPR diagnosed as pancolitis before
10 years.
• He stopped his treatment after initial remission
with sulphasalazine,inspite of occasional
episodes of BPR.

3. Chronic UC with Polypoid
:structures

4. Dysplasia/cancer in IBD

6. Dysplasia Associated
Lesions or Masses
Non Adenoma Like
Adenoma Like
Mass or NALM or
Mass ALM not a
NALD or DALM
DALM
THE
DIFFERENCE
IS: CAN IT BE
REMOVED….
BY WHOM?

7. DIAGNOSIS OF DYSPLASIA
Macroscopic heterogeneity
Flat
Elevated (polyp-like, DALM, ALM)