Colorectal Dysplasia in Inflammatory Bowel Disease: A Clinicopathologic Perspective  Matthew D. Rutter, Robert H. Riddell  Clinical Gastroenterology and Hepatology  Volume 12, Issue 3, Pages 359-367 (March 2014) DOI: 10.1016/j.cgh.2013.05.033 Copyright © 2014 AGA Institute Terms and Conditions

Figure 1 Paris 0–Is endoscopically unresectable dysplastic lesion. Clinical Gastroenterology and Hepatology 2014 12, 359-367DOI: (10.1016/j.cgh.2013.05.033) Copyright © 2014 AGA Institute Terms and Conditions

Figure 2 Paris 0-IIa/0-Is laterally spreading–type, granular, well-circumscribed endoscopically resectable dysplastic lesion. Clinical Gastroenterology and Hepatology 2014 12, 359-367DOI: (10.1016/j.cgh.2013.05.033) Copyright © 2014 AGA Institute Terms and Conditions

Figure 3 Typical colitic carcinoma of the tubuloglandular type. (A) Superficial villous mucosa with underlying invasion and numerous mucin pools. (B) Detail of carcinoma with mucin pool containing very small bland nuclei identical to those in panel D. (C) Detail of nodule in panel A that could have been biopsied. Note crypts meandering in all directions. (D) Detail of panel C shows very low-grade nuclei; the diagnosis of carcinoma is easy to miss. The architectural features with aberrant crypts in a pattern not seen in adenomas is the only suspicion of an underlying invasive component. Clinical Gastroenterology and Hepatology 2014 12, 359-367DOI: (10.1016/j.cgh.2013.05.033) Copyright © 2014 AGA Institute Terms and Conditions

Figure 4 (A) Very well-differentiated tubuloglandular adenocarcinoma forming well-defined crypts that infiltrate into muscularis propria (pink) with a subserosal mucin pool. (B) Detail shows an almost normal crypt within the muscle with minimal nuclear atypicality. Clinical Gastroenterology and Hepatology 2014 12, 359-367DOI: (10.1016/j.cgh.2013.05.033) Copyright © 2014 AGA Institute Terms and Conditions

Figure 5 Dysplastic lesions with (A) nondysplastic adjacent mucosa and (B and C) dysplastic mucosa. (A) The dysplastic nodule is right and the mucosa left has typical features of quiescent colitis. Had the nodule alone been resected, the biopsy of the adjacent mucosa (left) would have been nondysplastic. (B) A similar dysplastic nodule is present, but the adjacent mucosa to the left is also dysplastic and extends to the edge of the resection (far left). Had the nodule alone been resected, the adjacent mucosal biopsy specimens also would have been dysplastic. Clinical Gastroenterology and Hepatology 2014 12, 359-367DOI: (10.1016/j.cgh.2013.05.033) Copyright © 2014 AGA Institute Terms and Conditions