Dysplasia-associated lesion or mass (DALM) detected by colonoscopy in long-standing ulcerative colitis: an indication for colectomy.
Gastroenterology
; 80(2): 366-74, 1981 Feb.
Article
em En
| MEDLINE
| ID: mdl-7450425
ABSTRACT
In performing colonoscopy over a 4-yr period on 112 patients with long-standing ulcerative colitis, a dysplasia-associated lesion or mass (DALM) was found in 12. This appeared as either a single polypoid mass (5 cases), a plaquelike lesion (2 cases), or multiple polyps (5 cases). In 7 of these 12 cases carcinoma was subsequently found. This was particularly true in the 5 cases of single polypoid masses where all 5 contained invasive carcinoma. In none of the cases associated with malignancy did multiple biopsies of the DALM reveal invasive carcinoma. In only 2 of the 7 patients with carcinoma was the dysplasia "severe," being "mild" or "moderate" in the remaining 5. In the 27 patients with dysplasia found incidentally in random biopsies of flat mucosa only one carcinoma was found, in contrast to the 7 cancers in 12 patients with DALM. This difference leads us to regard the finding of DALM, especially a single polypoid mass, as highly significant in patients with long-standing ulcerative colitis. It carries a sufficiently high risk of cancer, thereby constituting a strong indication for colectomy.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Colite Ulcerativa
/
Colonoscopia
/
Colo
/
Neoplasias do Colo
Tipo de estudo:
Diagnostic_studies
/
Risk_factors_studies
Limite:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Gastroenterology
Ano de publicação:
1981
Tipo de documento:
Article