The histological diagnosis of dysplastic and neoplastic lesions in inflammatory bowel disease: a pathological perspective.Acta Chir Iugosl. 2004;51(2):109-16.

Patients with inflammatory bowel disease (IBD), both ulcerative colitis (UC) and Crohn's disease (CD), are at an increased risk for developing colorectal carcinoma (CRC). The accurate diagnosis of dysplasia in biopsies taken during periodic surveillance of long-standing IBD patients is most important in prevention of UC and CD related cancer. Distinction of low from high grade IBD-related dysplasia and differential diagnosis between IBD-related dysplasia and dysplasia in sporadic adenoma as well as distinction from pseudodysplastic lesions in inflammatory pseudopolyps or reparative lesions is often very subtle and difficult and demands expertise of second experienced gastrointestinal pathologist. Although surveillance colonoscopy with multiple biopsies does not reduce the cancer mortality, it offers a reasonable chance of detecting precancer and performed prophylactic colectomy. Novel methods of detecting dysplasia are continuously being evaluated, including chromoscopy and molecular biology markers. In the future, one may expect, from these new markers to detect the dysplasia in IBD patients before development of histological evidence of neoplastic changes.

Colocolonic intussusception of a giant pseudopolyp in a patient with ulcerative colitis: a case report and review of the literature.Inflamm Bowel Dis. 2004 Jan;10(1):41-4.

Adult intussusception in the setting of inflammatory bowel disease (IBD) is a rare phenomenon. Giant pseudopolyps, while generally considered benign, may function as lead points for intussusception. Diagnosis and management of intussusception in the setting of IBD can be fraught with hazards. We report the case of a 27-year-old male, recently diagnosed with ulcerative colitis and giant pseudopolyps, who presented with colocolonic intussusception and obstruction. Diagnosis was confirmed using CT imaging and the patient underwent resection of the colocolonic intussusception without reduction. The following case underscores the challenges in managing adult intussusception in the setting of IBD and allows for a review of the literature to date. Resection of non-reduced intussusception, rather than endoscopic or enema reduction, should continue to be definitive treatment of patients presenting with this unusual problem.

Total obliteration of colonic lumen by localized giant inflammatory polyposis in ulcerative colitis: report of a Japanese case. Intern Med. 1996 Jan;35(1):24-9

Although inflammatory polyposis of the colon is a recognized local complication of ulcerative colitis, giant inflammatory polyposis that totally obliterates the colonic lumen is uncommon, and most of the patients have been from Western countries. We report a Japanese man who had localized giant inflammatory polyposis that obstructed the retrograde flow of barium in a double-contrast barium enema study at the splenic flexure in ulcerative colitis. After resection by total proctocolectomy and ileostomy, pathological examination of the specimen confirmed localized giant inflammatory polyposis in the descending colon and spelnic flexure without malignancy.