Collagenous Colitis: A Clinical and Demographic Review of 2,368 Cases

Jeremy S. Ditelberg MD, Miraca Life Sciences Research Institute, Newton, MA

High-grade dysplasia (HGD) in colorectal adenomas is relevant for follow-up and management of patients with polyps. While some authors advocate that the presence of high-grade dysplasia in adenomas should be part of the routine pathology report (Rex, Goldblum, Hornick, Odze), others prefer not to report it (Appleman).

The study by Toll et al, demonstrates that patients who have a colorectal adenoma > 1 cm with high-grade dysplasia may be at high risk of developing further adenomas with high-grade dysplasia or carcinoma. Prior studies by Bertagne et al have described HGD in up to 32% of patients with adenomas. The aim of this study was to determine the rate of the HGD in a large cohort of US outpatient colonoscopy patients.

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