Dysplastic Crypts in Asymmetric Branching in Ulcerative Colitis: A Preliminary Report

Abstract

Aim: To report the detection of dysplastic crypts in asymmetric branching (DCAB) in biopsies from patients with ulcerative colitis (UC). Patients and Methods: One hundred consecutive endoscopic biopsies from patients with UC undergoing surveillance were reviewed. Results: Three biopsy/cases showed DCAB. The frequency of DCAB varied from two in one case, three in another case, and five in the remaining case. Conclusion: The final outcome of DCAB is to generate two or more dysplastic asymmetric offspring-crypts. Repeated DCAB offspring formation, together with new DCAB, would boost the pool of dysplastic crypts, resulting in an exponential expansion of the mucosal area occupied by dysplasia in UC.

The Number of Colon Crypts in Digital Mucosal Samples: A New Independent Parameter for Diagnosing Ulcerative Colitis

“…Importantly, out of the 237 biopsies showing ≥80% CCC, as many as 71% exhibited 100% CCC in individual biopsies. Similar percentages were found in control biopsies (13). Thus, most of the colon biopsies found in a routine setting often display cross-cut crypts.…”

“…We recently tested our subjective impression that most of the colon biopsies were also being crosscut at the laboratory (13). For that purpose, the percentage of routine biopsies with cross-cut crypts were assessed in 447 colon biopsies (376 with UC and 71 controls with mucosal inflammation: 50 with infectious colitis and 21 with sigmoid diverticulitis) (13). It was found that out of 376 colon biopsies with UC, 73% exhibited ≥60% CCC.…”

Crypts in Asymmetric Branching in Patients With Ulcerative Colitis in Remission

“…Chronic inflammation and protracted disease-duration in LLUC, increase the risk for colorectal dysplasia or carcinoma (22,23). In this context, dysplastic CAB were recently detected in patients with LLUC-associate dysplasia (24).…”