PATHOLOGICAL DIAGNOSIS AND DIAGNOSTIC CONCEPTS IN INFLAMMATORY BOWEL DISEASE-ASSOCIATED NEOPLASIA

Abstract

Discrepancies between endoscopic findings and pathological diagnoses are frequently encountered during colorectal surveillance in patients with inflammatory bowel disease (IBD). These discrepancies arise from attempts to interpret inflammation-associated carcinogenesis using conventional frameworks developed for sporadic colorectal neoplasia. IBD-associated dysplasia develops via carcinogenic pathways that are distinct from the adenoma-carcinoma sequence and exhibits substantial morphological heterogeneity. Besides the traditional Riddell classification, emerging concepts, such as conventional and non-conventional dysplasia, and the SCENIC international consensus statement highlight the need to redefine the role of pathological diagnosis. Pathology should accurately assess the presence and grade of dysplasia, which should be integrated with endoscopic and clinical information for appropriate management.