Flat Dysplasia: Ninjas of the Colon

12 August 2008 in medicine | No comments

Flat dysplastic lesions are the ninjas of the colon: they’re deadly, they’re hard to find, and nobody really knows how common they are. My last hurrah in medical school (for two years, at least) was a presentation on flat colonic dysplasia at the colorectal surgery/gastroenterology conference. Whether you’re planning on a career in general surgery or primary care, these lesions are important - they have a higher rate of malignant transformation than normal polyps and are difficult to locate using standard endoscopic techniques, so you should know enough about them to counsel your patients about appropriate surveillance and therapy. Without special training or chromoendoscopy, most American endoscopists miss these lesions! That newfangled CT colonography is also terrible at picking them up. If you’ve just got to know more, the best recent reference I found is Soetikno’s 2008 paper in JAMA.

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