Additional Crypt Phenotypes Lined With High-Grade Cellular Dysplasia in Protruding Growths in Ulcerative Colitis

Two crypt phenotypes (ACP): crypt rings in tandem (CRT) and crypts with lateral budding's (CLB's) were recently found interpolated amidst generally accepted crypt phenotypes (GACP, i.e., tubular, tubulovillous, villous and serrated). The frequency of cases with UC-PDG, with CRT and with CLB's in GACP and in UC-associated sporadic adenomas (UC-aspa) was recorded. The possibility that the presence of ACP could increase histological discrimination between UC-PDG and UC-aspa was also explored. Two hundred digitalized biopsy-cases were investigated: 100 with UC-PDG and 100 with UC-aspa. Six GACP and two types of cellular dysplasia: low-grade (LGD) and high-grade dysplasia (HGD) were found. CRT and CLB's were present in 66% of the 200 cases. A significantly higher number of cases with villous phenotype wihout or with HGD, with CLB's phenotype without or with HGD, and with tubulovillous phenotype with HGD were found in UC-PDG than in UC-asta. Several authors found no significant difference in the histological characteristics between UC-protruding dysplastic lesions and US-aspa. This work reveals, however, that the different number of cases with the above-mentioned histological parameters present in each group permitted to discriminate between UC-PDG and UC-asta.