Jeremy S. Ditelberg MD, Inform Diagnostics 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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