Difference between revisions of "Dysplasia-associated lesion or mass"
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'''Dysplasia-associated lesion or mass''', abbreviated '''DALM''', was a clinico-pathologic diagnosis rendered in the context of [[inflammatory bowel disease]]. | '''Dysplasia-associated lesion or mass''', abbreviated '''DALM''', was a clinico-pathologic diagnosis rendered in the context of [[inflammatory bowel disease]]. | ||
''DALM'' is considered an obsolete term.<ref name=pmid29789648>{{cite journal |authors=Chiu K, Riddell RH, Schaeffer DF |title=DALM, rest in peace: a pathologist's perspective on dysplasia in inflammatory bowel disease in the post-DALM era |journal=Mod Pathol |volume=31 |issue=8 |pages=1180–1190 |date=August 2018 |pmid=29789648 |doi=10.1038/s41379-018-0068-9 |url=}}</ref> | |||
==General== | ==General== | ||
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Image: | Image: | ||
*[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3158393/figure/F7/ DALM (nlm.nih.gov)].<ref name=pmid21912466/> | *[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3158393/figure/F7/ DALM (nlm.nih.gov)].<ref name=pmid21912466/> | ||
==Sign out== | |||
*''DALM'' is considered obsolete; it should ''not'' be used. | |||
*''DALM'' was replaced by ''visible dysplasia''; the endoscopist saw a lesion. | |||
''Visible dysplasia'' is subdivided into: | |||
#Polypoid. | |||
#Non-polypoid. | |||
==See also== | ==See also== | ||
*[[Inflammatory bowel disease]]. | *[[Inflammatory bowel disease]]. | ||
*[[Invisible colonic dysplasia]]. | |||
==References== | ==References== | ||
Latest revision as of 19:32, 9 March 2021
Dysplasia-associated lesion or mass, abbreviated DALM, was a clinico-pathologic diagnosis rendered in the context of inflammatory bowel disease.
DALM is considered an obsolete term.[1]
General
- Proving invasive malignancy (on histopathologic grounds alone) in the setting of chronic inflammation is difficult.[2]
- The diagnosis depended on correlation of endoscopy and histopathology - important.[3]
- Biopsies are usually taken of the lesion and around the base.
- This diagnosis (DALM) typically lead to colectomy.
- The same histology today (2014) may be managed endoscopically.[4]
Gross
- Endoscopically "suspicious", i.e. endoscopist thinks this is a DALM - essential feature.
- Usually have a positive lifting sign.
Microscopic
Features:
- Cytologic dysplasia - as in adenomatous polyps - key feature.
- Flat or polypoid.[2]
DDx:
- Sporadic adenomatous polyp -- favouring sporadic:
Image:
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- DALM is considered obsolete; it should not be used.
- DALM was replaced by visible dysplasia; the endoscopist saw a lesion.
Visible dysplasia is subdivided into:
- Polypoid.
- Non-polypoid.
See also
References
- ↑ Chiu K, Riddell RH, Schaeffer DF (August 2018). "DALM, rest in peace: a pathologist's perspective on dysplasia in inflammatory bowel disease in the post-DALM era". Mod Pathol 31 (8): 1180–1190. doi:10.1038/s41379-018-0068-9. PMID 29789648.
- ↑ 2.0 2.1 Blackstone, MO.; Riddell, RH.; Rogers, BH.; Levin, B. (Feb 1981). "Dysplasia-associated lesion or mass (DALM) detected by colonoscopy in long-standing ulcerative colitis: an indication for colectomy.". Gastroenterology 80 (2): 366-74. PMID 7450425.
- ↑ 3.0 3.1 3.2 Neumann, H.; Vieth, M.; Langner, C.; Neurath, MF.; Mudter, J. (Jul 2011). "Cancer risk in IBD: how to diagnose and how to manage DALM and ALM.". World J Gastroenterol 17 (27): 3184-91. doi:10.3748/wjg.v17.i27.3184. PMID 21912466.
- ↑ East, JE.; Toyonaga, T.; Suzuki, N. (Jul 2014). "Endoscopic management of nonpolypoid colorectal lesions in colonic IBD.". Gastrointest Endosc Clin N Am 24 (3): 435-45. doi:10.1016/j.giec.2014.03.003. PMID 24975534.
- ↑ Fogt, F.; Urbanski, SJ.; Sanders, ME.; Furth, EE.; Zimmerman, RL.; Deren, JJ.; Noffsinger, AE.; Vortmeyer, AO. et al. (Mar 2000). "Distinction between dysplasia-associated lesion or mass (DALM) and adenoma in patients with ulcerative colitis.". Hum Pathol 31 (3): 288-91. PMID 10746669.