Difference between revisions of "Dysplasia-associated lesion or mass"

From Libre Pathology
Jump to navigation Jump to search
(split out)
Line 1: Line 1:
'''Dysplasia-associated lesion or mass''', abbreviated ''DALM'', is a clinico-pathologic diagnosis seen in the context of [[inflammatory bowel disease]].
'''Dysplasia-associated lesion or mass''', abbreviated '''DALM''', is a clinico-pathologic diagnosis seen in the context of [[inflammatory bowel disease]].


==General==
==General==

Revision as of 19:22, 4 September 2014

Dysplasia-associated lesion or mass, abbreviated DALM, is a clinico-pathologic diagnosis seen in the context of inflammatory bowel disease.

General

  • Proving invasive malignancy (on histopathologic grounds alone) in the setting of chronic inflammation is difficult.[1]
  • This diagnosis depends on correlation of endoscopy and histopathology - important.[2]
    • Biopsies are usually taken of the lesion and around the base.
  • Historically, this diagnosis lead to colectomy.
    • It may be managed endoscopically in the context of modern endoscopy.[3]

Gross

  • Endoscopically "suspicious", i.e. endoscopist thinks this is a DALM - essential feature.
    • Usually have a positive lifting sign.

Microscopic

Features:

DDx:

  • Sporadic adenomatous polyp -- favouring sporadic:
    • Sharp transition between lesion and the surrounding tissue.[2]
    • Polyps not at site of active disease.[4]

Image:

See also

References

  1. ↑ 1.0 1.1 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.
  2. ↑ 2.0 2.1 2.2 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.
  3. ↑ 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.
  4. ↑ 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.
Retrieved from "https://librepathology.org/w/index.php?title=Dysplasia-associated_lesion_or_mass&oldid=33305"