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Difference between revisions of "Dysplasia-associated lesion or mass"
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Dysplasia-associated lesion or mass (view source)
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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== | ||
*Proving invasive malignancy (on histopathologic grounds alone) in the setting of chronic inflammation is difficult.<ref name=pmid7450425>{{Cite journal | last1 = Blackstone | first1 = MO. | last2 = Riddell | first2 = RH. | last3 = Rogers | first3 = BH. | last4 = Levin | first4 = B. | title = Dysplasia-associated lesion or mass (DALM) detected by colonoscopy in long-standing ulcerative colitis: an indication for colectomy. | journal = Gastroenterology | volume = 80 | issue = 2 | pages = 366-74 | month = Feb | year = 1981 | doi = | PMID = 7450425 }}</ref> | *Proving invasive malignancy (on histopathologic grounds alone) in the setting of chronic inflammation is difficult.<ref name=pmid7450425>{{Cite journal | last1 = Blackstone | first1 = MO. | last2 = Riddell | first2 = RH. | last3 = Rogers | first3 = BH. | last4 = Levin | first4 = B. | title = Dysplasia-associated lesion or mass (DALM) detected by colonoscopy in long-standing ulcerative colitis: an indication for colectomy. | journal = Gastroenterology | volume = 80 | issue = 2 | pages = 366-74 | month = Feb | year = 1981 | doi = | PMID = 7450425 }}</ref> | ||
* | *The diagnosis depended on correlation of endoscopy and histopathology - '''important'''.<ref name=pmid21912466>{{Cite journal | last1 = Neumann | first1 = H. | last2 = Vieth | first2 = M. | last3 = Langner | first3 = C. | last4 = Neurath | first4 = MF. | last5 = Mudter | first5 = J. | title = Cancer risk in IBD: how to diagnose and how to manage DALM and ALM. | journal = World J Gastroenterol | volume = 17 | issue = 27 | pages = 3184-91 | month = Jul | year = 2011 | doi = 10.3748/wjg.v17.i27.3184 | PMID = 21912466 }}</ref> | ||
**Biopsies are usually taken of the lesion and around the base. | **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.<ref name=pmid24975534>{{Cite journal | last1 = East | first1 = JE. | last2 = Toyonaga | first2 = T. | last3 = Suzuki | first3 = N. | title = Endoscopic management of nonpolypoid colorectal lesions in colonic IBD. | journal = Gastrointest Endosc Clin N Am | volume = 24 | issue = 3 | pages = 435-45 | month = Jul | year = 2014 | doi = 10.1016/j.giec.2014.03.003 | PMID = 24975534 }}</ref> | ||
</ref> | |||
==Gross== | ==Gross== | ||
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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== | ||