Crohn's colitis with carcinoma and dysplasia. Report of a case and review of 100 small and large bowel resections for Crohn's disease to detect incidence of dysplasia.

A patient who developed invasive adenocarcinoma of the cecum after a 20-year history of Crohn's enterocolitis is reported. Histologic examination of the resected specimen showed widespread severe dysplasia in addition to the invasive carcinoma. An additional 100 randomly selected bowel resection specimens removed for Crohn's disease were reviewed to determine the frequency of epithelial dysplasia. Applying rigorous criteria, we found a 2% incidence of mild dysplasia; no instance of severe dysplasia was identified.