講演情報
[JKS2-2]Diagnosis for Benign Diseases
Jun Woo Bong (Korea University Guro Hospital)
A wide spectrum of benign colorectal lesions may be identified during colonoscopy, many with clinical importance for symptoms, surveillance, and differentiation from malignancy. The most common are colorectal polyps: adenomas (tubular, villous, tubulovillous) that are precancerous; hyperplastic polyps, small and pale in the distal colon; and sessile serrated lesions, subtle and mucus-covered in the proximal colon. Juvenile and hamartomatous polyps appear lobulated or pedunculated and may occur in syndromic contexts. Complete removal and histology-based surveillance are essential.
Inflammatory diseases include ulcerative colitis (continuous from rectum), Crohn’s disease (skip lesions, cobblestoning), microscopic colitis (normal endoscopy, histology-based), eosinophilic colitis, ischemic colitis (segmental erythema/ulceration in watershed zones), radiation colitis (telangiectasia, strictures), and SCAD (localized sigmoid inflammation near diverticula).
Structural and other benign conditions include diverticulosis/diverticulitis, solitary rectal ulcer syndrome, melanosis coli, and pneumatosis coli. Vascular lesions encompass angiodysplasia, hemorrhoids, and rectal prolapse. Subepithelial lesions include lipomas, leiomyomas, duplication cysts, and rare endometriosis affecting the rectosigmoid.
Advanced imaging (high-definition, NBI, chromoendoscopy) enhances detection, enabling targeted biopsy, removal, and surveillance. Recognizing these diverse benign lesions ensures accurate diagnosis, tailored management, and improved outcomes.
Inflammatory diseases include ulcerative colitis (continuous from rectum), Crohn’s disease (skip lesions, cobblestoning), microscopic colitis (normal endoscopy, histology-based), eosinophilic colitis, ischemic colitis (segmental erythema/ulceration in watershed zones), radiation colitis (telangiectasia, strictures), and SCAD (localized sigmoid inflammation near diverticula).
Structural and other benign conditions include diverticulosis/diverticulitis, solitary rectal ulcer syndrome, melanosis coli, and pneumatosis coli. Vascular lesions encompass angiodysplasia, hemorrhoids, and rectal prolapse. Subepithelial lesions include lipomas, leiomyomas, duplication cysts, and rare endometriosis affecting the rectosigmoid.
Advanced imaging (high-definition, NBI, chromoendoscopy) enhances detection, enabling targeted biopsy, removal, and surveillance. Recognizing these diverse benign lesions ensures accurate diagnosis, tailored management, and improved outcomes.