Hypermucinous, Goblet Cell Deficient, and Crypt Cell Dysplasias in Inflammatory Bowel Disease are Often Associated with Flat/Invisible Endoscopic Appearance and Advanced Neoplasia on Follow-Up.

Hypermucinous, goblet cell deficient, and crypt cell dysplasias have distinct clinicopathologic features but appear to have a similar high risk of association with advanced neoplasia (HGD or adenocarcinoma). Greater than half of the lesions (66%) presented as flat/invisible dysplasia, suggesting that IBD patients may benefit from random biopsy sampling in addition to targeted biopsies. Although not uncommonly associated with conventional dysplasia, non-conventional dysplasia may be the only dysplastic subtype identified in IBD patients. Therefore, it is important to recognize these non-conventional subtypes and recommend complete removal and/or careful examination and follow-up.