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Dysplasia in ulcerative colitis — ESEGH MCQ

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HardGI CancerDysplasia in ulcerative colitisESEGH

A 55-year-old man with long-standing pancolitis undergoes surveillance chromoendoscopy. A 14 mm slightly raised lesion in the transverse colon is resected en bloc. Histology shows low-grade dysplasia with clear margins, and biopsies from surrounding mucosa are negative. What is the most appropriate management?

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Correct answer: A — Complete endoscopic resection followed by close surveillance

The best answer is “Complete endoscopic resection followed by close surveillance”. Endoscopic resection with close surveillance The alternatives “Repeat faecal calprotectin in 6 months”, “Start oral prednisolone, when clinically appropriate”, “No further colonoscopic surveillance, after specialist review”, “Immediate proctocolectomy for any dysplasia” are plausible in related gastroenterology presentations but do not match the defining finding, threshold, sequence or UK pathway in this stem.

Reference: BSG inflammatory bowel disease guideline: https://gut.bmj.com/content/68/Suppl_3/s1