Interobserver Agreement in the Diagnosis of Inflammatory Bowel Disease-Associated Neoplasia in China in Comparison to Subspecialized American Gastrointestinal Pathologists

Figure 1

Examples of colonic biopsies with consensus diagnoses by US pathologists were concurred by all 4 Chinese pathologists. (a) There was cryptal distortion, but without nuclear enlargement and hyperchromasia. Surface maturation was present. This case was interpreted as negative for dysplasia (H&E, 200x). (b) This biopsy showed hyperchromatic and enlarged nuclei without surface maturation. The overall features supported a diagnosis of low-grade dysplasia (H&E, 200x). (c) This colonic biopsy showed hyperchromatic nuclei without surface maturation. There was focal nuclear pleomorphism, loss of polarity, and architectural complexity, thus was interpreted as high-grade dysplasia (H&E, 200x). (d) This colonic biopsy showed proliferation of small glands with nuclear pleomorphism and loss of polarity, and desmoplasia, features diagnostic of invasive adenocarcinoma (H&E, 200x).

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