With a magnifying colonoscope and dye, another world is revealed.
WHAT IS SHOWN IN THIS PHOTOGRAPH?
■ Crypt distortion
No, these crypts are MUTATED!
■ Abberant crypt focus
You know your stuff!
■ Small flat adenoma
Histologically, you could be correct!
The link between ACF and proximal adenomas, I see as evidence of a colonic “field effect” in which exposure to carcinogenic 'drivers' (dietary, lifestyle, disease and genetic) all work together to prime the colon for the development of cancer. It's for this reason, that endoscopically resecting DALM's (I arbitrarily define DALM's as flat polyps within the colitic field of a patient with >6 yrs of colitis), then telling patients that they now have nothing to worry about, is naïve ...