Crohn's vs UC/colon cancer

[DrKitty]

How do you differentiate stricture of left colon (Crohn's disease) from annular colon adenocarcinoma (association with ulcerative colitis) that constricts the left colon?

---

Members don't see this ad.

 

[LUBDUBB]

How do you differentiate stricture of left colon (Crohn's disease) from annular colon adenocarcinoma (association with ulcerative colitis) that constricts the left colon?

A diagnosis of Crohn's vs. UC

A stricture in UC is cancer until proven otherwise.

 

[yaah]

How do you differentiate stricture of left colon (Crohn's disease) from annular colon adenocarcinoma (association with ulcerative colitis) that constricts the left colon?

Biopsy and clinical features.

Sometimes you can't tell clinically. Classic crohn ulcers that stricture are more readily distinguishable. But sometimes they are short segment and the surrounding fibrosis mimics a mass (and thus cancer).

 

[GynGuy1983]

Is it true that anyone over 50 with a + stool guiac have colon cancer until proven otherwise?

 

[DrKitty]

Biopsy and clinical features.

Sometimes you can't tell clinically. Classic crohn ulcers that stricture are more readily distinguishable. But sometimes they are short segment and the surrounding fibrosis mimics a mass (and thus cancer).

Yes, this is exactly the scenario I was thinking about: clinical ambiguity and/or diagnosing solely based on the way the lesion looks in a gross specimen or in vivo (colonoscopy/endoscopy).

 

[yaah]

Well, then pay attention to what else they tell you. While patients don't read textbooks, questionmakers do. Thus, if the patient has anal fissures or fistulas of any kind or has small intestinal strictures, oral lesions, etc etc, they are more likely crohn than UC. Of course, you can have Crohn + cancer. Sometimes patients with long term Crohn ulcer/stricture develop cancer in the stricture.