Volume 115, Issue 6, Pages (December 1998)

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Volume 115, Issue 6, Pages 1566-1573 (December 1998) Multifocal neoplasia involving the colon and appendix in ulcerative colitis: Pathological and molecular features Mark H. Lyda*, Amy Noffsinger*, Jenine Belli*, Josef Fischer‡, Cecilia M. Fenoglio-Preiser* Gastroenterology Volume 115, Issue 6, Pages 1566-1573 (December 1998) DOI: 10.1016/S0016-5085(98)70037-X Copyright © 1998 American Gastroenterological Association Terms and Conditions

Fig. 1 Cecal lesion. (A) A photograph of the gross appearance of the cecum showing marked mucosal distortion. An oval plaque-like DALM is present. It is elevated above the surrounding mucosa. All of the mucosa is dysplastic. (B) Whole-mount section of the lesion shown in A. The elevated DALM can be seen at the right side of the section. The surrounding mucosa also appears dysplastic, although it is not as elevated. (C) Histological features of the DALMs demonstrating high-grade dysplasia. Gastroenterology 1998 115, 1566-1573DOI: (10.1016/S0016-5085(98)70037-X) Copyright © 1998 American Gastroenterological Association Terms and Conditions

Fig. 2 Transverse colonic lesion. (A) Gross appearance of the transverse colon, which seems finely nodular. Two small hemispheric masses are present (arrow). (B) Cross section to the hemispheric masses showing an area of whitish discoloration corresponding to invasive carcinoma (arrow). (C) Histological features of the invasive carcinoma. Gastroenterology 1998 115, 1566-1573DOI: (10.1016/S0016-5085(98)70037-X) Copyright © 1998 American Gastroenterological Association Terms and Conditions

Fig. 3 Appendiceal lesion. (A) Appendix opened longitudinally to reveal a papillary mass in the proximal portion. (B) Cross section through this mass shows the presence of long filiform-like mucosal projections. (C) Whole-mount photograph of the papillary mucinous cyst adenoma. (D) Higher magnification showing the presence of a dysplastic population of cells lining the villous fronds. The dysplasia was classified as low-grade dysplasia. Gastroenterology 1998 115, 1566-1573DOI: (10.1016/S0016-5085(98)70037-X) Copyright © 1998 American Gastroenterological Association Terms and Conditions

Fig. 4 Diagram of the areas of the mucosa that were sampled for genetic analyses. Areas outlined by a bold line correspond to DALMs. Specimens 1–10 are derived from the first resection specimen and specimens 11–18 from the second resection specimen. The numbers in the diagram correspond to the numbers found in Table 3. The distribution of areas of MIN, ras mutations, and p53 mutations are also indicated. RER, replication error; wt, wild type. Gastroenterology 1998 115, 1566-1573DOI: (10.1016/S0016-5085(98)70037-X) Copyright © 1998 American Gastroenterological Association Terms and Conditions

Fig. 5 Ras and p53 mutations. (A and B) Ras mutations; (C and D) p53 mutations. (A) Ras mutation present in specimens 7 and 8, in which GGT is mutated to GAT. (B) Ras mutation present in specimens 2–4 and 6 in which GGC is mutated to TGC. (C) p53 mutation found in specimens 11–13 in which GTG is mutated to ATG. (D) p53 mutation found in specimen 3 in which CGC is mutated to CAC. Gastroenterology 1998 115, 1566-1573DOI: (10.1016/S0016-5085(98)70037-X) Copyright © 1998 American Gastroenterological Association Terms and Conditions