Tsunoda M1, Miura Y1, Osawa H1, Khurelbaatar T1, Sakaguchi M2, Fukuda H1, Lefor AK3, Yamamoto H1.
Clin Endosc. 2019 Apr 16. doi: 10.5946/ce.2018.195. [Epub ahead of print]
62-year-old man with a flat early esophageal cancer was referred for endoscopic treatment. White light imaging revealed a pale red lesion, whereas linked color imaging (LCI) and blue laser imaging (BLI) yielded purple and brown images, respectively. Iodine staining demonstrated a large unstained area with a homogenous but very weak pink-color sign. This area appeared more clearly as purple and green on LCI and BLI, respectively; however, a different colored portion was observed at the 4 o’clock position inside the iodineunstained area. Histopathology findings of the resected specimen revealed squamous intraepithelial neoplasia at the 4 o’clock position and an esophageal squamous cell carcinoma in the remaining iodine-unstained area. LCI and BLI combined with iodine staining produce characteristic images that overcomes the pink-color sign, reflecting the histological features of a flat esophageal neoplasm. This new method is useful for detailed evaluation of early flat squamous cell neoplasms.
1 Division of Gastroenterology, Department of Medicine
2 Department of Diagnostic Pathology
3 Department of Surgery, Jichi Medical University, Shimotsuke, Japan