Cannizzaro Renato, Maiero Stefania, Fornasarig Mara, Canzonieri Vincenzo, Magris Raffaella, Guarnieri Giovanni, Urbani Martina, Buonadonna Angela, Baresic Tanja, Spessotto Paola
Oncological Gastroenterology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy.
Pathology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy.
Onco Targets Ther. 2019 Jun 17;12:4577-4583. doi: 10.2147/OTT.S198034. eCollection 2019.
The potential role of the probe-based confocal laser endomicroscopy (pCLE) has been analyzed in different pathologic conditions of the gastrointestinal tract. Here, we analyzed a case of extrapulmonary high grade neuroendocrine rectal carcinoma (HGNEC) using, for the first time, the pCLE system. A 72-year old man was diagnosed with an 8 cm diameter rectal HGNEC by standard colonoscopy integrated with the pCLE system. The diagnosis of neuroendocrine carcinoma was confirmed by immunohistochemical analyses. By using the pCLE system, we well defined and resolved vascular structures and mucosal architecture. An altered mucosal pattern and vascular defects, peculiar for HGNEC, were observed at high magnification, allowing the identification of a pattern which was quite different from that observed in poorly differentiated adenocarcinomas (PDA) where tissues appear darker, very irregular, even if glandular structures can still be recognized. This underlines the usefulness of pCLE in discriminating HGNECs from PDAs. In conclusion, pCLE could represent a valid and helpful method for in vivo HGNEC diagnosis, allowing prompt and careful management of the patient.
基于探头的共聚焦激光内镜检查（pCLE）在胃肠道不同病理状况下的潜在作用已得到分析。在此，我们首次使用pCLE系统分析了一例肺外高级别神经内分泌直肠癌（HGNEC）病例。一名72岁男性通过结合pCLE系统的标准结肠镜检查被诊断为直径8厘米的直肠HGNEC。免疫组化分析证实了神经内分泌癌的诊断。通过使用pCLE系统，我们清晰地界定并分辨了血管结构和黏膜结构。在高倍放大下观察到了HGNEC特有的黏膜模式改变和血管缺陷，从而识别出一种与低分化腺癌（PDA）中观察到的模式截然不同的模式，在低分化腺癌中，组织显得更暗、非常不规则，即便仍可识别出腺管结构。这凸显了pCLE在鉴别HGNEC与PDA方面的有用性。总之，pCLE可能是一种用于体内HGNEC诊断的有效且有帮助的方法，有助于对患者进行及时且细致的管理。
