Tsunoda Masato, Miura Yoshimasa, Osawa Hiroyuki, Khurelbaatar Tsevelnorov, Sakaguchi Mio, Fukuda Hisashi, Lefor Alan Kawarai, Yamamoto Hironori
Division of Gastroenterology, Department of Medicine, Jichi Medical University, Shimotsuke, Japan.
Department of Diagnostic Pathology, Jichi Medical University, Shimotsuke, Japan.
Clin Endosc. 2019 Sep;52(5):497-501. doi: 10.5946/ce.2018.195. Epub 2019 Apr 16.
A 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.
一名患有早期平坦型食管癌的62岁男性被转诊接受内镜治疗。白光成像显示为淡红色病变，而链接彩色成像（LCI）和蓝光激光成像（BLI）分别产生紫色和棕色图像。碘染色显示有一个大的未染色区域，伴有均匀但非常淡的粉红色征象。该区域在LCI和BLI上分别更清晰地呈现为紫色和绿色；然而，在碘未染色区域内的4点钟位置观察到一个不同颜色的部分。切除标本的组织病理学检查结果显示，4点钟位置为鳞状上皮内瘤变，其余碘未染色区域为食管鳞状细胞癌。LCI和BLI联合碘染色产生的特征性图像克服了粉红色征象，反映了平坦型食管肿瘤的组织学特征。这种新方法有助于对早期平坦型鳞状上皮肿瘤进行详细评估。
