| Theme | How to Confirm IIc Lesion | |
|---|---|---|
| Title | Differential diagnosis of superficial depressed adenoma and carcinoma of the colorectum by electronic endoscopy | |
| Publish Date | 1997/03 | |
| Author | Hiroyuki Kobayashi | Institute of Gastroenterogy, Matsuyama Red Cross Hospital |
| [ Summary ] | The authors herein review the literature and investigate the usefulness of electronic endoscopy for the differential diagnosis of superficial depressed adenoma and carcinoma of the colorectum by electronic endoscopy. The size of adenomas correlated well with the rate of early adenocarcinoma and the degree of dysplasia and the majority of lesions over 10mm were diagnosed as early adenocarcinoma. Although electronic endoscopic findings such as easy bleeding and margin shapes of the depression with the dye-spreading method were useful for discriminating cancer from adenoma, there were few cancers with easy bleeding and few adenomas with an irregular margin (zig-zag pattern). In conclusion, it was too difficult to discriminate cancer from adenoma by electronic endoscopic findings, because the electronic endoscopic magnification was not adequate to observe the fine appearance of superficial and depressed neoplasms, most of which were minute lesions less than 5 mm in diameter. In case of the macroscopic classification and the pathological criteria not being able to ultimately define the superficial flat or depressed pattern of colonic neoplasm, it appears adequate to treat all lesions because the definitive differential diagnosis between adenoma and cancer can not be achieved even with electronic endoscopy. |
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