| Series | ||
|---|---|---|
| Title | Case of type 0-IIa＋IIc early colorectal cancer diagnosed with Endocytoscopy | |
| Publish Date | 2014/11 | |
| Author | Fumihiko Urushibara | Digestive Disease Center, Showa University Northern Yokohama Hospital |
| Author | Shin-ei Kudo | Digestive Disease Center, Showa University Northern Yokohama Hospital |
| Author | Yuichi Mori | Digestive Disease Center, Showa University Northern Yokohama Hospital |
| Author | Katsuro Ichimasa | Digestive Disease Center, Showa University Northern Yokohama Hospital |
| Author | Fumio Ishida | Digestive Disease Center, Showa University Northern Yokohama Hospital |
| Author | Shigeharu Hamatani | Division of Pathology, Showa University Northern Yokohama Hospital |
| [ Summary ] | A 48-year-old man was referred to our center for a detailed examination of a depressed type lesion located in the ascending colon. White light endoscopy revealed a slightly reddish flat lesion 12 mm in diameter. Indigo carmine spraying revealed elevation and shallow depression of the lesion, with a clear border from the surrounding mucosa. As a results, a morphological type lesion was diagnosed as a type 0-IIa+IIc lesion. The vascular pattern was diagnosed as sparse using Narrow Band Imaging. Magnifying chromoendoscopy found type VN pit patterns in the depressed area. However, type VI pit patterns were most often observed. Endocytoscopy (EC; OLYMPUS), with ultra-magnification capability (380 or 450×) using a contact light microscopy system. We detected a destroyed gland and distorted nuclei in the depressed area. As a result, this lesion was diagnosed as EC3b using the EC classification. Based on the detailed endoscopic examination outlined above, this lesion was diagnosed as a massively invasive submucosal cancer. The patient underwent laparoscopic colectomy. The final pathological diagnosis was adenocarcinoma (tub2>tub1), with a submucosal invasion being positive, a depth of 1,375μm, lymphatic invasion negative, venous invasion was negative, budding was Grade 2 and nodal metastasis was negative. By comparing the pathological findings to endoscopic ones, EC findings of EC3b corresponded well with pathological findings of tubular adenocarcinoma exposed on the lesion surface. In this case, Endocytoscopy was useful in making an estimation of lesion pathology. |
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