INTESTINE Vol.2 No.1(2-2)

Theme	True type IIc colorectal lesion? -- An issue of its morphological diagnosis
Title	Minute surface structure and IIc
Author	Hideki Mitooka	Kobe Kaisei Hospital
[ Summary ]	Superficial depressed neoplastic lesions have increasingly been drawing attention because such lesions have a tendency to invade deeply despite their small size as compared with the other morphological types of neoplastic lesions. The conventional endoscopic features of superficial depressed neoplastic lesions are the existence of a depressed area and a star-like pattern which indicates the borderline between the neoplastic lesion and non-neoplastic mucosa. Histological features of superficial depressed neoplastic lesions include horizontal growth of straight neoplastic glands in the mucosa. Therefore, the minute surface structure of such lesions is characterized small, round pits densely assembled (Kudo's IIIs pit). This minute surface structure is easily observed using a high-resolution magnifying video colonoscope developed recently. It is easy to operate and confirmative for diagnosing superficial depressed neoplastic lesion if three typical endoscopic features, the existence of a depressed area, star-like pattern and IIIs pit, are observed using a high-resolution magnifying video colonoscope. The high-resolution magnifying video colonoscope improves the quality of colonoscopy, resulting in a level of diagnosis and treatment that has heretofore not been possible with conventional colonoscopes.