| Theme | Depressed type of lesions over 10 mm in size | |
|---|---|---|
| Title | Endoscopic features of depressed-type colorectal tumors over ten millimeters in diameter; focus on pit patterns | |
| Publish Date | 2004/05 | |
| Author | Tsukasa Takeuchi | Digestive Disease Center, Showa University Nothern Yokohama Hospital |
| Author | Shin-ei Kudo | Digestive Disease Center, Showa University Nothern Yokohama Hospital |
| Author | Hiroshi Kashida | Digestive Disease Center, Showa University Nothern Yokohama Hospital |
| Author | Yoshiro Tamegai | Digestive Disease Center, Showa University Nothern Yokohama Hospital |
| Author | Toshinori Kurahashi | Digestive Disease Center, Showa University Nothern Yokohama Hospital |
| Author | Yui Kudo | Digestive Disease Center, Showa University Nothern Yokohama Hospital |
| Author | Shinya Satake | Digestive Disease Center, Showa University Nothern Yokohama Hospital |
| Author | Hiro-o Yamano | Division of Gastroenterology, Akita Red Cross Hospital |
| [ Summary ] | We define the depressed type of colorectal tumor as a lesion with a demarcated depression. In order to clarify the endoscopic features of depressed type colorectal tumors over 10 mm in size, we compared the pit patterns in these lesions with those of the LST-NG pseudodepressed type and depressed-type lesions under 10 mm in size. In the depressed lesions over 10 mm in size, the major pit pattern in the depression was the type VN pit pattern (90.9%), and that in the marginal area was the type I (97.0%) Histopathologically, most of these lesions had invaded deeply into the submucosal layer (so-called sm massive cancers) (90.9%). In contrast,with the LST-NG pseudodepressed type, only 29.6% showed type VN pit patterns in the central concave area (pseudodepression) and 70.4% showed type IIIL pit patterns in the marginal area. Only 22.2% of this type were so-called sm massive cancers. In the depressed lesions, those under 10 mm in size, only 23.6% showed type VN pit patterns in the depressed area. Histopathologically, only 18.2% of these lesions were sm massive cancers. In summary, depressed-type colorectal tumors over 10 mm in size, are almost invariably sm massive cancer. These lesions are markedly defferent from the LST-NG pseudodepressed type or the depressed lesion under 10 mm in size, in pit pattern analysis and in histopathology. Therefore, it is indispensable that we diagnose these lesions very carefully, using chromoendoscopy and magnifying endoscopy. |
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