| Theme |
The front line of magnifying endoscopy and pit pattern diagnosis -- Now and future |
| Title |
Significance of magnifying observation of DALM |
| Author |
Masahiro Igarashi |
Department of Gastroenterology, Kitasato University East Hospital |
| Author |
Miwa Sada |
Department of Gastroenterology, Kitasato University East Hospital |
| Author |
Kiyonori Kobayashi |
Department of Gastroenterology, Kitasato University East Hospital |
| Author |
Shigeru Yoshizawa |
Department of Gastroenterology, Kitasato University East Hospital |
| Author |
Tomoe Katsumata |
Department of Gastroenterology, Kitasato University East Hospital |
| [ Summary ] |
We reviewed the significance of magnifyied observation of DALM for 14 patients (19 lesions) who were observed with magnifying colonoscopy. The frequency of DALM was discovered in 11 cases (12.5 %) of extensive colitis (88 patients) and in 3 cases (6.5 %) of left sided colitis (46 patients) that we performed surveillance colonoscopy on. The average age of patients with DALM was 54.8 ± 16.2 years old and the average morbidity period was 13.7 ± 6.6 years. DALM was located in 95 % of the cases in the rectum and the sigmoid colon. The macroscopic type of Nagasako classification of DALM indicated the superficial elevated type -- 53 %, the nodule -- aggregating type -- 26 %, the sessile type -- 11 % and the depressed type -- 5 %, respectively. Discovery of elevated lesions with DALM were not so difficult to observe, however, superficial elevated lesions or flat lesions were difficult without using the dye spraying method. Using magnifying observation was useful to diagnose dysplasia, which was revealed in patterns and which resembled neoplastic pit patterns. On the other hand, differential diagnosis with sporadic adenoma and dysplasia was difficult using only magnifying views.
It is concluded that magnifying observation with dye spraying is the most efficient method of diagnosis for ulcerative colitis associated with dysplasia. |