Improved optical identification of laterally spreading type “0-IIb” gastric lesion with narrow band imaging magnification endoscopy
نویسندگان
چکیده
Endoscopic submucosal dissection (ESD) has become the treatment of choice for early gastric cancer. Accurate identification of tumor borders is crucial for curative ESD. Narrow band imaging magnification endoscopy (NBI-ME) has been effectively used for assessment of superficial gastric lesions; however, international experience in type "0-IIb" gastric lesions is limited. Successful endoscopic tissue characterization of laterally spreading type "0-IIb" early gastric cancer in a 74-year-old male with known type "0-IIa" lesion, using zoom NBI-ME, is reported. While the type "0-IIa" gastric lesion was clearly recognized by white light endoscopy and indigo carmine chromoendoscopy, the laterally spreading type "0-IIb" gastric cancer was only identified on the basis of NBI-ME malignant microvascular and mucosal microsurface pattern. Based on NBI-ME findings, accurate border marking approximately 1 mm apart from the demarcation line and complete en bloc ESD resection of both tumors was successfully succeeded. Recovery was uneventful. Histopathology showed moderately differentiated gastric adenocarcinoma in type "0-IIa" lesion and a small area of low-grade well-differentiated gastric adenocarcinoma in type "0-IIb" lesion. Conclusively, improved real-time optical identification of laterally spreading type "0-IIb" gastric lesion was achieved with NBI-ME.
منابع مشابه
Effective optical identification of type “0-IIb” early gastric cancer with narrow band imaging magnification endoscopy, successfully treated by endoscopic submucosal dissection
BACKGROUND Endoscopic submucosal dissection (ESD) is currently considered the minimal invasive endoscopic treatment for early gastric cancer. Most superficial gastric neoplastic lesions are depressed type "0-IIc" (70-80%), while totally flat, classified as type "0-IIb" early gastric cancer, is rarely reported (0.4%). The aim of the present study was to assess the efficacy of narrow band imaging...
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