A Case of Esophageal Xanthoma with Epithelial Reactive Inflammation with a Characteristic Finding of Narrow-Band Imaging Magnifying Endoscopy

2019 ◽  
Vol 38 (1) ◽  
pp. 85-88
Author(s):  
Hideki Mori ◽  
Motohiko Kato ◽  
Toshio Uraoka
Keyword(s):  
Biopsy Specimen ◽  
Narrow Band ◽  
Narrow Band Imaging ◽  
Basal Layer ◽  
Excisional Biopsy ◽  
Magnifying Endoscopy ◽  
Thoracic Esophagus ◽  
Characteristic Finding ◽  
Capillary Loop ◽  
White Substance

A 75-year-old woman had a 5 mm slightly elevated yellowish lesion in her thoracic esophagus. Narrow-band imaging magnifying endoscopy (NBI-ME) revealed aggregations of a tiny white substance beneath each intrapapillary capillary loop with weaving, dilatation, and a different shape. In this case, an irregular caliber was absent. The biopsy specimen taken from the lesion showed cells with large nuclei and increased chromatin clumping in the basal layer. These cells were positive for p53. Endoscopic submucosal dissection was performed for the purpose of excisional biopsy. Finally, it was diagnosed as an esophageal xanthoma with a benign epithelial reactive inflammation. This is the first report of esophageal xanthoma showing the characteristic NBI-ME finding of esophageal xanthoma. Further studies are required to determine whether the characteristic finding of NBI-ME is generally found in esophageal xanthomas.

scholarly journals Comparison of Magnifying Endoscopy with Blue Light Imaging and Narrow Band Imaging for Determining the Invasion Depth of Superficial Esophageal Squamous Cell Carcinoma by the Japanese Esophageal Society’s Intrapapillary Capillary Loop Classification

Diagnostics ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. 1941
Author(s):  
Waku Hatta ◽  
Tomoyuki Koike ◽  
Yohei Ogata ◽  
Yutaka Kondo ◽  
Nobuyuki Ara ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Esophageal Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Blue Light ◽  
Narrow Band ◽  
Narrow Band Imaging ◽  
Magnifying Endoscopy ◽  
Invasion Depth ◽  
Diagnostic Ability ◽  
Capillary Loop

Blue light imaging (BLI) and narrow-band imaging (NBI) are two modalities that enable narrow-band light observation. We aimed to compare the diagnostic ability of magnifying endoscopy with BLI (ME-BLI) and NBI (ME-NBI) for determining the invasion depth of superficial esophageal squamous cell carcinoma (SESCC) by the Japanese Esophageal Society’s intrapapillary capillary loop (IPCL) classification. We enrolled 81 patients between 2014 and 2018, and the still endoscopic images for diagnosing the invasion depth at the same part in ME-BLI and ME-NBI were registered. Two blinded investigators reviewed them and diagnosed the invasion depth by the IPCL classification. Subsequently, the diagnostic yields in two modalities were compared. The overall accuracies for the invasion depth by the IPCL classification in ME-BLI and ME-NBI did not differ significantly (67.9–71.6% vs. 72.8–74.1%). In the analysis based on the invasion depth, the sensitivities and positive predictive values in tumors invading the muscularis mucosa or submucosa ≤200 µm were low (23.1–30.8% and 16.7–25.0%, respectively) in both modalities. In conclusion, the diagnostic ability for determining the invasion depth of SESCC by the IPCL classification was relatively similar in ME-BLI and ME-NBI, but diagnosis by magnifying endoscopy alone might not be satisfactory.

Endoscopic submucosal dissection by using Clutch cutter and IT knife 2 for early gastric cancer with severe submucosal fibrosis: a case report

MedPharmRes ◽  
2018 ◽  
Vol 2 (3) ◽  
pp. 17-21
Author(s):  
Nhan Le ◽  
Phuong Vien ◽  
Nghia Le
Keyword(s):  
Gastric Cancer ◽  
Early Gastric Cancer ◽  
Endoscopic Submucosal Dissection ◽  
Narrow Band ◽  
Narrow Band Imaging ◽  
Magnifying Endoscopy ◽  
Gastrointestinal Cancers ◽  
Pathological Result ◽  
Well Differentiated ◽  
Submucosal Fibrosis

Introduction: Gastric cancer is one of the highly malignant gastrointestinal cancers and the third leading cause of cancer death. In the last decade, early gastric cancer (EGC) has been reported by using narrow-band imaging (NBI) magnifying endoscopy. Advances in endoscopic techniques, such as endoscopic submucosal dissection (ESD), have enabled the en bloc resection of these EGC. Although ESD is performed for early gastric cancer, there are still many difficult problems in technique of this procedure. The difficulty of gastric ESD depends on the size and location of a tumor, presence of severe submucosal fibrosis, presence of ulceration... We report a case of our successful ESD by using Clutch cutter and IT knife 2 in treatment of EGC with severe submucosal fibrosis. Case presentation: A 62-year-old man felt an epigastric discomfort two months ago. The narrow-band imaging (NBI) magnifying endoscopy revealed a suspected early gastric cancer type 0 - IIa + IIc (Japanese classification of early gastrointestinal cancers) at the incisura angularis, the size of this lesion was 15 mm in diameter, and pathological result of endoscopic biopsy was a well-differentiated adenocarcinoma. ESD was performed and we found there was severe submucosal fibrosis which was dissected safer and faster by using Clutch cutter and IT knife 2. There were no complications such as severe bleeding and perforation. The size of resected specimen was 60 x 35 mm and the time of procedure was 150 minutes. After ESD, the pathological result was a well differentiated adenocarcinoma, pT1a, UL(-), LY(-), V(-), no cancer cell in vertical and horizontal margins. The healing time of ESD-induced ulcer was 5 weeks without local recurrence. Conclusion: Through this case, we aim to emphasize the importance of using Clutch cutter and IT knife 2 as a modified technique which makes ESD a safe procedure in treatment of EGC with severe submucosal fibrosis.

Rare Primary Esophageal Paget’s Disease Diagnosed on a Large Bloc Specimen Obtained by Endoscopic Mucosal Resection

2017 ◽  
Vol 26 (4) ◽  
pp. 417-420 ◽  
Author(s):  
Hirohito Mori ◽  
Maki Ayaki ◽  
Hideki Kobara ◽  
Yasuhiro Goda ◽  
Noriko Nishiyama ◽  
...  
Keyword(s):  
Endoscopic Mucosal Resection ◽  
Narrow Band ◽  
Narrow Band Imaging ◽  
Case Reports ◽  
Paget’S Disease ◽  
Paget's Disease ◽  
Endoscopic Examination ◽  
Capillary Loop ◽  
Mucosal Resection ◽  
Cap Method

Primary esophageal Paget’s disease is rare. Only a few case reports have described the intraepithelial papillary capillary loop (IPCL) pattern obtained by magnified Narrow Band Imaging (M-NBI) endoscopy in this rare pathology. This report highlights the usefulness of M-NBI and the successful diagnosis using a large bloc specimen obtained by endoscopic mucosal resection with the cap method (EMR−c). A 53-year-old man was referred to endoscopic examination for dysphagia. The endoscopic image revealed a ring-shaped scarring of the esophagus suggestive for eosinophilic esophagitis. The IPCL pattern by M-NBI endoscopy showed an inflammatory pattern, and the entire epithelium of the esophagus was not stained by Lugol iodine spraying. Based on six biopsies randomly performed, a poorly differentiated adenocarcinoma was diagnosed. Since the M-NBI pattern and the histology were completely different, EMR−c was performed to obtain large bloc specimens for a more detailed diagnosis. The pathological findings revealed extensive Paget’s cells infiltration into the epithelium and multifocal invasion from the mucosa to the submucosal layer with adenocarcinoma. In conclusion, a large bloc specimen by EMR-c might be more useful than a small biopsy for an accurate diagnosis of the rare esophageal Paget’s disease.Key words:  –  – .Abbreviations: EMR−c: endoscopic mucosal resection with cap method; IPCL: intraepithelial papillary capillary loop; LVLs: Lugol-voiding lesions; M-NBI: magnified Narrow Band Imaging; PET-CT: Positron-Emission Tomography and Computed Tomography.

scholarly journals Role of magnifying endoscopy with narrow‐band imaging in the diagnosis of noninvasive gastric neoplasia

JGH Open ◽  
2021 ◽  
Vol 5 (4) ◽  
pp. 446-453
Author(s):  
Keisuke Tanaka ◽  
Shinya Maekawa ◽  
Takashi Yoshida ◽  
Tatsuya Yamaguchi ◽  
Shinichi Takano ◽  
...  
Keyword(s):  
Narrow Band ◽  
Narrow Band Imaging ◽  
Magnifying Endoscopy ◽  
Gastric Neoplasia
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