Abstract
An 82-year-old woman presented for a periodic endoscopic examination after radiotherapy and endoscopic mucosal resection (EMR) of a cancer in the esophagus. Conventional endoscopy demonstrated a tiny, flat, reddish lesion about 1 mm in diameter proximal to the scar of the previous esophageal EMR. Observation after iodine staining showed an apparent unstained area in the lesion. Magnifying observation using a Q240Z (Olympus, Tokyo, Japan) revealed a clearly demarcated aggregation of dilated intrapapillary capillary loops in this part of the lesion. Endocytoscopic observation (XEC120U prototype; Olympus) showed increased cellular density and irregularity of the epithelial nuclei. Endoscopic mucosal resection of the lesion was performed. Pathological studies of the resected specimen revealed a squamous cell carcinoma, maximal diameter 920 μm, confined to the epithelium. We believe that the Endocytoscope has the potential to reduce biopsy histology in cases of esophageal squamous cell carcinoma.
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