Autofluorescence imaging of a diminutive, depressed-type early colon cancer invaded to the submucosal layer

Abstract

View Large Image Figure Viewer Download Hi-res image View Large Image Figure Viewer Download Hi-res image View Large Image Figure Viewer Download Hi-res image A 61-year-old woman with a positive fecal occult blood study result underwent a colonoscopy that indicated an early cancer in her sigmoid colon. She was then referred to our hospital for further evaluation. Colonoscopic re-evaluation of the lesion was done using an autofluorescence imaging system consisting of an image processor (XCV-260HP; Olympus Medical Systems, Tokyo, Japan), a light source (XCLV-260HP, Olympus), and a colonoscope with 2 charged, coupled devices for white light imaging and autofluorescence imaging modes (XCF-Q240FZI, Olympus). Autofluorescence imaging revealed a 5-mm green area surrounded by magenta mucosa (A). White light imaging (B) and chromoendoscopy with 0.4% indigo carmine (C) revealed a depressed-type lesion colored similarly to the surrounding mucosa. EUS revealed a minute tumor that invaded down to the submucosa. The lesion was diagnosed as an early colon cancer invading into the submucosa, and sigmoidectomy was performed. Histologic examination (D, H&E, orig. mag. × 7.5) of the resected specimen revealed a moderately differentiated adenocarcinoma invading into the submucosa (submucosal invasion [SM] 150 μm). The cancer was more depressed than the surrounding mucosa, whereas the surrounding submucosal layer was relatively thick. Thus, a green image of a lesion surrounded by a magenta mucosa on autofluorescence imaging may be representative of the depressed-type colon cancer. View Large Image Figure Viewer Download Hi-res image View Large Image Figure Viewer Download Hi-res image