Abstract
"Effective Optical Identification of Depressed Type “0-IIc” Early Primary Nonampullary Duodenal Neoplasms with Narrow Band Imaging Magnification Endoscopy"
Highlights
Primary non-ampullary duodenal (NADN) is an extremely rare disease that is confined to mucosa or submucosa and does not touch the papilla of Vater
Narrow-band imaging magnification endoscopy (NBI-ME) in combination with acetic acid spray is a useful method for optical characterization of early NonAmpullary Duodenal Neoplasm (NADN)
The aim of the present study is to report on three cases of depressed type ‘0-IIc’ early NADN, two cases with duodenal adenomas and one case with primary early adenocarcinoma, successfully identified endoscopically, by NBI-ME upon indication
Summary
Primary non-ampullary duodenal (adenoma or adenocarcinoma) (NADN) is an extremely rare disease that is confined to mucosa or submucosa and does not touch the papilla of Vater. Narrow-band imaging magnification endoscopy (NBI-ME) has been effectively used for real time, optical diagnosis of superficial gastric and colorectal lesions [3,4,5,6,7,8,9,10,11,12], with specific standardized classifications [10,13] are routinely in use by Japanese experts; international experience for duodenal lesions is limited, while no standardized NBI-ME classification has been yet reported for such rare lesions. NBI without magnification (Figures 1C-1D & 3D) showed better the duodenal lesions and the papilla of Vater (bile under NBI became red colored, Figure 1D), without any advantage to WLE or indigo carmine chromoendoscopy, regarding the endoscopic tissue characterization. Endoscopic histology in real-time by NBI-ME could provide a higher diagnostic value for surveillance of periampullary and nonampullary adenomas in FAP patients, according to rare reports [1,2]
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