Texture and color enhancement imaging in combination with indigo carmine dye spraying to highlight the border of flat ulcerative colitis–associated neoplasia

Abstract

A 45-year-old man with long-standing ulcerative colitis (UC) for 20 years was referred to our hospital because of positive horizontal margins after treatment for dysplasia. White light imaging identified whitish mucosa with scarring in the rectum (A). Histopathologic examination of the biopsy specimen revealed p53 overexpression, suggesting UC-associated neoplasia (UCAN). It was difficult to determine the extent of the lesion by using only chromoendoscopy with indigo carmine dye spraying (B), but the combination with texture and color enhancement imaging (TXI) made the boundary clear (C).