Clin Endosc.  2019 May;52(3):273-277. 10.5946/ce.2018.100.

Blue Laser Imaging with a Small-Caliber Endoscope Facilitates Detection of Early Gastric Cancer

Affiliations
  • 1Division of Gastroenterology, Department of Medicine, Jichi Medical University, Shimotsuke, Tochigi, Japan. osawa@jichi.ac.jp
  • 2Department of Surgery, Jichi Medical University, Shimotsuke, Tochigi, Japan.

Abstract

Conventional endoscopy often misses early gastric cancers with minimal red discoloration because they cannot be distinguished from inflamed mucosa. We treated a patient with a small early gastric cancer that was difficult to diagnose using conventional endoscopy. Conventional endoscopy using a small-caliber endoscope showed only subtle red discoloration of the gastric mucosa. However, blue laser imaging showed a clearly discolored area measuring 10 mm in diameter around the red lesion, which was distinct from the surrounding inflamed mucosa. Irregular vessels on the tumor surface (suspicious for early gastric cancer) were observed even with small-caliber endoscopy. Biopsy revealed a well-moderately differentiated tubular adenocarcinoma, and endoscopic submucosal dissection was performed. Histopathological examination of the specimen confirmed well-moderately differentiated adenocarcinoma localized to the mucosa with slight depression compared to the surrounding mucosa, consistent with the endoscopic findings. This small early gastric cancer became clearly visible with blue laser imaging using small-caliber endoscopy.

Keyword

Early gastric cancer; Blue laser imaging; Small-caliber endoscopy; Endoscopic submucosal dissection

MeSH Terms

Adenocarcinoma
Biopsy
Depression
Endoscopes*
Endoscopy
Gastric Mucosa
Humans
Mucous Membrane
Stomach Neoplasms*
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