DEPRESSED ADENOMA OF THE DUODENUM DIAGNOSED USING IMAGE-ENHANCED ENDOSCOPY

DOI 21 References
  • SHIKATA Kentaro
    Department of Gastroenterology, Fukuoka Sanno Hospital. Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University.
  • KOBAYASHI Hiroyuki
    Department of Gastroenterology, Fukuoka Sanno Hospital.
  • KOCHI Shuji
    Department of Gastroenterology, Fukuoka Sanno Hospital.
  • ENDO Shingo
    Department of Gastroenterology, Fukuoka Sanno Hospital.
  • HIRAHASHI Minako
    Departments of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University.
  • TSUNEYOSHI Masazumi
    Division of Pathology, Fukuoka Sanno Hospital.
  • MATSUMOTO Takayuki
    Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University.

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Other Title
  • 画像強調内視鏡で観察しえた十二指腸陥凹型腺腫の1例

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Abstract

A 51-year-old man underwent screening by upper gastrointestinal endoscopy, which revealed a tiny IIa+IIc-like depressed lesion in the second part of the duodenum. The lesion was slightly reddish and surrounded by whitish protrusions. Magnifying endoscopy combined with narrow band imaging (NBI) system revealed that the lesion contained a regular and diminutive network of microvessels within the central depression. Following crystal violet staining, magnifying endoscopy revealed the characteristic IIIL pit pattern commonly observed in colonic adenomas. In addition, the light blue crest commonly observed in normal duodenal mucosa was indistinct. These endoscopic findings suggested a diagnosis of an epithelial tumor. Endoscopic ultrasound (EUS) revealed that the lesion was restricted to the mucosa. The examination of the lesion that measured 7mm following endoscopic mucosal resection revealed that the lesion was an adenoma with moderate epithelial atypia. A classification system for magnifying endoscopy findings for duodenal as well as gastric and colorectal neoplasms is required.

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