A Case of Dysplasia Diagnosed Based on Detailed Observation Using Narrow Band Imaging (NBI)

DOI
  • Nishine Hiroki
    Division of Respiratory and Infectious Diseases, Department of Internal Medicine, St. Marianna University School of Medicine
  • Kurimoto Noriaki
    Division of Chest Surgery, Department of Surgery, St. Marianna University School of Medicine
  • Morikawa Kei
    Division of Respiratory and Infectious Diseases, Department of Internal Medicine, St. Marianna University School of Medicine
  • Inoue Takeo
    Division of Respiratory and Infectious Diseases, Department of Internal Medicine, St. Marianna University School of Medicine
  • Mineshita Masamichi
    Division of Respiratory and Infectious Diseases, Department of Internal Medicine, St. Marianna University School of Medicine
  • Miyazawa Teruomi
    Division of Respiratory and Infectious Diseases, Department of Internal Medicine, St. Marianna University School of Medicine

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Other Title
  • 狭帯域光観察(narrow band imaging : NBI)による気管支粘膜異形成の観察経験

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Description

Background. It is often difficult to differentiate dysplasia from carcinoma in situ using white light bronchoscopy (WLB) alone. WLB combined with narrow band imaging (NBI), however, has been proven to be useful for detecting and assessing dotted vessels at sites of abnormal fluorescence. Case. A 65-year-old man was admitted to our institution with an abnormal chest shadow in the lingular segment. A white light examination revealed redness and swelling at the bifurcation of right B^6 and basal bronchus. A light reddish-brown area was identified on a fluorescence examination. The NBI image visualized the lesion with unclear margin and brownish dotted vessels in some areas within the lesion. Although it is difficult to distinguish between carcinoma in situ and dysplasia based on bronchoscopic findings, the biopsy specimens revealed a histopathological diagnosis of mild dysplasia. Conclusions. NBI proved useful for assessing the regular pattern of dotted vessels and border clarity at abnormal sites under fluorescence. NBI may facilitate the accurate discrimination between dysplasia and carcinoma in situ.

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