MINUTE FLAT DEPRESSED NEOPLASTIC LESIONS OF THE COLON DETECTED BY CONTRAST CHROMOSCOPY USING AN INDIGO CARMINE CAPSULE

被引：78

作者：

MITOOKA, H

FUJIMORI, T

MAEDA, S

NAGASAKO, K

机构：

[1] KOBE SEASIDE HOSP,DIV GASTROENTEROL,KOBE,JAPAN

[2] KOBE UNIV,DEPT PATHOL 2,KOBE,JAPAN

[3] TOKYO WOMENS COLL,INST GASTROENTEROL,TOKYO,JAPAN

来源：

GASTROINTESTINAL ENDOSCOPY | 1995年 / 41卷 / 05期

关键词：

D O I：

10.1016/S0016-5107(05)80003-3

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Thirty-seven diminutive flat depressed neoplastic lesions of the colon, smaller than 5 mm, were detected by contrast chromoscopy using an indigo carmine capsule and subsequently removed by endoscopic mucosal resection. We investigated the endoscopic, macroscopic, and histologic characteristics of these lesions and also evaluated the usefulness of chromoscopy and the magnifying endoscope for detecting this type of lesion. The lesions were classified into two types according to the measured height of the histologic sections: 28 lesions were truly flat depressed and the remaining 9 lesions were flat elevated. Of the 37 lesions, 18 were adenomas with mild atypia, 14 with moderate atypia, and 5 with severe atypia. The flat depressed lesions included 12 with mild atypia, 11 with moderate atypia, and 5 with severe atypia. No invasive carcinoma was present in either type, and no adenoma with severe atypia was identified in any of the flat elevated lesions. The overall rate of severe atypia was 13.5%; the rate of severe atypia for the flat depressed type was 17.9%, which is approximately 14-fold greater than that of ordinary diminutive polypoid adenomas (1.3%). The detection of these lesions was facilitated by the use of indigo carmine dye, which clearly demonstrated the mucosal irregularities. The frequency of detection of these lesions was increased four to five times with a magnifying endoscope, as occurred in nearly 10% of all of the patients examined. These data suggest that the finding of endoscopically minute flat depressed neoplastic lesions is not at all uncommon when examination is meticulously performed. Furthermore, these lesions, especially the truly flat depressed type, have a high rate of severe atypia despite their small size and should be carefully treated. To detect and treat this type of lesion, meticulous colonoscopic examinations, aided by chromoscopy and a magnifying colonoscope, may be warranted.

引用

页码：453 / 459

页数：7

共 18 条

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