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Esophageal Case 3

Prof. Stefan Seewald​

GastroZentrum Hirslanden, Zurich

Procedure Information


Scope:GIF-EZ1500

Case: Squamous Cell Carcinoma

Organ: Esophagus

Patient information: M, 74

Medical history: Smoker

1. WLI

#WLI #A7 structure enhancement #Auto Iris

A suspicious reddish lesion can be identified at 6 to 9 o’clock.

2. TXI

#TXI Mode 1 #A7 structure enhancement #Auto Iris

TXI suggests a larger area that may be interpreted as reflux esophagitis at the first glance.

3. NBI

#TXI Mode 1 #A7 structure enhancement #Auto Iris

However, with NBI abnormal IPCLs can be identified which require closer examination.

4. Near Focus with NBI

#NBI #NBI Color Mode 1 #B7 Structure Enhancement #Auto Iris

Abnormal IPCLs can be confirmed under near focus with 1.6x electronic magnification, suggesting a squamous cell carcinoma.

5. Lugol staining (WLI)

#WLI + Lugol Staining #A7 structure enhancement #Auto Iris

To confirm the extend of the carcinoma, Lugol staining was applied. Various Lugol-voiding lesions can be identified.

6. Lugol Staining (TXI)

#TXI 1 + Lugol Staining #A7 structure enhancement #Auto Iris

Under TXI 1, the delineation is supported by stronger color contrast of the carcinoma. The pink color sign is more prominent compared to white light.

Case video

Overall Comment

This case presents an incidentally detected squamous cell carcinoma. NBI is considered most beneficial for detection and characterization. TXI in combination with Lugol was helpful to delineate the lesion. TXI improves the delineation with Lugol compared to white light.

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