Gastric Case 1
Prof. Stefan Seewald
GastroZentrum Hirslanden, Zurich
Scope:GIF-EZ1500
Case: Intramucosal Gastric Carcinoma (AEG Siewert Type III)
Organ: Stomach
Patient information:M, 70
Medical history: Incidental finding
1. WLI
Retroflex assessment of the fundus in white light reveals a suspicious area of patchy appearance spreading from 1-5 o’clock.
2. TXI
TXI is enhancing the color contrast and structure between the suspicious area and the surrounding mucosa.
3. NBI
NBI is bright enough but for characterization near focus with NBI is necessary.
4. Near Focus with NBI
Near Focus with NBI reveals irregular VS pattern suggesting early gastric carcinoma.
5. TXI with indigocarmine
The contrast effect of indigocarmine is enhanced by TXI and improves the delineation.
6. TXI with indigocarmine
The extent of the lesion can be nicely identified by TXI in combination with indigocarmine.
Overall Comment
The case illustrates the value of TXI in detection and delineation of early gastric carcinomas. Especially the delineation was difficult due to indistinct borders. The combination of TXI and indigocarmine enabled the strong color contrast and delineation of the lesion. NBI remains the first-hand modality for optical diagnosis.
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