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Gastric Case 1

Prof. Stefan Seewald​

GastroZentrum Hirslanden, Zurich

Procedure information


Case: Intramucosal Gastric Carcinoma (AEG Siewert Type III)

Organ: Stomach

Patient information:M, 70

Medical history: Incidental finding

1. WLI

#WLI #A7 structure enhancement #Auto Iris

Retroflex assessment of the fundus in white light reveals a suspicious area of patchy appearance spreading from 1-5 o’clock.

2. TXI

#TXI Mode 1 #A7 structure enhancement #Auto Iris

TXI is enhancing the color contrast and structure between the suspicious area and the surrounding mucosa.

3. NBI

#NBI #B7 structure enhancement #Auto Iris

NBI is bright enough but for characterization near focus with NBI is necessary.

4. Near Focus with NBI

#NBI #B7 Structure enhancement #Auto Iris

Near Focus with NBI reveals irregular VS pattern suggesting early gastric carcinoma.

5. TXI with indigocarmine

#TXI Mode 1 #A7 structure enhancement #Auto Iris

The contrast effect of indigocarmine is enhanced by TXI and improves the delineation.

6. TXI with indigocarmine

#TXI Mode 1 #A7 structure enhancement #Auto Iris

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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