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Colorectal Case 16

Dr. Serhii Polishchuk
Gastrointestinal endoscopist at LLC “GASTROCENTER” Olymed; Trainer at NGO “EndoAcademy”, Ukraine

Procedure Information


Scope: CF-EZ1500DL

Case Findings: SM deep invasive cancer of colon – JNET3

Organ: Colon (sigmoid colon)

Patient information: 88y.o. male come for colonoscopy with bowel habit change

Medical history: Bowel habit change (constipation). No family history of CRC. No alcohol abuse, no smoking

1. SM deep invasive cancer of colon

TXI light observation (slightly elevated lesion with slightly depressed component)

Texture and Color Enhancement Imaging (TXI): Mode 1

2. SM deep invasive cancer of colon

TXI light observation + indigo carmine (slightly elevated lesion with slightly depressed component)

Texture and Color Enhancement Imaging (TXI): Mode 1

3. SM deep invasive cancer of colon

TXI light observation + indigo carmine (slightly elevated lesion with slightly depressed component)

Texture and Color Enhancement Imaging (TXI): Mode 1

4. SM deep invasive cancer of colon

NBI observation (slightly elevated lesion with slightly depressed component) (vessel pattern – irregular caliber of vessels and irregular distribution of vessels; irregular surface pattern)

NBI Color Mode 3
Enhancement: A5

5. SM deep invasive cancer of colon

NBI observation + dual focus (vessel pattern – irregular caliber of vessels and loose vessel areas, interruption of thick vessels)

NBI Color Mode 3
Enhancement: A5

6. SM deep invasive cancer of colon

NBI observation + dual focus (vessel pattern – irregular caliber of vessels and loose vessel areas, interruption of thick vessels; small amorphous areas are present)

NBI Color Mode 3
Enhancement: A5

Case Video

SM deep invasive cancer of colon - JNET3

Overall Comment

The final optical diagnosis in this case was:

Location: sigmoid colon

Size: ~13mm

Morphology (Paris classification): 0-IIa+IIc

Pit pattern: Kudo classification IIIL+Vi+Vn

JNET classification: JNET3 (vessel pattern – loose vessel areas, interruption of thick vessels; amorphous areas)

Optical diagnosis: submucosal deep invasive cancer

Treatment: surgical resection

Pathology report: well differentiated adenocarcinoma of the sigmoid colon pT2N0R0LV1Pn0G1 (ICD-O code: 8140/3)

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