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The techniques and clinical opinions presented in this material reflect the personal experience and professional judgment of the healthcare professional and do not necessarily represent the views of Olympus. This material is intended for healthcare professionals only. Users should always refer to the applicable Instructions for Use (IFU) and use Olympus products in accordance with the approved indications and local regulatory requirements. The healthcare professional presenting this material has been engaged by Olympus and compensated at fair market value for their services.

Colorectal Case 35

Yasushi Sano^1.2

MD, PhD, FJGES, and ANBIIG ³

Clinical Professor, Kansai Medical University Osaka, Japan
Director & Chief of Gastrointestinal Center Sano Hospital, Kobe, Japan
Secretary, Asian Novel Bio-Imaging and Intervention Group

Procedure information

Scope: CF-XZ1200I

Case: Detection

Site of lesion: Sigmoid colon

Patient information: M, 80s

Medical history: Screening

1. WLI

On white-light imaging, a 3-mm lesion shows loss of normal vascular transparency with faint erythema.

2. TXI

With TXI, the loss of vascular transparency and faint erythema are further emphasized by enhanced contrast.

3. NBI

On conventional NBI, the lesion is recognized as a brownish area.

4. NBI

On NBI-TXI, the brownish area is accentuated, resulting in improved visibility.

5. NBI

On magnifying NBI, regular meshed capillary vessels are observed throughout the lesion.

6. NBI+TXI

On NBI-TXI observation, the vessels become more distinct, and the lesion was diagnosed as JNET Type 2.

7. Chromoendoscopy

After indigo carmine spraying, the lesion was diagnosed as a superficially elevated lesion with relative central depression (0-IIa).

8. Chromoendoscopy

Magnifying chromoendoscopy demonstrated a Kudo type IIIL pit pattern.

9. Pathological image

10. Pathological diagnosis

Pathological diagnosis: IIa, 3 mm, Sigmoid colon Tubular adenoma with Moderate atypia

11. Pathological image

Case Video

Overall Comment

This case highlights the value of TXI and NBI-TXI for the detection and characterization of a diminutive colorectal adenoma. On white-light imaging, the lesion showed only subtle loss of vascular transparency and faint erythema. TXI enhanced these changes and improved lesion recognition. NBI identified the lesion as a brownish area, and NBI-TXI further increased its visibility. Magnifying observation demonstrated a regular vascular pattern and a Kudo type IIIL pit pattern, findings consistent with JNET Type 2A adenoma. Histopathology confirmed a tubular adenoma with moderate atypia.

* Specifications, design and accessories are subject to change without any notice or obligation on the part of the manufacturer.

Cases 34: A 30-mm non-granular laterally spreading tumor (LST-NG-FE)
Prof. Yunho Jung Cases 36:Detection 0-IIa, SSL with CD
Prof. Yasushi Sano

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