EVIS X1 Atlas ― RDI

Pathological Findings

The tumor biopsy was performed using the peripheral approach to avoid bleeding.

• Figure A (Papanicolaou staining): Clusters of glandular cells with atypical morphology can be seen. These feature a high nuclear-to-cytoplasmic ratio, irregularly shaped nuclei, and increased nuclear chromatin.
• Figure B (Papanicolaou staining): Glandular cells with atypical morphology are observed both in small clusters and scatterings. These feature unevenly distributed nuclei, a high nuclear-to-cytoplasmic ratio, and nuclear hypertrophy and irregularity.
• EGRF genetic mutation was detected by a gene mutation search.
• Final diagnosis: Primary lung adenocarcinoma (EGFR exon 21 L858R)

Overall Comment

In the comparison between WLI and TXI viewed from above the tracheal bifurcation, the peripheral lesion could be recognized first with the BAI-MAC function, which made the lesion brighter than its surroundings. TXI observation increased the visibility not only of the lesion but also the normal structures in the trachea and bronchi. In this respect, the value of high-specification equipment has been proven. Subepithelial vessels characteristic of tumors were most clearly depicted with the TXI and RDI3 settings. Since there were no significant invasion findings, low-grade malignancy was taken into consideration and the lesion was designated as an EGFR-mutant lung adenocarcinoma. Molecular-targeted medication demonstrated high efficacy.