1. Confocal Endomicroscopy in Ulcerative Colitis: Differentiating Dysplasia-Associated Lesional Mass and Adenoma-Like Mass 
David P. Hurlstone, Mike Thomson, S. Brown, Nick Tiffin, Simon S. Cross, Michael D. Hunter 
Clinical Gastroenterology and Hepatology 
Volume 5, Issue 10, Pages (October 2007)
DOI: /j.cgh
Copyright © 2007 AGA Institute Terms and Conditions

2. Figure 1
(A) Conventional “white light” colonoscopic views of a Paris 0-II + IIc lesion (flat with central depression). The lesion contours have been delineated with IC 0.5% chromoscopy. (B) CLE scan of the mucosa adjacent to the lesion (red arrow) at a z-axis depth of 100 μm, with the gray-scale macro showing a vascular hexagonal pattern with only a mild increase in capillary density. (C) High-power hematoxylin and eosin stain of the tissue sampled using targeted CLE, showing no evidence of dysplastic crypts with a marginal increase in inflammatory cells only, compatible with established chronic inflammatory bowel disease. (D) CLE at 50 μm in the z-axis. showing clear disruption to the nonneoplastic crypt architecture as demonstrated in (B) with irregular “ridge”-lined epithelial cells, goblet cell attenuation, and mucin depletion. (E) CLE at 150 μm in the z-axis showing a grossly abnormal vascular network with capillary truncation and fluorescein extravasation. Combined imaging in the superficial axis (D) and deep vascular imaging (E) confirm the Mainz criteria for IN. The adjacent mucosa is nondysplastic on both CLE imaging and histopathology. Thus, ALM is confirmed, and local resection is indicated. (F) High-power hematoxylin and eosin staining of the targeted biopsy specimen using CLE showing low-grade dysplastic changes with central high-grade dysplasia, with no evidence of deep invasion or overt carcinoma.
Clinical Gastroenterology and Hepatology 2007 5, DOI: ( /j.cgh )
Copyright © 2007 AGA Institute Terms and Conditions