Detection and staging of esophageal cancers within Barrett's esophagus is improved by assessment in specialized Barrett's units Georgina R. Cameron,

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Presentation transcript:

Detection and staging of esophageal cancers within Barrett's esophagus is improved by assessment in specialized Barrett's units Georgina R. Cameron, MBBS (Hons), BMus (Hons), FRACP, Chatura S. Jayasekera, MBBS (Hons), FRACP, DMedSci, Richard Williams, MBBS, PhD, FRCPA, FFSc, FHKCPath, FHKAM(Pathol), Finlay A. Macrae, MBBS (Hons), FRACP, MD, FRCP, AGAF, Paul V. Desmond, MBBS, FRACP, Andrew C. Taylor, MBBS, FRACP, MD Gastrointestinal Endoscopy Volume 80, Issue 6, Pages 971-983.e1 (December 2014) DOI: 10.1016/j.gie.2014.03.051 Copyright © 2014 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 1 A, Case 1: Paris Classification 02A lesion seen with NBI. Nodular area at 41 to 42 cm at the 8 to 12 o'clock position with loss and irregularity of villous and vascular pattern. B, The same lesion seen with WLE. Cautery marks from tip of snare are used to demarcate the lesion prior to EMR. Submucosal cancer was found in the EMR specimen. Gastrointestinal Endoscopy 2014 80, 971-983.e1DOI: (10.1016/j.gie.2014.03.051) Copyright © 2014 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 2 A, Case 2: Paris Classification 02A lesion seen with WLE. A nodular area is seen at 40 to 41 cm at the 9 to 1 o'clock position (rotated in this image) demarcated for EMR. B, The same lesion seen on closer inspection with NBI shows irregular mucosal pattern. EMR of this lesion found submucosal cancer. Gastrointestinal Endoscopy 2014 80, 971-983.e1DOI: (10.1016/j.gie.2014.03.051) Copyright © 2014 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 3 A, Case 3: Paris Classification 02C lesion seen on WLE. Diffusely abnormal mucosa at 32 to 34.5 cm at the 11 to 5 o'clock position with minor depression and slight nodularity. There is patchy superficial ulceration and slough over this. B, The mucosal and vascular patterns are irregular and indistinct in areas on narrow-band imaging. Submucosal cancer was found following EMR of this lesion. Gastrointestinal Endoscopy 2014 80, 971-983.e1DOI: (10.1016/j.gie.2014.03.051) Copyright © 2014 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 4 A, Case 5: Paris Classification 02A lesion seen with WLE. Nodular, slightly raised area at 37 to 38 cm at the 3 to 4 o'clock position. seen on WLE. B, There is irregularity and loss of the normal mucosal pattern on inspection with NBI. EMR of this lesion detected intramucosal cancer. Gastrointestinal Endoscopy 2014 80, 971-983.e1DOI: (10.1016/j.gie.2014.03.051) Copyright © 2014 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 5 Case 6: Paris Classification 01S lesion seen with NBI. Lesion at 35 to 36 cm at the 12 to 2 o'clock position with loss of normal mucosal pattern. EMR of this lesion found intramucosal cancer. Gastrointestinal Endoscopy 2014 80, 971-983.e1DOI: (10.1016/j.gie.2014.03.051) Copyright © 2014 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 6 Case 8: Paris Classification 02A+C lesion seen with WLE. Nodular lesion at 39 cm at the 12 o'clock position 1 cm in size with some subtle depression at 38 cm under the squamous mucosa. This was found to harbor intramucosal cancer following EMR. Gastrointestinal Endoscopy 2014 80, 971-983.e1DOI: (10.1016/j.gie.2014.03.051) Copyright © 2014 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 7 Case 9: Paris Classification 01S lesion. A 10-mm nodule at 36 cm at the 3 o'clock position with irregular mucosal pattern seen with NBI. This was found to harbor intramucosal cancer following EMR of the lesion. Gastrointestinal Endoscopy 2014 80, 971-983.e1DOI: (10.1016/j.gie.2014.03.051) Copyright © 2014 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 8 A, Case 10: Paris Classification 02A lesion seen with WLE. Nodular lesion at 28 to 30 cm at the 11 to 1 o'clock position with superficial ulceration. B, NBI shows the distorted and irregular mucosal pattern. EMR of this lesion found intramucosal cancer. Gastrointestinal Endoscopy 2014 80, 971-983.e1DOI: (10.1016/j.gie.2014.03.051) Copyright © 2014 American Society for Gastrointestinal Endoscopy Terms and Conditions