By Rikiya Fujita, Hiroshi Takahashi
Since a couple of mucosal digestive tract melanoma detected has elevated lately with an strengthen of endoscopic tools, endoscopic therapy of digestive tract melanoma is commonly unfold in Japan yet now not in different nations. Minute cancers appear to have personal attribute mucosal indicators in comparison with benign lesions. accordingly, thoughts, these are assorted in Japan from different international locations, of endoscopic prognosis are very important.
The melanoma institute clinic of JFCR (Japan beginning of melanoma learn) is among the best associations which do the simplest endoscopic therapy in Japan. This publication is anticipated to be the 1st necessary atlas within which the considerable reviews of this health facility supply attractive photos of minute cancers with none scars of biopsies which switch features of unique lesions. This publication additionally supply photos of magnifying endoscopy utilizing NBI (Narrow Band Imaging) and pathological findings.
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Extra info for Gastrointestinal Cancer Atlas for Endoscopic Therapy
2. a Biopsy specimen. Well-differentiated adenocarcinoma was observed, with swollen nuclei up to the mucosal surface and an irregular glandular structure b ESD specimen. This endoscopic submucosal dissection (ESD) specimen failed to reveal cancer distinctly, and no cancer was observed in the specimen after additional thin slicing vascular patterns speciﬁc for cancer by magnifying endoscopy combined with NBI has increased the diagnostic accuracy (2). In terms of the third question, it has previously been reported that the disappearance of cancer after biopsy can be conﬁrmed upon surgical resection (1), but less invasive endoscopic resection has increasingly been carried out (6, 7).
Because visualization of the lesion may become even more difﬁcult with chromo-endoscopy, it is better to use ﬁrst an indigo carmine solution that is more highly diluted. Should the lesion be difﬁcult to visualize after dye spraying, the endoscopist should rinse the dye away thoroughly and reexamine the lesion. Fig. 2. Pathohistological ﬁndings: The lesion, completely resected by EMR in one piece, was found to be a minute signet-ring cell carcinoma. The lesion was mainly localized at the proliferative zone, and cancer was not exposed to the mucosal surface Histology: ssg, depth M, ly0, v0, l-ce(−), v-ce(−) 48 Case Presentations: Early Gastric Cancer Case 4 72-year-old man early gastric cancer, greater curvature of the upper body (remnant stomach), type 0-IIb, 3-mm signet-ring cell carcinoma (sig).
However, depressed-type small and minute gastric cancers may change morphologically after biopsy because of a decrease in the cancer volume due to the biopsy (3). The width of the biopsy forceps used for general endoscopic examinations is 6 mm when opened, so a biopsy can potentially remove most of the minute gastric cancer tissue. Some minute gastric cancers are diagnosed by biopsy but cannot be visualized later when the cancer site is endoscopically reexamined to formulate the treatment strategy.