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. 2021 Nov 26;7(1):29-32.
doi: 10.1016/j.vgie.2021.10.004. eCollection 2022 Jan.

The utility of image-enhanced endoscopy and Lugol's for the assessment of esophageal squamous carcinoma

Douglas Motomura  1 , David Hurlbut  1 , Wiley Chung  1 , Robert Bechara  1
Affiliations

The utility of image-enhanced endoscopy and Lugol's for the assessment of esophageal squamous carcinoma

Douglas Motomura et al. VideoGIE. .

Abstract

Video 1This is a case of a patient with esophageal squamous cell carcinoma who underwent endoscopic submucosal dissection and subsequent esophagectomy. The endoscopic findings using imaged endoscopy, magnification, and Lugol's are demonstrated. There is a demonstration of endoscopic and pathological correlation in addition to the emphasis on a patient-centered multidisciplinary approach to esophageal neoplasia and the diagnostic utility of endoscopic submucosal dissection.

Keywords: ESCC, esophageal squamous cell carcinoma; ESD, endoscopic submucosal dissection; HGD, high-grade dysplasia; SCC, squamous cell carcinoma.

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Figures

Figure 1
Figure 1
Macroscopic findings of the squamous cell carcinoma. A, White light examination (WLE). B, Optical enhancement mode 2 (OE-2). C, Optical enhancement mode 1 (OE-1). Thirty seconds after 1.5% Lugol’s. D, WLE. E, OE-2. F, OE1. Three minutes after 1.5% of Lugol’s. G, WLE. H, OE-2. I, OE-1.
Figure 2
Figure 2
Magnification and resection of the squamous cell carcinoma. A, Optical enhancement mode 1 (OE-1) low magnification. B, OE-1 medium magnification. C, OE-1 high magnification (blue arrows indicate B2 vessels and red arrow heads indicates reticular pattern vessels). D, Marking. E, Submucosal dissection. F, Gross specimen with depressed area with B2 vessels outlined in red. G, In situ squamous cell carcinoma. Lymphovascular invasion present within underlying lamina propria with hematoxylin phloxine saffron stain, orig. mag. ×50. H, Tumor in endothelial-lined spaces, orig. mag. ×200. I, SM2 disease, orig. mag. ×50.
Figure 3
Figure 3
Esophagectomy intralymphatic squamous cell carcinoma (SCC) at proximal anastomosis donut. Proximal resection margin donut with lymphovascular invasion by SCC. A, Orig. mag. ×50. B, Orig. mag. ×100. Lymphovascular invasion by SCC, orig. mag. ×200. C, D2-40—highlights lymphatic space. D, P40—stains SCC tumor cell nuclei within the lymphatic space. E, Metastatic SCC in lymph node, orig. mag. ×100.
See this image and copyright information in PMC

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