%0 Journal Article
%T Endocytoscopic visualization of squamous cell islands within BarrettĄ¯s epithelium
%A Nicholas Eleftheriadis
%A Haruhiro Inoue
%A Haruo Ikeda
%A Manabu Onimaru
%J World Journal of Gastrointestinal Endoscopy
%D 2013
%I Baishideng Publishing Group Co. Limited
%R 10.4253/wjge.v5.i4.174
%X AIM: To study the endocytoscopic visualization of squamous cell islands within BarrettĄ¯s epithelium. METHODS: Endocytoscopy (ECS) has been studied in the surveillance of BarrettĄ¯s esophagus, with controversial results. In initial studies, however, a soft catheter type endocytoscope was used, while only methylene blue dye was used for the staining of BarrettĄ¯s mucosa. Integrated type endocytoscopes (GIF-Q260 EC, Olympus Corp, Tokyo, Japan) have been recently developed, with the incorporation of a high-power magnifying endocytoscope into a standard endoscope together with narrow-band imaging (NBI). Moreover, double staining with a mixture of 0.05% crystal violet and 0.1% of methylene blue (CM) during ECS enables higher quality images comparable to conventional hematoxylin eosin histopathological images. RESULTS: In vivo endocytoscopic visualization of papillary squamous cell islands within glandular BarrettĄ¯s epithelium in a patient with long-segment BarrettĄ¯s esophagus is reported. Conventional white light endoscopy showed typical long-segment BarrettĄ¯s esophagus, with small squamous cell islands within normal BarrettĄ¯s mucosa, which were better visualized by NBI endoscopy. ECS after double CM staining showed regular BarrettĄ¯s esophagus, while higher magnification (ĄÁ 480) revealed the orifices of glandular structures better. Furthermore, typical squamous cell papillary protrusion, classified as endocytoscopic atypia classification (ECA) 2 according to ECA, was identified within regular glandular BarrettĄ¯s mucosa. Histological examination of biopsies taken from the same area showed squamous epithelium within glandular BarrettĄ¯s mucosa, corresponding well to endocytoscopic findings. CONCLUSION: To our knowledge, this is the first report of in vivo visualization of esophageal papillary squamous cell islands surrounded by glandular BarrettĄ¯s epithelium.
%K Endocytoscopy
%K BarrettĄ¯s esophagus
%K Surveillance
%K Endocytoscopic atypia classification
%K Crystal violet
%K Methylene blue
%K Hematoxylin eosin stain
%U http://www.wjgnet.com/1948-5190/full/v5/i4/174.htm