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CC BY 4.0 · Endoscopy 2024; 56(S 01): E571
DOI: 10.1055/a-2337-7551
E-Videos

First report of opportunistic screening for nasopharyngeal carcinoma by gastroscopy

Jialiang Huang
1   Gastroenterology, Second Affiliated Hospital of Soochow University, Suzhou, China (Ringgold ID: RIN105860)
,
Qinkai Li
1   Gastroenterology, Second Affiliated Hospital of Soochow University, Suzhou, China (Ringgold ID: RIN105860)
,
Wei Wu
1   Gastroenterology, Second Affiliated Hospital of Soochow University, Suzhou, China (Ringgold ID: RIN105860)
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A 45-year-old woman presented at our hospital with epigastric pain. Gastroscopy was undertaken, but before the gastroscope was inserted into her esophagus, her nasopharynx was examined. This examination revealed a 1.8-cm lesion ([Video 1]) near the pharyngeal opening of the eustachian (pharyngotympanic) tube on the right side. Blue light imaging and linked color imaging showed irregular microvasculature on the surface of the lesion ([Fig. 1]). Pathological analysis identified squamous cell nonkeratinized carcinoma, with positive immunohistochemistry for P40 ([Fig. 2] a) and CK5/6 ([Fig. 2] b). The Ki-67 index was 50%. Subsequently, the patient was diagnosed with nasopharyngeal carcinoma. This is the first report of opportunistic screening for nasopharyngeal carcinoma using gastroscopy.

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Fig. 1 a Gastroscopic observation of squamous cell nonkeratinized carcinoma in the nasopharynx of a 45-year-old woman (dashed lines outline the lesion): a white light imaging; b blue light imaging; c linked color imaging.
Zoom Image
Fig. 2 a Positive immunohistochemical staining: a P40 (× 100); b CK5/6 (× 100).

Quality:
Observation of the nasopharynx by gastroscopy.Video 1

The nasopharynx is easy to access using a gastroscope. The gastroscope provides sufficient illumination and a high-quality visual field, and is equipped with electronic staining and magnification functions, which contribute to early detection of changes in the nasopharyngeal mucosal surface. It is particularly sensitive for detecting surface roughness, localized hyperplasia, and color changes, and enables any nasopharyngeal lesions identified to be biopsied. Opportunistic screening can enhance the detection rate of nasopharyngeal carcinoma, particularly in regions with a high incidence of this cancer.

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Publication History

Article published online:
03 July 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/).

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