High-Magnification Chromoscopic Ileoscopy in Familial Adenomatous Polyposis: Detection In Vivo of Colonic Metaplasia and Microadenoma Formation

Figure 1 Ileal microadenomas with morphological features similar to colorectal aberrant crypt foci occur in the ileum of patients with familial adenomatous polyposis (FAP). Ileal microadenomas may occur secondarily to ileal-colonic metaplasia. High-magnification chromoscopic endoscopy permits in vivo observation of this phenomenon. These views were obtained during a 50-cm ileoscopy of a patient with sporadic FAP. a Terminal-ileal views at 5 cm from the ileocaecal valve using 0.05 % indigo carmine. The villous pattern is replaced with a Kudo type I crypt typical of columnar epithelium (magnification × 100). b and c View at 10 cm from the ileocaecal valve using 0.05 % indigo carmine. Diminutive protrusions cluster among the normal ”round” villous network. The protruded areas demonstrate small crypt openings (magnification × 100).

Figure 2 Microadenoma of Figure 1 c at histopathological examination (haematoxylin & eosin stain).