Pit Pattern in Colorectal Neoplasia: Endoscopic Magnifying View

S. Kudo; C. A. Rubino; C. R. Teixeira; H. Kashida; E. Kogure

doi:10.1055/s-2004-826104

Endoscopy, Table of Contents

Endoscopy 2001; 33(4): 367-373
DOI: 10.1055/s-2004-826104

The Expert Approach

Pit Pattern in Colorectal Neoplasia: Endoscopic Magnifying View

S. Kudo¹ , C. A. Rubino² , C. R. Teixeira³ , H. Kashida⁴ , E. Kogure¹

¹Dept. of Surgery and Gastroenterology, Akita Red Cross Hospital, Akita, Japan
²Dept. of Pathology, Karolinska Institute, Stockholm, Sweden
³Fugast, Porto Alegre RS, Brazil
⁴Division of Gastroenterology and Hepatology, Kobe City General Hospital, Kobe, Japan

Special Section Committee: Chairman: R. Lambert (Lyon) Specialists: R. Kozarek (Seattle), H. Inoue (Tokyo), P. Sakai (Sao Paulo), H. Neuhaus (Düsseldorf), C. Neumann (Birmingham)

Abstract

Full Text

References

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S. KudoM.D.

Dept. of Surgery and Gastroenterology Akita Red Cross Hospital

222-1 Aza-naeshirosawa Saruta Kamikitade Akita 010-1495 Japan

Fax: + 81-18-829-5115

Email: kudo-s@synap.ne.jp

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The magnifying colonoscope has opened the door to the new field of diagnosing colorectal lesions. By using this new instrument together with dye spraying (chromoscopy), surface morphology can be clearly visualized with a maximum magnification of up to 100 ×. It is surprising how the tiny pit pattern can be clearly seen in vivo, as under the dissecting microscope. This short paper describes how this new technology is effective in observing the pit patterns of colorectal flat and depressed lesions, which reflect their histology quite well. As the text explains, the classification of the pit pattern is not so simple, but experienced colonoscopists are able to distinguish neoplastic lesions from non-neoplastic ones, and furthermore, submucosal carcinomas from mucosal ones in vivo during colonoscopy It seems as if histological diagnosis might not be mandatory; however, this is not always the case, and careful comparison of the pit pattern with histology in individual cases is essential. In order to establish the usefulness and merit of this new technology, the magnifying colonoscope should be widely used around the world. It is interesting to speculate how far this new technology will go, and what will be seen beyond the opened door in the future.

T. Muto, M.D., Ph.D.

The Cancer Institute Hospital, Tokyo, Japan

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