Ultra‐high Magnification Endoscopic Observation of Carcinoma in situ of the Esophagus

Abstract: Super‐zooming observation of carcinoma in situ of the esophagus was achieved utilizing an ultra‐high magnification endoscope which has a 150X magnification capacity. Superficial flat and slightly depressed lesions (O‐llb and O‐llc according to the Japanese classification of esophageal cancer), usually observed as a well‐demarcated reddish patch, were revealed to be a composite of scattered red dots and a pinkish homogeneous background. Those red dots were disclosed to be intrapapillary capillary loop changes such as dilatation, meandering and caliber irregularities. These changes were never observed in normal mucosa or in the setting of esophagitis. These characteristic findings were confirmed histologically in the resected specimen.