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Magnifying Endoscopy with Narrow Band Imaging for Diagnosis of Nonampullary Duodenal Adenomas and Early Cancers Shuji Inatsuchi 1,2 , Yoshinobu Maeda 3 1Department of Gastroenterology, Toyama Red Cross Hospital, Toyama, Japan 3Department of Pathology, Toyama Red Cross Hospital, Toyama, Japan Keyword: 十二指腸 , 十二指腸腺腫 , 十二指腸早期癌 , 拡大内視鏡 , NBI pp.1604-1617
Published Date 2011/10/25
DOI https://doi.org/10.11477/mf.1403102379
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 19 cases of nonampullary duodenal adenomas and early cancers were examined, using conventional endoscopy and magnifying endoscopy with narrow band imaging(NBI). Their frequency under routine endoscopy was extremely low with adenoma at 0.034% and early cancer at 0.017%. 80% of adenomas were located in the 2nd part of the duodenum. Of the 19 lesions, 16(84%)had a whitish villous color could be a helpful sign for the recognition of nonampullary duodenal intraepithelial tumors, under conventional endoscopy. Observation with magnified NBI might be a promising approach for the differential diagnosis of adenoma and cancer. The differential diagnosis of adenoma and cancer has been regarded as important. However, it was difficult using conventional endoscopy. On narrow-band imaging magnified endoscopy, all tumors had a heterogeneous pattern. The mucosal microsurface structure is classified into tubular structure, cobblestone-like structure, papillary structure, and villous-like structure. Tubular and cobblestone-like structure were most frequently observed in adenomas, but carcinomas tended to present villous-like structure. Network pattern on the mucosal microvascular architecture was observed in two cases of adenoma, but was not recognized for carcinoma. Regarding nonampullary tumors, villous-like structural mucosa and abnormal vessels were able to be seen more often in cancers. Though duodenal adenoma is comparatively rare, it is difficult to distinguish it from a cancer, therefore endoscopic resection is necessary when it is located in the mucosa. Observation with magnified NBI might be a promising approach to the differential diagnosis of adenoma and cancer.


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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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