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Constitution of the Superficial Esophageal Lesions Visualized Via Microvascular Observation Using Magnifying Endoscopy Miwako Arima 1 , Mika Tsunomiya 1 , Ayataka Ishikawa 2 1Department of Gastroenterology, Saitama Cancer Center, Saitama, Japan 2Department of Diagnostic Pathology, Saitama Cancer Center, Saitama, Japan Keyword: 食道拡大内視鏡 , GERD , 早期食道癌 , 日本食道学会分類 , 微細血管 pp.1271-1279
Published Date 2018/8/25
DOI https://doi.org/10.11477/mf.1403201464
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 The subepithelial papillary vessel is a fundamental unit of the esophageal epithelium[synonymous with the intra-epithelial papillary capillary loop(IPCL)]. Inflammation increases the number of the IPCLs, expands and extends its length, divergence, and causes swelling of the tip. The epithelium thickens following inflammatory cell permeation and edema, and only the tip of the IPCL is observed. Therefore, the IPCLs appear as connected in one line or as agglutinates in a fence form. According to the classification by Japan Esophageal Society, type B1 is defined as loop-like irregular vessel. However, they appear as a series of linear dots because only the tip of the micro vessels can be visualized when the epithelium is replaced with cancer cells. B1 vessels alter their arrangement during erosion accompanying the lesion and may appear as a mesh-like pattern or a form of baran(green partition used for lunch).

 These micro vessels extend in a straight fashion, either vertically or diagonally toward the lumen. Even in cases with cancer of the initial permeation level, very thin B2 vessels branch off irregularly with unequal diameters. Determining the appearance of actual B2 vessels is essential for diagnosing true permeation.


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

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