In-vivo microvascular imaging of early squamous-cell cancer of the esophagus by confocal laser endomicroscopy

We present the case of a 63-year-old man with an early esophageal squamous-cell cancer that was visualized and analyzed by fluorescein-aided confocal laser endomicroscopic imaging. Our findings indicate that endomicroscopy is readily able to provide images of microvessels and to differentiate between normal and abnormal tumor vessels. Endomicroscopy therefore has the potential to characterize microvascular changes in early squamous-cell cancer, suggesting that this technique might have major implications for optimizing treatment strategies in modern endoscopy.

References

• 1 Kiesslich R, Burg J, Vieth M. et al . Confocal laser endoscopy for diagnosing intraepithelial neoplasias and colorectal cancer in vivo.  Gastroenterology. 2004;  127 706-713
• 2 Polglase A L, McLaren W J, Skinner S A. et al . A fluorescence confocal endomicroscope for in vivo microscopy of the upper- and lower-GI tract.  Gastrointest Endosc. 2005;  62 686-695
• 3 The Paris endoscopic classification of superficial neoplastic lesions: esophagus, stomach, and colon.  Gastrointest Endosc. 2003;  58 (6 Suppl) S3-S43
• 4 Yoshida T, Inoue H, Usui S. et al . Narrow-band imaging system with magnifying endoscopy for superficial esophageal lesions.  Gastrointest Endosc. 2004;  59 288-295
• 5 Inoue H, Honda T, Nagai K. et al . Ultra-high magnification endoscopic observation of carcinoma in situ of the esophagus.  Dig Endosc. 1997;  9 16-18
• 6 Kumagai Y, Inoue H, Nagai K. et al . Magnifying endoscopy, stereoscopic microscopy, and the microvascular architecture of superficial esophageal carcinoma.  Endoscopy. 2002;  34 369-375