Magnifying fiber-colonoscopy reveals that adenoma, minute carcinomatous lesion in an adenoma (which is termed focal carcinoma), and mucosal carcinoma of the colon, each has its own characteristic pit pattern. Inspection by dissecting microscope of resected specimens obtained from subjects whose colonic mucosa had been considered normal, often reveals an abnormal pit pattern of less than 1 mm, and subsequent histologic examination confirms the frequent presence of incipient adenoma. Clinical magnification inspection of areas of colonic mucosa considered normal on the basis of ordinary observation, reveals pit patterns identical to those seen in resected specimens.

On the basis of considerable experiences, we have correlated findings under the dissecting microscopy (1, 3, 6, 7) with findings obtained with the magnifying fiberoptic endoscope (2, 5), and have established a system of classification (2, 4) to help the endoscopist determine the nature of elevated lesions of the stomach without a biopsy.

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We have adapted a new, high-performance magnifying fibercolonoscope (FCS-ML II) developed by Machida Industries, for clinical use. We have observed the remission process of ulcerative colitis with this new instrument and have compared our findings with those obtained by clinical examination, X-ray, ordinary gastroscope, and histologic examination of biopsy specimens. Our results show that the findings of magnifying fiber-colonoscopy correspond to those obtained with biopsy and histology, indicating that this new instrument promises to be a highly effective tool for the accurate assessment of the degree of remission of ulcerative colitis.

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