In Situ Carcinoma of the Esophagus Macroscopic Study with Particular Reference to the Lugol Test

Abstract

The results presented here concern the study of in situ cancer and marked dysplasia revealed during the pathological study of 39 specimens removed during esophagogastrectomy for invasive carcinoma of the esophagus. In 12 cases, macroscopic study made it possible to define precisely the macroscopic features of in situ canccer; in one case, however, the mucous membrane at the site of the in situ cancer was macroscopically normal. The iodine test performed in 37 cases showed that the normal esophageal mucosa is iodine-positive and that in situ and invasive squamous cell carcinoma are always represented by sharply defined iodine-negative zones: in the case in which it was sufficiently extensive, marked dysplasia presented the same iodine-negative character. The possibilities for applying these results to early endoscopic diagnosis of esophageal cancer are presented.

Endoscopic submucosal dissection with a combination of small-caliber-tip transparent hood and flex knife is a safe and effective treatment for superficial esophageal neoplasias

“…Recently, superficial esophageal neoplasias in the squamous epithelium or in the metaplastic columnar mucosa (Barrett's esophagus) could be detected by using chromoendoscopy with iodine staining and narrow-band imaging (NBI) [6][7][8][9]. Although EMR techniques such as the lift-and-cut method, the cap method, and the ligation technique have been widely used to resect superficial esophageal neoplasias, especially squamous cell neoplasias, en bloc resection for larger lesions was considered infeasible.…”

Mucosal iodine staining improves endoscopic visualization of squamous dysplasia and squamous cell carcinoma of the esophagus in linxian, china

“…In one of these studies, we found that the majority (73%) of the biopsies of high grade (moderate and severe) squamous dysplasia and all biopsies of invasive squamous cell carcinoma came from endoscopically visible mucosal lesions, but a significant minority (27%) of the sites containing high grade dysplasia could not be identified visually by routine endoscopic examination. 6 For several years, Japanese and European authors have reported that staining the esophageal mucosa with Lugol's iodine solution can make the presence and extent of squamous dysplastic and cancerous foci more clear, [7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26] but this technique has not often been used by Chinese or American endoscopists. The purpose of this study was to evaluate whether mucosal iodine staining could improve the detection and delineation of high grade squamous dysplasia and squamous cell carcinoma of the esophagus in Linxian.…”

Endoscopic Findings of 100 Early‐Stage Esophageal Cancers

“…Another method of anatomopathologic examination was proposed by Mandard et al, in 1980 (Mandard et al, 1980). It consists of painting all macroscopically visible lesions as well as those discovered by vital staining with green China ink; this makes all the pathologic zones immediately obvious on the histologic slides.…”