Japanese Journal of Clinical Oncology

Cover Illustration: A Case of Superficial Hypopharyngeal Cancers Treated by EMR

A 66-year-old man who had undergone esophagectomy for early esophageal cancer 12 years previously had a follow-up endoscopy. No abnormalities were detected by conventional method (Cover Illustration A). With the narrow band imaging (NBI) system, however, a brownish area of ∼10 mm was demonstrated at the right hypopharynx (Cover Illustration B). Magnifying endoscopy revealed characteristic changes of intra-epithelial papillary capillary loops (IPCL) for carcinoma in situ (Figure C). With iodine staining, the margin of hypopharyngeal lesion was delineated clearly (Figure D), and biopsy revealed squamous cell carcinoma. Endoscopic mucosal resection with the cap method was performed (Figures E and F). The squamous cell carcinoma was confined to the mucosal layer (Figure G).

Magnifying endoscopy with the NBI system is useful to detect capillary vessels as in this patient, and may be effective in early detection of esophageal and phayngeal cancers.

(Chika Kusano and Haruhisa Suzuki. Endoscopy Division, National Cancer Center Hospital, Tokyo)

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