Application of high-resolution narrow band imaging and endocytoscopy for early diagnosis of esophageal neoplasia.

The worldwide incidence of esophageal carcinoma has been rising rapidly over the past few decades. However, in only 31% of patients the carcinoma is detected early in situ. It is essential to detect the malignancy early and to determine the extent of the disease to ensure the best option for a cure. Recent advances in endoscopic technology, including high-resolution magnification endoscopy, narrow-band imaging and endocytoscopy, have increased detection rates of oesophageal microcarcinomas. We report three cases of esophageal malignancy where the use of newer diagnostic techniques ensured an early diagnosis which led to a modified course of management.

Role of magnification endoscopy in the diagnosis and evaluation of suspected celiac disease: correlation with histology.

BACKGROUND: Magnification endoscopy (ME), with 115-fold magnification, allows visualization of duodenal villi. We assessed the efficacy of ME for evaluation of villous atrophy. METHODS: ME and duodenal biopsy were done in 16 patients with suspected celiac disease and 16 control subjects undergoing endoscopy for reflux symptoms. The pathologist was unaware of the ME findings. RESULTS: Sensitivity, specificity and positive and negative predictive values for villous atrophy (partial or total) were 100%, 91%, 83% and 100%, respectively. Corresponding values for normal villous structure were 91%, 100%, 100% and 83%, respectively. There was significant concordance between the ME and histology findings. CONCLUSION: ME is a reliable technique to diagnose villous atrophy.