Radiological diagnosis of superficial spreading type esophageal carcinoma

Kato, H.; Yoshida, M.

Stomach and Intestine 30(8): 1001-1010


ISSN/ISBN: 0536-2180
Accession: 009293878

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According to the definition by the Japanese Society for Esophageal Diseases, superficial spreading type carcinoma is recognized as a superficial flat type lesion expanding to more than 5cm in diameter. Using this definition, this study was made concerning radiological findings of six superficial spreading type carcinomas. Twelve oral and anal margins of six lesions were intraepithelial carcinomas. In radiological examination seven type 0-IIc margins and one 0-IIb margin with total epithelial layer type growth showed slight changes of longitudinal folds, unclearly-outlined folds, windings of folds, and width changes of folds. It was difficult to detect borders of other four 0-IIb margins with basal cell layer type growth. As some superficial spreading type legions had deepest invasion to mucosal or submucosal layer only in small regions, it was necessary in radiological examination, to make a diagnosis of the depth of invasion not only from the profile view but from the enface view. Radiological findings of mi carcinoma were changes of folds depicted by a small amount of air, unclearly-outlined granules depicted by a midlum amount of air, and disappearance of granules depicted by a large amount of air. m-2 invasion could be differentiated from m-1 carcinoma by granules remaining in a large amount of air. Granules in the m-3 invading carcinomas had clear outlines and irregular shapes in medium or large amount of air. Distinct findings of m-3 invasion were thick folds, or wider and higher fold than folds on normal mucosa. Though there were no findings to distinguish sm-1 invasion from m-3 or other deeper submucosal invasion, sm-1 invasion could be suspected by a broad region showing thick folds. The findings concerning of slight changes of folds were useful to detect margins of superficial spreading lesions, and appearance of granules and thick folds were findings for effectual diagnosis of depth of invasion.