Figure 3:

Endoscopic images of the same lesion of esophageal squamous dysplasia, with WLE, NBI, Magnifying NBI, and Lugol’s chromoendoscopy.

a. | Endoscopic finding with conventional white light imaging. A flat reddish lesion was seen in the upper thoracic esophagus (between the arrows). At the edge of the lesion, the vascular pattern in the surrounding mucosa was interrupted.

b. | Endoscopic finding with narrow band imaging of the lesion from panel a. The lesion was contrasted as darker area (arrow) and the boundary of the lesion is clearer than in white light images.

c. | Endoscopic finding with magnifying narrow-band imaging. Dilated irregular microvascular pattern was clearly visualized in the lesion. A distinct demarcation line between the background mucosa and the lesion is visible (arrow). Note the color of the epithelium in the lesion is browner than the surrounding mucosa. Accordingly, endoscopic diagnosis of intramucosal squamous cell carcinoma or high-grade dysplasia can be made with high confidence.

d. | Endoscopic finding using Lugol’s chromoendoscopy for the lesion depicted in panels a and b. The lesion is clearly visualized as a lighter (yellow) unstained area within the brown stained area. The boundary of the lesion can be clearly delineated with chromoendoscopy. (Reprinted with permission from Veitch AM, et al. Nat Rev Gastroenterol & Hepatol. 2015)