Volumetric laser endomicroscopy in the detection of neoplastic lesions of the esophagus

Volumetric laser endomicroscopy (VLE) in a 64-year-old man with Barrett's esophagus revealed two regions with intramucosal adenocarcinoma missed by high magnification narrow-band imaging. On VLE, these regions where characterized by lack of regular striations in the architecture, jagged shaped ducts suggestive of glandular atypia, and heterogenous signal intensity consistent with irregular nuclei (Arrows, Fig. 1; Normal, Fig. 2). Histopathology on targeted endoscopic mucosal resection showed high-grade dysplasia with focal intramucosal adenocarcinoma, and high-grade dysplasia with papillary intramucosal adenocarcinoma, respectively.

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