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Texture and Color Enhancement Imaging With Indigo Carmine Dye Effectively Delineates Duodenal Adenoma

  • Kimitoshi Kubo
    Correspondence
    Correspondence: Address correspondence to: Kimitoshi Kubo, MD, Department of Gastroenterology, National Hospital Organization Hakodate National Hospital, 18-16 Kawahara-cho, Hakodate, Hokkaido 041-8512, Japan.
    Affiliations
    Department of Gastroenterology, National Hospital Organization Hakodate National Hospital, Hakodate, Hokkaido, Japan
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  • Noriko Kimura
    Affiliations
    Department of Pathology, National Hospital Organization Hakodate National Hospital, Hakodate, Hokkaido, Japan
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Open AccessPublished:May 22, 2022DOI:https://doi.org/10.1016/j.gastha.2022.05.010
      Screening esophagogastroduodenoscopy (GIF-XZ1200 with the EVIS X1 video system; Olympus Medical Systems, Tokyo, Japan) performed on a 72-year-old man revealed a 7-mm isochromatic, slightly elevated lesion with a central depression located in the descending part of the duodenum on white-light imaging (Figure A). On texture and color enhancement imaging (TXI) mode 1 with indigo carmine dye (chromo-TXI), the lesion was delineated as a neoplastic lesion with (1) a clear boundary between the surrounding villi and (2) a regular surface structure (Figure B and Figure C, at low and moderate magnifications, respectively). Cold forceps polypectomy was performed on the suspicion of an adenoma for biopsy and endoscopic diagnosis. Histologic examination showed the lesion to be low-grade adenoma (Figure D).