Chromoendoscopy
Monday 31 March 2008, Branislav Kunčak, M. D.
Chromoendoscopy is the topical application of stains during endoscopy.
Methylene blue selectively stains specialized columnar epithelium (SCE) in Barrett´s esophagus. Non-dysplastic and non-neoplastic SCE stains differently from dysplastic and neoplastic areas in Barrett´s esophagus (low-grade dysplasia-LGD, high-grade dysplasia-HGD and small foci of cancer). It might be helpful in diagnosing HGD and early carcinoma in Barrett´s esophagus. It mihgt help to target biopsy towards these areas. Increased heterogenity and decreased intensity of methylene blue staining are predictors of HGD and carcinoma.
Bigger image, Endoscopy
Fig. 1
Long segment of Barrett´s esophagus.
Methylene blue staining. Stain heterogenity. Dark blue stain corresponds to SCI with no dysplasia. Unstained and less intensively stained areas could correspond to gastric-type metaplastic epithelium or areas with dyplasia and neoplasia (in this case only gastric-type metaplasia and LGD).
Bigger image, Endoscopy
Fig. 2
Short segment of Barrett´s esophagus (tongue). Before application of methylene blue stain.
Bigger image, Endoscopy
Fig. 3
Tongue of short segment Barrett´s esophagus stained very dark blue with methylene blue (see also figure 2).
