Usefulness of Double-Balloon Endoscopy in the Diagnosis of Malignant Small-Bowel Tumors  Hirokazu Yamagami, Nobuhide Oshitani, Shuhei Hosomi, Takehisa Suekane, Noriko Kamata, Mitsue Sogawa, Hirotoshi Okazaki, Kenji Watanabe, Kazunari Tominaga, Toshio Watanabe, Yasuhiro Fujiwara, Tetsuo Arakawa  Clinical Gastroenterology and Hepatology  Volume 6, Issue 11, Pages 1202-1205 (November 2008) DOI: 10.1016/j.cgh.2008.05.014 Copyright © 2008 AGA Institute Terms and Conditions

Figure 1 (A) DBE revealed ulceration on a gently protruding submucosal tumor in the jejunum, confirming adenocarcinoma with intramural metastases from primary adenocarcinoma of the small intestine detected at autopsy (patient 1). (B) DBE reveals stenosis of the jejunum. The tip of the endoscope could not pass through the stenosis, and appropriate sampling could not be performed. Adenocarcinoma was confirmed in surgical specimens (patient 6). (C) DBE revealed tumor in the jejunum confirmed to be metastatic carcinoma from the kidney. Handling of the endoscope to obtain an adequate view of tumor was difficult because of the large size of tumor (patient 9). (D) Biopsy specimen obtained from this tumor by DBE showed clear cell carcinoma with clear cytoplasm and irregular nuclei with large nucleoli (patient 9). H&E staining: original magnification, 400×. Clinical Gastroenterology and Hepatology 2008 6, 1202-1205DOI: (10.1016/j.cgh.2008.05.014) Copyright © 2008 AGA Institute Terms and Conditions