Detection of Nonpolypoid Colorectal Neoplasia Using Magnifying Endoscopy in Colonic Inflammatory Bowel Disease Shiro Oka, MD, PhD, Shinji Tanaka, MD,

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Detection of Nonpolypoid Colorectal Neoplasia Using Magnifying Endoscopy in Colonic Inflammatory Bowel Disease Shiro Oka, MD, PhD, Shinji Tanaka, MD, PhD, Kazuaki Chayama, MD, PhD Gastrointestinal Endoscopy Clinics Volume 24, Issue 3, Pages 405-417 (July 2014) DOI: 10.1016/j.giec.2014.03.011 Copyright © 2014 Elsevier Inc. Terms and Conditions

Fig. 1 A 53-year-old woman, 10 years after the onset of UC. (A) Ordinary colonoscopic view. A flat elevated lesion was noted in the rectum. (B) NBI showed the slightly elevated lesion with mucus present. (C) High-magnification imaging with NBI revealed the irregular surface pattern. (D) View with indigo carmine dye spraying. The focal lesion that is not covered with the indigo carmine solution is unclear. Proctocolectomy was performed. (E) Cross section of the specimen (hematoxylin-eosin). (F) The lesion was diagnosed histologically as intramucosal well-differentiated adenocarcinoma. Gastrointestinal Endoscopy Clinics 2014 24, 405-417DOI: (10.1016/j.giec.2014.03.011) Copyright © 2014 Elsevier Inc. Terms and Conditions

Fig. 2 A 35-year-old man, 21 years after the onset of UC. (A) Ordinary colonoscopic view. The reddened flat lesion was identified. (B) NBI showed the flat lesion as a brownish area. (C) High-magnification imaging with NBI revealed the irregular surface pattern and microvessels. (D) View with indigo carmine dye spraying. A 0-IIa+IIc lesion was clearly delineated. Proctocolectomy was performed. (E) The lesion was diagnosed histologically as submucosal invasive well-differentiated adenocarcinoma. Gastrointestinal Endoscopy Clinics 2014 24, 405-417DOI: (10.1016/j.giec.2014.03.011) Copyright © 2014 Elsevier Inc. Terms and Conditions

Fig. 3 A 47-year-old woman, 5 years after the onset of UC. (A) Ordinary colonoscopic view. A whitish flat elevated lesion was noted in the rectum. (B) NBI showed the slightly elevated lesion. (C) High-magnification imaging with NBI revealed the mild irregular surface pattern. (D) View with indigo carmine dye spraying. The focal lesion was relatively clear. Endoscopic submucosal dissection was performed on the lesion. (E) Cross section of the specimen (hematoxylin-eosin). (F) The lesion was diagnosed histologically as low-grade dysplasia. Gastrointestinal Endoscopy Clinics 2014 24, 405-417DOI: (10.1016/j.giec.2014.03.011) Copyright © 2014 Elsevier Inc. Terms and Conditions