Volume 132, Issue 3, Pages 874-882 (March 2007) Chromoscopy-Guided Endomicroscopy Increases the Diagnostic Yield of Intraepithelial Neoplasia in Ulcerative Colitis  Ralf Kiesslich, Martin Goetz, Katharina Lammersdorf, Constantin Schneider, Juergen Burg, Manfred Stolte, Michael Vieth, Bernhard Nafe, Peter R. Galle, Markus F. Neurath  Gastroenterology  Volume 132, Issue 3, Pages 874-882 (March 2007) DOI: 10.1053/j.gastro.2007.01.048 Copyright © 2007 AGA Institute Terms and Conditions

Figure 1 Comparison between endomicroscopy and histology for inflammatory changes in UC. (A) Normal crypt architecture. Typical round crypts with regular lumen (arrow) are visible. Black spots within the epithelial layer represent mucin in goblet cells. (B) Corresponding histologic specimen (H&E staining). Crypt lumen, mucin, and nuclei are present in regularly distributed crypts. (C) Dilated and distorted capillaries are brightly displayed by endomicroscopy. Black dots within the capillaries represent blood cells. Crypt architecture shows different shape and size and increased distance between the crypts. (D) Corresponding histology shows similar changes. However, delineation of single vessels is more difficult. (E) A mixed cellular infiltration is present in the lamina propria. The crypts are not affected. (F) Corresponding histology revealed similar changes. The cellular infiltration is highlighted by an arrow. Gastroenterology 2007 132, 874-882DOI: (10.1053/j.gastro.2007.01.048) Copyright © 2007 AGA Institute Terms and Conditions

Figure 2 Diagnosis of nonneoplastic and neoplastic tissue using confocal endomicroscopy in circumscribed lesions in UC. (A) Differences in shape and size of crypts are visible. In addition, enlarged luminal opening is present. However, distribution of goblet cells is normal and epithelial cells show a regular pattern indicating nonneoplastic tissue. (B) These results are confirmed ex vivo by H&E staining of biopsy specimens. (C) Ridged line epithelial layer is present with different shape and size of cells, but a clear basal border. In addition, leakage of vessels is present and depletion of goblet cells indicating neoplasia. (D) Corresponding histology revealed low-grade IN. (E) Different shape and size of epithelial cells and irregular configuration of crypts is present. In addition, the basement membrane cannot be delineated. Goblet cells are depleted. The overall pattern indicates neoplasia. (F) Corresponding histology revealed similar changes and high-grade IN was diagnosed. Gastroenterology 2007 132, 874-882DOI: (10.1053/j.gastro.2007.01.048) Copyright © 2007 AGA Institute Terms and Conditions