TY  - JOUR
A1  - Götz, Martin
A1  - Hoffman, Arthur
A1  - Kiesslich, Ralf
T1  - Confocal endomicroscopy of the stomach: gastritis, intestinal metaplasia, adenoma, and gastric cancer
T2  - Video Journal and Encyclopedia of GI Endoscopy
N2  - In the stomach, neoplastic lesions often arise in the setting of precursor conditions such as gastritis, intestinal metaplasia, or adenomatous lesions. Biopsies may, therefore, underestimate disease severity or even miss the diagnosis (sampling error). Endomicroscopy is able to visualize typical features of such pathologies. It enables in vivo microscopy of gastritis with definition of enhanced vascularity and vascular leakage, but the typical cobblestone appearance of the gastric mucosa is preserved. The presence of intestinal metaplasia is confirmed by columnar absorptive cells with brush border and goblet cells within villiform foveolar epithelium. Gastric neoplasia is characterized by crowded glands with intraluminal folding and glandular budding and branching accompanied by increased density of dilated and distorted capillaries. Finally, in gastric cancer, gland and overall mucosal architecture is progressively lost. These features are shown side by side with white-light endoscopic findings. Endomicroscopy is used in such a setting to rapidly screen larger areas (optical biopsies) and subsequently target tissue sampling to areas with highly suspicious microscopic patterns. In experienced hands, it therefore constitutes an important part especially in the presence of neoplastic lesions within noncircumscript gastric premalignant conditions. This article is part of an expert video encyclopedia.
KW  - Endomicroscopy
KW  - Gastric adenoma
KW  - Gastric cancer
KW  - Gastritis
KW  - Intestinal metaplasia
KW  - Standard endoscopy
KW  - Video
Y1  - 2013
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/76811
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-768112
SN  - 2212-0971
VL  - 1
IS  - 1
SP  - 115
EP  - 116
PB  - Elsevier
CY  - Amsterdam
ER  -