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Updated: May 1, 2026

Diagnosis of Neoplasia in Barrett’s Esophagus using Vital-dye Enhanced Fluorescence Imaging
Published on: May 11, 2014
[Endoscopic diagnosis of tissue atypism (EA) in the pharyngeal and esophageal squamous epithelium; IPCL pattern
1Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan.
Abstract:
Standard magnifying endoscopy has around 100 fold magnifying power. Intra-epithelial papillary capillary loop (IPCL) pattern is diagnosed with it. Narrow band imaging system (NBI) is extremely useful to recognize IPCL well as a brown spot. In IPCL type classification, type I mainly includes normal epithelium. Type Il corresponds to inflammatory change or non-neoplastic tissue and type Ill reflects border line lesions. Type IV strongly suggests carcinoma in situ. Type V-1 is definitely diagnosed as carcinoma in situ. Endocytoscopy has around 500 fold magnification, which enables observation of cell and nucleus. Endocytoscopic images are classified into 5 categories from normal epithelium to malignant tissue as endocytoscopic atypism classification (ECA classification). ECA IV and V are considered to be treated in clinical setting.
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