Detection of minute intestinal metaplastic lesions by video microscopy

Using video microscopy in 225 resected stomachs we detected 32 minute solitary lesions of intestinal metaplasia histologically. The magnified features of the minute lesions showed a characteristic appearance and were classified into three types: mesh-like (type A), villoid (type B), and tubular (type C). All the lesions classified as type A exhibited the incomplete type of intestinal metaplasia according to the results of histopathological and/or histochemical examination. In contrast, most lesions classified as type B exhibited the complete type of intestinal metaplasia. We concluded that intentional detection of minute lesions in resected stomachs by video microscopy is simple and useful, especially in cases of minute lesions < 5 mm in diameter. Moreover, our findings demonstrate that the minute intestinal metaplastic lesions have morphological characteristics based on which they can be classified into three types of lesions. These morphological characteristics correlate with their histopathological findings.