Colon - Aberrant Crypt Foci Stained with Methylene Blue
Comments: The entire rectum and sigmoid is stained with methylene blue in a 0.1% concentration to look for aberrant crypt foci in this 65 year old man with an adenoma at the cecum. Methylene blue is already absorbed and the characteristic staining pattern of normal crypt openings is visible.
Within the stained area, a blue spot is detected. With the help of a magnifying endoscope the view is magnified 150 fold. Some aggregated crypts of regular shape with a clear border can be identified within surrounding normal mucosa. The lesion is 1 mm in size and a targeted biopsy could now be easily performed.
Histology shows dilated and elongated crypts with normal size and arrangement of nuclei. The final diagnosis is aberrant crypt foci without dysplasia.
The second case shows a 59 year old woman with known colon cancer at the splenic flexure. As seen before the sigmoid and rectum is stained with methylene blue in an untargeted fashion. A large ACF of 2 cm in size is unmasked after intravital staining. The border and the surface architecture can be seen with great clarity using magnifying endoscopy.
Histology shows dilated crypts with nuclear disarrangement favoring dysplasia. The final diagnosis is dysplastic aberrant crypt foci.
| Contributed by: |
Ralf Kiesslich, M.D. Chief of Endoscopy University of Mainz, Germany |
|
Citation: Kiesslich, R. (Jan 15 2004). Colon - Aberrant Crypt Foci Stained with Methylene Blue. The DAVE Project. Retrieved Feb, 9, 2010, from http://daveproject.org/viewfilms.cfm?film_id=89 Times viewed since Feb 2006: 10182 |
|
