Endoscopic findings using narrow-band imaging to distinguish between basal cell hyperplasia and carcinoma of the pharynx.
Bottom Line: The clinicopathological factors were also compared.The size of the BCH lesions was significantly smaller (P < 0.001), and their intervascular transparency was more clearly observed (P < 0.001).Intra-epithelial papillary capillary loop (IPCL) shapes were less variable and monotonous (P < 0.001), and the distribution of the IPCL was more regular with an interval comparable to that of SCC (P < 0.001), although no significant differences in the sharpness of the lesion border, dilatation of IPCL and tortuosity of the IPCL were seen between the BCH and SCC lesions.
Affiliation: Endoscopy Division, Department of Gastroenterology, National Cancer Center Hospital East, Chiba, Japan.Show MeSH
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Mentions: Typical BCH and HNSCC cases are shown in Fig. 1. Both lesions were recognized as brownish areas on the NBI images; however, intervascular transparency and a regular distribution were only observed in the BCH lesion. The endoscopic findings for the BCH and SCC lesions are shown in Table 3. The typical findings for BCH were defined as a regular distribution of IPCL composed of 2–4 loop-shaped (“lasso-like”) capillaries, with all the cases except for one exhibiting this typical finding (Fig. 1). As a result, the BCH were significantly smaller (P < 0.001), had a more preserved intervascular transparency (flat type) (P < 0.001), had fewer variations in IPCL shapes (P < 0.001) and had a more regular distribution of IPCL (P < 0.001) than the SCC. In contrast, no significant difference in the sharpness of the margin was seen between the BCH and SCC lesions (P = 0.17), and the IPCL of both of them were dilated and tortuous. Among the 21 cases of non-elevated (flat or mixed with flat and elevated) BCH, the intervascular transparency was not impaired in any of the cases (i.e. preserved or slightly impaired) and the intervascular color changes were positive in two cases (10%, 2/21). Among the 26 cases of non-elevated (flat or depressed) SCC, 20 cases (77%) had an impaired intervascular transparency, and among the remaining 6 cases, the intervascular color change was positive in 3 cases (50%, 3/6). The features of BCH and SCC are summarized in Fig. 2.
Affiliation: Endoscopy Division, Department of Gastroenterology, National Cancer Center Hospital East, Chiba, Japan.