Decreased numbers of vascular networks and irregular vessels on narrow-band imaging are useful findings for distinguishing intestinal lymphoma from lymphoid hyperplasia
Background No method for sufficiently making the differential diagnosis of intestinal lymphoma resembling lymphoid hyperplasia (LH) on endoscopy has yet been established. Objective The aim of this study was to evaluate the usefulness of narrow-band imaging (NBI) in diagnosing intestinal lymphoma. De...
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creator | Fujiya, Mikihiro, MD Kashima, Shin, MD Ikuta, Katsuya, MD Dokoshi, Tatsuya, MD Sakatani, Aki, MD Tanaka, Kazuyuki, MD Ando, Katsuyoshi, MD Ueno, Nobuhiro, MD Tominaga, Motoya, MD Inaba, Yuhei, MD Ito, Takahiro, MD Moriichi, Kentaro, MD Tanabe, Hiroki, MD Saitoh, Yusuke, MD Kohgo, Yutaka, MD |
description | Background No method for sufficiently making the differential diagnosis of intestinal lymphoma resembling lymphoid hyperplasia (LH) on endoscopy has yet been established. Objective The aim of this study was to evaluate the usefulness of narrow-band imaging (NBI) in diagnosing intestinal lymphoma. Design Prospective study. Setting Single-center study. Patients Sixty-one patients with primary or systemic lymphoma were enrolled in this study. Interventions The terminal ileum and entire colon were observed by using conventional endoscopy. NBI was subsequently performed when small polypoid lesions were detected. A decrease in the number of vascular networks (DVNs) and the presence of irregular vessels on the surface of the epithelia were defined as characteristic findings of intestinal lymphoma. The diagnostic accuracy of these 2 findings in distinguishing intestinal lymphoma from LH was examined. Main Outcome Measurements The ability to use NBI to distinguish intestinal lymphoma from LH. Results Two hundred ninety-four small polypoid lesions, including 59 lymphomas and 235 LH lesions, were detected. The rates of detecting DVNs and the presence of irregular vessels were significantly higher in the lymphoma samples (81.4% and 62.7%) than in the LH samples (25.5% and 4.7%). Based on these findings, the diagnostic accuracy, sensitivity, specificity, and positive and negative predictive values for differentiating intestinal lymphoma from LH were 88.8%, 62.7%, 95.3%, 77.1%, and 91.1%, respectively, which are significantly higher than those of conventional endoscopy. Limitations Single-center study. Conclusion DVNs and the presence of irregular vessels on NBI are thus considered to be useful findings for differentiating intestinal lymphoma from benign LH. |
doi_str_mv | 10.1016/j.gie.2014.03.030 |
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Objective The aim of this study was to evaluate the usefulness of narrow-band imaging (NBI) in diagnosing intestinal lymphoma. Design Prospective study. Setting Single-center study. Patients Sixty-one patients with primary or systemic lymphoma were enrolled in this study. Interventions The terminal ileum and entire colon were observed by using conventional endoscopy. NBI was subsequently performed when small polypoid lesions were detected. A decrease in the number of vascular networks (DVNs) and the presence of irregular vessels on the surface of the epithelia were defined as characteristic findings of intestinal lymphoma. The diagnostic accuracy of these 2 findings in distinguishing intestinal lymphoma from LH was examined. Main Outcome Measurements The ability to use NBI to distinguish intestinal lymphoma from LH. Results Two hundred ninety-four small polypoid lesions, including 59 lymphomas and 235 LH lesions, were detected. The rates of detecting DVNs and the presence of irregular vessels were significantly higher in the lymphoma samples (81.4% and 62.7%) than in the LH samples (25.5% and 4.7%). Based on these findings, the diagnostic accuracy, sensitivity, specificity, and positive and negative predictive values for differentiating intestinal lymphoma from LH were 88.8%, 62.7%, 95.3%, 77.1%, and 91.1%, respectively, which are significantly higher than those of conventional endoscopy. Limitations Single-center study. Conclusion DVNs and the presence of irregular vessels on NBI are thus considered to be useful findings for differentiating intestinal lymphoma from benign LH.</description><identifier>ISSN: 0016-5107</identifier><identifier>EISSN: 1097-6779</identifier><identifier>DOI: 10.1016/j.gie.2014.03.030</identifier><identifier>PMID: 24830575</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Blood Vessels - pathology ; Cohort Studies ; Colon - blood supply ; Colonoscopy - methods ; Diagnosis, Differential ; Female ; Gastroenterology and Hepatology ; Hodgkin Disease - diagnosis ; Hodgkin Disease - pathology ; Humans ; Ileum - blood supply ; Intestinal Diseases - diagnosis ; Intestinal Diseases - pathology ; Intestinal Neoplasms - diagnosis ; Intestinal Neoplasms - pathology ; Lymphoma, Non-Hodgkin - diagnosis ; Lymphoma, Non-Hodgkin - pathology ; Male ; Narrow Band Imaging - methods ; Predictive Value of Tests ; Prospective Studies ; Pseudolymphoma - diagnosis ; Pseudolymphoma - pathology ; Sensitivity and Specificity</subject><ispartof>Gastrointestinal endoscopy, 2014-12, Vol.80 (6), p.1064-1071</ispartof><rights>American Society for Gastrointestinal Endoscopy</rights><rights>2014 American Society for Gastrointestinal Endoscopy</rights><rights>Copyright © 2014 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c544t-cfe657c38e326f09ca3147d500f345fd66803d374ed1c850e06446f930317f0a3</citedby><cites>FETCH-LOGICAL-c544t-cfe657c38e326f09ca3147d500f345fd66803d374ed1c850e06446f930317f0a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.gie.2014.03.030$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3536,27903,27904,45974</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24830575$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Fujiya, Mikihiro, MD</creatorcontrib><creatorcontrib>Kashima, Shin, MD</creatorcontrib><creatorcontrib>Ikuta, Katsuya, MD</creatorcontrib><creatorcontrib>Dokoshi, Tatsuya, MD</creatorcontrib><creatorcontrib>Sakatani, Aki, MD</creatorcontrib><creatorcontrib>Tanaka, Kazuyuki, MD</creatorcontrib><creatorcontrib>Ando, Katsuyoshi, MD</creatorcontrib><creatorcontrib>Ueno, Nobuhiro, MD</creatorcontrib><creatorcontrib>Tominaga, Motoya, MD</creatorcontrib><creatorcontrib>Inaba, Yuhei, MD</creatorcontrib><creatorcontrib>Ito, Takahiro, MD</creatorcontrib><creatorcontrib>Moriichi, Kentaro, MD</creatorcontrib><creatorcontrib>Tanabe, Hiroki, MD</creatorcontrib><creatorcontrib>Saitoh, Yusuke, MD</creatorcontrib><creatorcontrib>Kohgo, Yutaka, MD</creatorcontrib><title>Decreased numbers of vascular networks and irregular vessels on narrow-band imaging are useful findings for distinguishing intestinal lymphoma from lymphoid hyperplasia</title><title>Gastrointestinal endoscopy</title><addtitle>Gastrointest Endosc</addtitle><description>Background No method for sufficiently making the differential diagnosis of intestinal lymphoma resembling lymphoid hyperplasia (LH) on endoscopy has yet been established. Objective The aim of this study was to evaluate the usefulness of narrow-band imaging (NBI) in diagnosing intestinal lymphoma. Design Prospective study. Setting Single-center study. Patients Sixty-one patients with primary or systemic lymphoma were enrolled in this study. Interventions The terminal ileum and entire colon were observed by using conventional endoscopy. NBI was subsequently performed when small polypoid lesions were detected. A decrease in the number of vascular networks (DVNs) and the presence of irregular vessels on the surface of the epithelia were defined as characteristic findings of intestinal lymphoma. The diagnostic accuracy of these 2 findings in distinguishing intestinal lymphoma from LH was examined. Main Outcome Measurements The ability to use NBI to distinguish intestinal lymphoma from LH. Results Two hundred ninety-four small polypoid lesions, including 59 lymphomas and 235 LH lesions, were detected. The rates of detecting DVNs and the presence of irregular vessels were significantly higher in the lymphoma samples (81.4% and 62.7%) than in the LH samples (25.5% and 4.7%). Based on these findings, the diagnostic accuracy, sensitivity, specificity, and positive and negative predictive values for differentiating intestinal lymphoma from LH were 88.8%, 62.7%, 95.3%, 77.1%, and 91.1%, respectively, which are significantly higher than those of conventional endoscopy. Limitations Single-center study. Conclusion DVNs and the presence of irregular vessels on NBI are thus considered to be useful findings for differentiating intestinal lymphoma from benign LH.</description><subject>Blood Vessels - pathology</subject><subject>Cohort Studies</subject><subject>Colon - blood supply</subject><subject>Colonoscopy - methods</subject><subject>Diagnosis, Differential</subject><subject>Female</subject><subject>Gastroenterology and Hepatology</subject><subject>Hodgkin Disease - diagnosis</subject><subject>Hodgkin Disease - pathology</subject><subject>Humans</subject><subject>Ileum - blood supply</subject><subject>Intestinal Diseases - diagnosis</subject><subject>Intestinal Diseases - pathology</subject><subject>Intestinal Neoplasms - diagnosis</subject><subject>Intestinal Neoplasms - pathology</subject><subject>Lymphoma, Non-Hodgkin - diagnosis</subject><subject>Lymphoma, Non-Hodgkin - pathology</subject><subject>Male</subject><subject>Narrow Band Imaging - methods</subject><subject>Predictive Value of Tests</subject><subject>Prospective Studies</subject><subject>Pseudolymphoma - diagnosis</subject><subject>Pseudolymphoma - pathology</subject><subject>Sensitivity and Specificity</subject><issn>0016-5107</issn><issn>1097-6779</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9ksGKFDEQhhtR3NnVB_AiOXrpsdJJp7sRBNl1VVjwoJ5DJqnMZDadjMn0LPNGPqbpndGDB6EgVPH9RaX-qqpXFJYUqHi7Xa4dLhugfAmsBDypFhSGrhZdNzytFlCguqXQXVSXOW8BoG8YfV5dNLxn0Hbtovp1gzqhymhImMYVpkyiJQeV9eRVIgH3DzHdZ6KCIS4lXD-WD5gz-oIGElRK8aFePQKjWruwJiohmTLayRPrgimlTGxMxLi8L8nk8mbGXNjjXFCe-OO428RREZvieM6cIZvjDtPOq-zUi-qZVT7jy_N7Vf24_fj9-nN99_XTl-sPd7VuOd_X2qJoO816ZI2wMGjFKO9MC2AZb60RogdmWMfRUN23gCA4F3ZgwGhnQbGr6s2p7y7Fn1OZT44ua_ReBYxTllQ0Q9sLLlhB6QnVKeac0MpdKitIR0lBzgbJrSwGydkgCawEFM3rc_tpNaL5q_jjSAHenYCyXzw4TDJrh0GjcQn1Xpro_tv-_T9q7V1wWvl7PGLeximVdZdfyNxIkN_mC5kPhHKgzTBQ9hs7yLn0</recordid><startdate>20141201</startdate><enddate>20141201</enddate><creator>Fujiya, Mikihiro, MD</creator><creator>Kashima, Shin, MD</creator><creator>Ikuta, Katsuya, MD</creator><creator>Dokoshi, Tatsuya, MD</creator><creator>Sakatani, Aki, MD</creator><creator>Tanaka, Kazuyuki, MD</creator><creator>Ando, Katsuyoshi, MD</creator><creator>Ueno, Nobuhiro, MD</creator><creator>Tominaga, Motoya, MD</creator><creator>Inaba, Yuhei, MD</creator><creator>Ito, Takahiro, MD</creator><creator>Moriichi, Kentaro, MD</creator><creator>Tanabe, Hiroki, MD</creator><creator>Saitoh, Yusuke, MD</creator><creator>Kohgo, Yutaka, MD</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20141201</creationdate><title>Decreased numbers of vascular networks and irregular vessels on narrow-band imaging are useful findings for distinguishing intestinal lymphoma from lymphoid hyperplasia</title><author>Fujiya, Mikihiro, MD ; Kashima, Shin, MD ; Ikuta, Katsuya, MD ; Dokoshi, Tatsuya, MD ; Sakatani, Aki, MD ; Tanaka, Kazuyuki, MD ; Ando, Katsuyoshi, MD ; Ueno, Nobuhiro, MD ; Tominaga, Motoya, MD ; Inaba, Yuhei, MD ; Ito, Takahiro, MD ; Moriichi, Kentaro, MD ; Tanabe, Hiroki, MD ; Saitoh, Yusuke, MD ; Kohgo, Yutaka, MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c544t-cfe657c38e326f09ca3147d500f345fd66803d374ed1c850e06446f930317f0a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Blood Vessels - pathology</topic><topic>Cohort Studies</topic><topic>Colon - blood supply</topic><topic>Colonoscopy - methods</topic><topic>Diagnosis, Differential</topic><topic>Female</topic><topic>Gastroenterology and Hepatology</topic><topic>Hodgkin Disease - diagnosis</topic><topic>Hodgkin Disease - pathology</topic><topic>Humans</topic><topic>Ileum - blood supply</topic><topic>Intestinal Diseases - diagnosis</topic><topic>Intestinal Diseases - pathology</topic><topic>Intestinal Neoplasms - diagnosis</topic><topic>Intestinal Neoplasms - pathology</topic><topic>Lymphoma, Non-Hodgkin - diagnosis</topic><topic>Lymphoma, Non-Hodgkin - pathology</topic><topic>Male</topic><topic>Narrow Band Imaging - methods</topic><topic>Predictive Value of Tests</topic><topic>Prospective Studies</topic><topic>Pseudolymphoma - diagnosis</topic><topic>Pseudolymphoma - pathology</topic><topic>Sensitivity and Specificity</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Fujiya, Mikihiro, MD</creatorcontrib><creatorcontrib>Kashima, Shin, MD</creatorcontrib><creatorcontrib>Ikuta, Katsuya, MD</creatorcontrib><creatorcontrib>Dokoshi, Tatsuya, MD</creatorcontrib><creatorcontrib>Sakatani, Aki, MD</creatorcontrib><creatorcontrib>Tanaka, Kazuyuki, MD</creatorcontrib><creatorcontrib>Ando, Katsuyoshi, MD</creatorcontrib><creatorcontrib>Ueno, Nobuhiro, MD</creatorcontrib><creatorcontrib>Tominaga, Motoya, MD</creatorcontrib><creatorcontrib>Inaba, Yuhei, MD</creatorcontrib><creatorcontrib>Ito, Takahiro, MD</creatorcontrib><creatorcontrib>Moriichi, Kentaro, MD</creatorcontrib><creatorcontrib>Tanabe, Hiroki, MD</creatorcontrib><creatorcontrib>Saitoh, Yusuke, MD</creatorcontrib><creatorcontrib>Kohgo, Yutaka, MD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Gastrointestinal endoscopy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Fujiya, Mikihiro, MD</au><au>Kashima, Shin, MD</au><au>Ikuta, Katsuya, MD</au><au>Dokoshi, Tatsuya, MD</au><au>Sakatani, Aki, MD</au><au>Tanaka, Kazuyuki, MD</au><au>Ando, Katsuyoshi, MD</au><au>Ueno, Nobuhiro, MD</au><au>Tominaga, Motoya, MD</au><au>Inaba, Yuhei, MD</au><au>Ito, Takahiro, MD</au><au>Moriichi, Kentaro, MD</au><au>Tanabe, Hiroki, MD</au><au>Saitoh, Yusuke, MD</au><au>Kohgo, Yutaka, MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Decreased numbers of vascular networks and irregular vessels on narrow-band imaging are useful findings for distinguishing intestinal lymphoma from lymphoid hyperplasia</atitle><jtitle>Gastrointestinal endoscopy</jtitle><addtitle>Gastrointest Endosc</addtitle><date>2014-12-01</date><risdate>2014</risdate><volume>80</volume><issue>6</issue><spage>1064</spage><epage>1071</epage><pages>1064-1071</pages><issn>0016-5107</issn><eissn>1097-6779</eissn><abstract>Background No method for sufficiently making the differential diagnosis of intestinal lymphoma resembling lymphoid hyperplasia (LH) on endoscopy has yet been established. Objective The aim of this study was to evaluate the usefulness of narrow-band imaging (NBI) in diagnosing intestinal lymphoma. Design Prospective study. Setting Single-center study. Patients Sixty-one patients with primary or systemic lymphoma were enrolled in this study. Interventions The terminal ileum and entire colon were observed by using conventional endoscopy. NBI was subsequently performed when small polypoid lesions were detected. A decrease in the number of vascular networks (DVNs) and the presence of irregular vessels on the surface of the epithelia were defined as characteristic findings of intestinal lymphoma. The diagnostic accuracy of these 2 findings in distinguishing intestinal lymphoma from LH was examined. Main Outcome Measurements The ability to use NBI to distinguish intestinal lymphoma from LH. Results Two hundred ninety-four small polypoid lesions, including 59 lymphomas and 235 LH lesions, were detected. The rates of detecting DVNs and the presence of irregular vessels were significantly higher in the lymphoma samples (81.4% and 62.7%) than in the LH samples (25.5% and 4.7%). Based on these findings, the diagnostic accuracy, sensitivity, specificity, and positive and negative predictive values for differentiating intestinal lymphoma from LH were 88.8%, 62.7%, 95.3%, 77.1%, and 91.1%, respectively, which are significantly higher than those of conventional endoscopy. Limitations Single-center study. Conclusion DVNs and the presence of irregular vessels on NBI are thus considered to be useful findings for differentiating intestinal lymphoma from benign LH.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>24830575</pmid><doi>10.1016/j.gie.2014.03.030</doi><tpages>8</tpages></addata></record> |
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subjects | Blood Vessels - pathology Cohort Studies Colon - blood supply Colonoscopy - methods Diagnosis, Differential Female Gastroenterology and Hepatology Hodgkin Disease - diagnosis Hodgkin Disease - pathology Humans Ileum - blood supply Intestinal Diseases - diagnosis Intestinal Diseases - pathology Intestinal Neoplasms - diagnosis Intestinal Neoplasms - pathology Lymphoma, Non-Hodgkin - diagnosis Lymphoma, Non-Hodgkin - pathology Male Narrow Band Imaging - methods Predictive Value of Tests Prospective Studies Pseudolymphoma - diagnosis Pseudolymphoma - pathology Sensitivity and Specificity |
title | Decreased numbers of vascular networks and irregular vessels on narrow-band imaging are useful findings for distinguishing intestinal lymphoma from lymphoid hyperplasia |
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