Confocal laser endomicroscopy and immunoendoscopy for real-time assessment of vascularization in gastrointestinal malignancies

Figure 1 Esophageal surface epithelium visualized using intravenous fluorescein. A: Capillary loops (arrows) of the esophageal papillae; B: Dilatation of intercellular spaces and increased vasculature off the papillae in reflux esophagitis; C: Presence of cylindrical epithelial cell and goblet cells (arrows) in the distal esophagus suggesting Barrett’s epithelium.

Figure 2 Confocal laser endomicroscopy of the stomach using intravenous fluorescein. A: Columnar epithelium of the antral gastric mucosa and regulated microvascular matrix; B: Atrophic gastritis with intestinal metaplasia and presence of goblet cells (arrows); C: Early gastric cancer with disorganized tissue architecture, few regular crypts (arrowhead) and very tortuous, dilated, irregular vessels (arrows).

Figure 3 Confocal laser endomicroscopy of the normal colon using intravenous fluorescein. A: Normal aspect of colonic mucosa showing regular architecture of crypts and capillaries of lamina propria (arrows); B: Dark shadows in the lumen of the vessels representing the red blood cells (arrows).

Figure 4 Confocal laser endomicroscopy of the colon using intravenous fluorescein. A: Colon carcinoma with total disorganization of cell architecture, invasion and destruction of the vessels with leakage of fluorescein (arrows); B: Severe inflammatory changes in ulcerative colitis with cellular infiltrate causing an increase in the distance between crypts and excessive vascularity (arrows).

Figure 5 Confocal laser microscopy of the chick embryo chorioallantoic membrane. A: Chick normal chorioallantoic membrane with visualization of large vessels (arrowheads), medium vessels (arrows) and circulating nucleated erythrocytes; B: Fragment of viable human colon cancer tissue (arrows) implanted on chick embryo chorioallantoic membrane.