Superficial esophageal lesions detected by endoscopic ultrasound enhanced with submucosal edema

Figure 1 Flow diagram of study protocol. EUS: Endoscopic ultrasonography; HFE: High frequency electro-coagulation generator.

Figure 2 Schematic diagrams of superficial lesions in the esophagus with different depths in a canine model.

Figure 3 Endoscopic ultrasonography and tissue examination of the normal esophagus in a beagle dog. A: The three layers of a normal esophagus, as visualized by endoscopic ultrasonography (EUS); B: Tissue examination showed that the esophageal wall is composed of the mucosa (including squamous epithelium, lamina propria, and muscularis mucosa), submucosa, and muscularis propria and adventitia.

Figure 4 Endoscopic ultrasonography and tissue examination of esophageal lesions located in the superficial mucosa (A, B) and deep mucosa (C, D). A, C: Endoscopic ultrasonography (EUS) imaging: high echoic lesions located in the mucosa (A) and relatively high echoic lesion (C) located in the mucosa with obvious submucosal edema, as visualized by EUS; B, D: Pathology: tissue examination showed that the lesions were located in the mucosa with complete (B) and incomplete (D) squamous epithelium, intact muscularis mucosa, and obvious submucosal edema.

Figure 5 Endoscopy, endoscopic ultrasonography, and tissue examination of an esophageal lesion invading into the submucosa (A, B) and muscularis propria (C, D). A, C: Endoscopic ultrasonography (EUS) imaging: Middle echoic lesion (A) and low echoic lesion (C) invading the submucosa with obvious submucosal edema, as visualized by EUS; B, D: Pathology: Lesion invading into the submucosa (B) and muscularis propria (D) was characterized as squamous epithelium with disappearing muscularis mucosa and submucosal edema, as revealed by pathological examination.