In vivo histological diagnosis for gastric cancer using endocytoscopy

Figure 1 Normal mucosa (fundic gland mucosa). A: Endocytoscopic appearance of fundic gland mucosa. The foveolar epithelium was arranged in a circle, and the glandular lumens were round. The nuclei were weakly stained; B: Histological appearance of the corresponding normal mucosa (H&E-stained horizontal section, × 200).

Figure 2 Normal mucosa (pyloric gland mucosa). A: Endocytoscopic appearance of pyloric gland mucosa. The foveolar epithelium was regularly arranged in ridges, and the glandular lumens were slit-like. The nuclei were weakly stained; B: Histological appearance of the corresponding pyloric gland mucosa (H&E-stained horizontal section, × 200).

Figure 3 Intestinal metaplastic mucosa. A: Endocytoscopic appearance of intestinal metaplastic mucosa. The foveolar epithelium exhibited a villous architecture and the gland lumens were widened. Goblet cells (arrow) were observed among the epithelial cells. The nuclei were stained more intensely than in the normal mucosa; B: Histological appearance of the corresponding intestinal metaplastic mucosa (H&E-stained horizontal section, × 200).

Figure 4 Well differentiated adenocarcinoma. A: Endocytoscopic appearance of a well differentiated adenocarcinoma. The glands were branched irregularly and the width of the lumen varied. The epithelium was arranged in a disorderly fashion. The nuclei were deeply stained and pseudostratified; B: Histological appearance of the corresponding well-differentiated adenocarcinoma (H&E-stained horizontal section, × 200).

Figure 5 Poorly differentiated adenocarcinoma. A: Endocytoscopic appearance of a poorly differentiated adenocarcinoma. The tubular architecture was lost, and the nuclei were hyper-chromatic and anisokaryotic; B: Histological appearance of the corresponding poorly differentiated adenocarcinoma (H&E-stained horizontal section, × 200).

Figure 6 Signet ring cell carcinoma. A: Endocytoscopic appearance of a signet ring cell carcinoma. Slit-like glandular lumens surrounded by regularly arranged foveolar cells were observed, a finding consistent with normal mucosa in endocytoscopy; B: Histological appearance of the corresponding signet ring cell carcinoma (H&E-stained horizontal section, × 200). Signet-ring cells were observed in the lamina propria (circle), but not exposed on the mucosal surface.