Diagnosis of small intramucosal signet ring cell carcinoma of the stomach by non-magnifying narrow-band imaging: A pilot study

Figure 3 Endoscopic and microscopic images of signet ring cell carcinoma (Case 9). A: Endoscopy with WLI revealed a 0-IIb lesion with slight discoloration (arrows) at the greater curvature of the angulus; B: NM-NBI of the cancer area showed an isolated clear whitish area. The cancerous areas were more clearly captured by NM-NBI endoscopy than by WLI endoscopy. The NBI and WLI index were respectively 25.6 and 12.8, and the C-index was 0.77; C and D: The demarcation line of the SRC was not clearly identified even by magnifying NBI and chromoendoscopy (arrows); E: The histology of a specimen resected by endoscopic submucosal dissection revealed an intramucosal SRC (arrowheads) in the upper third of the mucosa beneath a preserved surface epithelium; F: SRC cells showed positive for cytokeratin AE1/AE3 staining (arrowheads). WLI: White-light imaging; NM-NBI: Non-magnifying narrow-band imaging; SRC: Signet ring cell carcinoma.