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.


METHODS
Prospective study.


METHODS
Single-center study.


METHODS
Sixty-one patients with primary or systemic lymphoma were enrolled in this study.


METHODS
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.


METHODS
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.


CONCLUSIONS
Single-center study.


CONCLUSIONS
DVNs and the presence of irregular vessels on NBI are thus considered to be useful findings for differentiating intestinal lymphoma from benign LH.
Division of Gastroenterology and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, Asahikawa, Japan.
Mikihiro
M
Fujiya
Division of Gastroenterology and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, Asahikawa, Japan.
Shin
S
Kashima
Division of Gastroenterology and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, Asahikawa, Japan.
Katsuya
K
Ikuta
Division of Gastroenterology and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, Asahikawa, Japan.
Tatsuya
T
Dokoshi
Division of Gastroenterology and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, Asahikawa, Japan.
Aki
A
Sakatani
Division of Gastroenterology and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, Asahikawa, Japan.
Kazuyuki
K
Tanaka
Division of Gastroenterology and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, Asahikawa, Japan.
Katsuyoshi
K
Ando
Division of Gastroenterology and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, Asahikawa, Japan.
Nobuhiro
N
Ueno
Division of Gastroenterology and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, Asahikawa, Japan.
Motoya
M
Tominaga
Division of Gastroenterology and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, Asahikawa, Japan.
Yuhei
Y
Inaba
Division of Gastroenterology and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, Asahikawa, Japan.
Takahiro
T
Ito
Division of Gastroenterology and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, Asahikawa, Japan.
Kentaro
K
Moriichi
Division of Gastroenterology and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, Asahikawa, Japan.
Hiroki
H
Tanabe
Digestive Disease Center, Asahikawa City Hospital, Asahikawa, Japan.
Yusuke
Y
Saitoh
Division of Gastroenterology and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, Asahikawa, Japan.
Yutaka
Y
Kohgo
D001808:Blood Vessels / Q000473:pathology*; D015331:Cohort Studies; D003106:Colon / Q000098:blood supply*; D003113:Colonoscopy / Q000379:methods; D003937:Diagnosis, Differential; D005260:Female; D006689:Hodgkin Disease / Q000175:diagnosis* / Q000473:pathology; D006801:Humans; D007082:Ileum / Q000098:blood supply*; D007410:Intestinal Diseases / Q000175:diagnosis / Q000473:pathology; D007414:Intestinal Neoplasms / Q000175:diagnosis* / Q000473:pathology; D008228:Lymphoma, Non-Hodgkin / Q000175:diagnosis* / Q000473:pathology; D008297:Male; D062048:Narrow Band Imaging / Q000379:methods*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D019310:Pseudolymphoma / Q000175:diagnosis* / Q000473:pathology; D012680:Sensitivity and Specificity