Application of novel magnified single balloon enteroscopy for a patient with Cronkhite-Canada syndrome

Figure 1 Esophagogastroduodenoscopy and histopathological findings. A: Diffuse sessile and semipendunculated polyps were observed in the antrum; B: Biopsies of the polyps in the antrum indicated interstitial edematous and myxomatous lesions; C: Mild polyposis was observed in the upper body of the stomach; D: Biopsies of the interpolypoid lesions indicated the presence of the same interstitial edematous and myxomatous lesions as observed in polyp biopsies.

Figure 2 Colonoscopy and histopathological findings. A: White light observation demonstrated flat elevated lesions with intense reddening throughout the entire large bowel; B: We observed both inflammatory cell infiltration into the large bowel mucosal epithelium and cystic ductal dilatation.

Figure 3 Trans-oral single balloon enteroscopy (jejunum) and histopathological findings. A: White light observation demonstrated scattered white spots and reddening; B: Magnified observation under white light demonstrated scattered white spots (black arrows) as well as irregular caliber of the loop-like capillaries; C: Underwater magnifying enteroscopy demonstrated elongated villi and fine granular structures at the tips of villi (white arrowheads); D: Histopathological findings demonstrated twisted crypts and interstitial edema.

Figure 4 Trans-anal single balloon enteroscopy (ileum) and histopathological findings. A: White light observation demonstrated prominent reddening of villi. Scattered white spots were also observed; B: Magnifying enteroscopy with indigo carmine contrast demonstrated irregular villus structure; C: Narrow-band imaging magnified observation demonstrated spotted reddening within villi (white arrow heads) and irregular caliber of the loop-like capillaries; D: Histopathological findings demonstrated elongated crypts and atrophied villi as well as inflammatory cell infiltrates predominantly composed of eosinophils.