Improved visibility of early gastric cancer by using a combination of chromoendoscopy and texture and color enhancement imaging

A 70-year-old woman was found on esophagogastroduodenoscopy (EGD) to have a 25-mm, isochromatic, flat-type early gastric cancer in the lesser curve of the upper gastric body of the stomach. White-light endoscopy revealed a subtle lesion (A, arrow). Chromoendoscopy with the use of indigo carmine was then performed to delineate the extent of the tumor (B, arrow), and texture and color enhancement imaging (TXI) mode 1 was applied to improve the visibility of the lesion (C, arrow). The lesion was removed by endoscopic submucosal dissection, and histopathologic examination of the resected specimen showed well-differentiated tubular adenocarcinoma that retained the negative mucosal resection margins.