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A screening colonoscopy was performed on an asymptomatic 68-year-old woman. A diminutive 1 mm diameter Paris-type 0-IIc neoplastic lesion was diagnosed in the ascending colon (fig 1A). Further characterisation using high-magnification chromoscopic colonoscopy and 0.05% crystal violet intravital staining revealed a Kudo-type IIIs crypt architecture in the depressed component, which suggested that this lesion was limited to the mucosal layer. Endoscopic mucosal resection (EMR) was considered to be the most appropriate firstline endoluminal treatment in this case to confirm histologically the absence of neoplastic disease beyond 1000 μm in the vertical margin, where data from both Japan and Europe have shown that despite diminutive endoluminal appearances, such …
Competing interests: None.