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IIc or not IIc: a question for meticulous optical evaluation
  1. Neal Shahidi1,2,
  2. Mayenaaz Sidhu1,3,
  3. Iddo Bar-Yishay1,
  4. Michael J Bourke1,3
  1. 1 Department of Gastroenterology and Hepatology, Westmead Hospital, Sydney, New South Wales, Australia
  2. 2 Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
  3. 3 Westmead Clinical School, University of Sydney, Sydney, New South Wales, Australia
  1. Correspondence to Dr Neal Shahidi, Department of Medicine, University of British Columbia, Vancouver, V6T 1Z4, Canada; nealshahidi{at}gmail.com

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Introduction

A middle-aged man was referred to assess the feasibility of endoscopic removal of a 35 mm laterally spreading lesion within the sigmoid colon. The referring endoscopist appreciated a central depression (0–IIc Paris morphology) and raised the concern for submucosal invasive cancer.

Using an Olympus 190 series high-definition colonoscope (Olympus, Tokyo, Japan), the lesion was carefully examined under white light and narrow-band imaging (NBI) (figure 1A). The central aspect of the …

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