1. Finding a needle in a haystack: use of volumetric laser endomicroscopy in targeting focal dysplasia in long-segment Barrett’s esophagus

    Finding a needle in a haystack: use of volumetric laser endomicroscopy in targeting focal dysplasia in long-segment Barrett’s esophagus

    A 64-year-old man underwent esophagoscopy 15 months earlier, which diagnosed long-segment Barrett’s esophagus. Examination of random biopsy specimens yielded a diagnosis of intestinal metaplasia, with 1 biopsy specimen as indefinite for dysplasia. Two subsequent esophagoscopies were performed 6 months apart, and random biopsy specimens were negative for dysplasia. The patient was referred for volumetric laser endomicroscopy (VLE) (NVisionVLE, NinePoint Medical, Cambridge, Mass). At esophagoscopy, high-definition white-light endoscopy showed a 7-cm segment of flat salmon-colored mucosa (Prague class C6M7) ( A ).

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