# A Case of Duodenal Adenocarcinoma Effectively Highlighted by Linked Color Imaging and Confirmed by Histopathology

## TL;DR

Linked color imaging helped identify a duodenal adenocarcinoma, confirmed by histopathology in a 67-year-old man.

## Contribution

Demonstrates the usefulness of linked color imaging in diagnosing duodenal adenocarcinoma.

## Key findings

- LCI highlighted a 20-mm lesion in the duodenal bulb with distinct color features.
- Histopathology confirmed the lesion as an adenocarcinoma within an adenoma.
- The lesion was classified as papillary, type 0-Ip, with no lymphovascular invasion.

## Abstract

While the differential diagnosis of duodenal adenocarcinoma versus adenoma remains the key to determining treatment strategies in patients with suspected duodenal adenocarcinoma, the role of linked color imaging (LCI) in their differential diagnosis remains insufficiently documented. In this case, esophagogastroduodenoscopy (EGD) was performed on a 67-year-old man for anemia, which revealed a 20-mm-sized, whitish, partially reddish, pedunculated lesion located in the duodenal bulb on white light imaging. Using LCI, the lesion was highlighted as a whitish, pedunculated lesion with its central and inferior areas depicted as orangish and reddish, respectively. Endoscopic mucosal resection was performed on the suspicion of an adenocarcinoma for biopsy and endoscopic diagnosis. Histological examination revealed the lesion to be an adenocarcinoma contained in an adenoma: papillary, type 0-Ip, measuring 20x20 mm, pTis (M), involving no lymphovascular invasion. This case appears to underpin the usefulness of LCI in the differential diagnosis of duodenal adenocarcinoma.