IIc or not IIc: a question for meticulous optical evaluation

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 …