A 72-year-old male had a well-defined 3×3 mm elevated lesion on the cervical esophagus, displaying JES classification type B2 blood vessels on the surface. Type B1 blood vessels were observed on the surrounding flat lesion. The superficial esophageal cancer was diagnosed as 0-IIa+IIb/cT1a-MM, and removed by endoscopic submucosal dissection. Pathologically, the elevated lesion with B2 blood vessels showed granulation tissue, while the elevated edge and B1 blood vessel area exhibited squamous cell carcinoma. The final diagnosis was SCC, pT1a, LPM, INFa, ly (−), v (−), pHM0, pVM0. B2 blood vessels are abnormal vessels with a sparse loop structure, commonly observed in deeper invasive esophageal cancers (MM-SM1). However, similar vessels were reported in inflammatory tissues. This case could not be differentiated from B2 vessels in cancer. This case showed that B2 blood vessels, defined as abnormal vessels seen in cancer, also occur in benign granulation tissue.
