The patient was a 64-year-old man in whom esophagogastroduodenoscopy showed a 30-mm-diameter, reddish, depressed, partly nodular lesion at the lower esophagus as the depth of invasion was SM1/2. Magnifying endoscopy with NBI revealed type B1 vessels in the depressed area and Type B2 vessels in the nodular area as the depth of invasion was MM1/SM1. Since there was a deviation between the white-light and NBI findings, we performed EUS, and confirmed that the third layer was intact. Based on these findings, the lesion was classified as type 0-IIc＋Is with an invasion depth of MM/SM1. Based on the final pre-operative diagnosis, ESD underwent for achieving a block resection. Histopathologically, the depth of invasion of the lesion was classified as up to MM. 0-Is area contained more abundant inflammatory cells, and was observed as a tall lesion, with the result that the depth of invasion was diagnosed as deeper with white-light. The present case suggests that the depth of invasion should be comprehensively and accurately diagnosed using not only white-light but also NBI-magnifying endoscopy and EUS.
