Reply To: EMR-ESD specimens – public comments

Michael Vieth

One further remark on terminology and the figures : it is not the outer true muscularis mucosae. Both layers are ‚true‘ layers of the muscularis mucosa, they are just divided and intermingle at some point on some slices. You can also observe it in early esophageal squamous cell carcinomas and in ulcerative colitis on general. It seems to be more something reactive rather than something new or true or old or original. I would recommend the Japanese terminology by Kaiyo Takubo : superficial versus deep !?
He is not the one who described it first in the esophagus but the first who published it properly and realized the importance possibly resulting in overdiagnosing a mucosal lesion as submucosal invasion.

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