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The spectrum of benign esophageal lesions: imaging findings.

Jang KM, Lee KS, Lee SJ, Kim EA, Kim TS, Han D, Shim YM - Korean J Radiol (2002 Jul-Sep)

Bottom Line: Barium studies are useful for the evaluation of mucosal surface lesions but provide little information about the extramucosal extent of disease.Computed tomography and magnetic resonance imaging, on the other hand, permit the assessment of wall thickness, mediastinal involvement, adjacent lymphadenopathy, and distant spread.In diseases such as fibrovascular polyps, duplication cysts, scleroderma, trauma, caustic esophagitis, hiatal hernia, esophageal diverticulum, achalasia, and paraesophageal varices, the findings of imaging studies are specific, obviating the need for further invasive diagnostic work-up.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

ABSTRACT
Benign esophageal lesions occur in various diseases. Barium studies are useful for the evaluation of mucosal surface lesions but provide little information about the extramucosal extent of disease. Computed tomography and magnetic resonance imaging, on the other hand, permit the assessment of wall thickness, mediastinal involvement, adjacent lymphadenopathy, and distant spread. In diseases such as fibrovascular polyps, duplication cysts, scleroderma, trauma, caustic esophagitis, hiatal hernia, esophageal diverticulum, achalasia, and paraesophageal varices, the findings of imaging studies are specific, obviating the need for further invasive diagnostic work-up. The advent of helical computed tomography and its volume data set allows the acquisition of multiplanar images, and magnetic resonance imaging is useful both for this and for tissue characterization. Thus, multiplanar cross-sectional imaging further extends the role of imaging modalities to the evaluation of benign esophageal lesions. Through an awareness of the multiplanar cross-sectional appearances of various benign esophageal lesions, the radiologist can play an important role in the detection, diagnosis, further diagnostic planning, and treatment of the diseases in which they occur.

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Esophagopleural fistula in a 35-year-old man with chronic destructive pulmonary tuberculosis.A. Mediastinal window of unenhanced (7-mm collimation) CT scan obtained at the level of the thoracic inlet depicts a fistulous tract (arrows) between the proximal esophagus and right pleural space.B. Posteroanterior view of three-dimensional CT image using the shaded-surface display technique reveals the presence of fistulous tracts between the esophagus and right pleural space (arrows)(t = trachea, e = esophagus, m = main bronchus).
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Figure 13: Esophagopleural fistula in a 35-year-old man with chronic destructive pulmonary tuberculosis.A. Mediastinal window of unenhanced (7-mm collimation) CT scan obtained at the level of the thoracic inlet depicts a fistulous tract (arrows) between the proximal esophagus and right pleural space.B. Posteroanterior view of three-dimensional CT image using the shaded-surface display technique reveals the presence of fistulous tracts between the esophagus and right pleural space (arrows)(t = trachea, e = esophagus, m = main bronchus).

Mentions: Esophagopleural fistulae are usually caused by previous surgery, infection, esophageal instrumentation, radiation, or direct invasion of the pleural space by advanced esophageal carcinoma. The CT findings of esophagopleural fistula include visualization of the fistulous tract, the presence of barium, air and fluid in the pleural space, and pneumonia (26) (Fig. 13).


The spectrum of benign esophageal lesions: imaging findings.

Jang KM, Lee KS, Lee SJ, Kim EA, Kim TS, Han D, Shim YM - Korean J Radiol (2002 Jul-Sep)

Esophagopleural fistula in a 35-year-old man with chronic destructive pulmonary tuberculosis.A. Mediastinal window of unenhanced (7-mm collimation) CT scan obtained at the level of the thoracic inlet depicts a fistulous tract (arrows) between the proximal esophagus and right pleural space.B. Posteroanterior view of three-dimensional CT image using the shaded-surface display technique reveals the presence of fistulous tracts between the esophagus and right pleural space (arrows)(t = trachea, e = esophagus, m = main bronchus).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2713885&req=5

Figure 13: Esophagopleural fistula in a 35-year-old man with chronic destructive pulmonary tuberculosis.A. Mediastinal window of unenhanced (7-mm collimation) CT scan obtained at the level of the thoracic inlet depicts a fistulous tract (arrows) between the proximal esophagus and right pleural space.B. Posteroanterior view of three-dimensional CT image using the shaded-surface display technique reveals the presence of fistulous tracts between the esophagus and right pleural space (arrows)(t = trachea, e = esophagus, m = main bronchus).
Mentions: Esophagopleural fistulae are usually caused by previous surgery, infection, esophageal instrumentation, radiation, or direct invasion of the pleural space by advanced esophageal carcinoma. The CT findings of esophagopleural fistula include visualization of the fistulous tract, the presence of barium, air and fluid in the pleural space, and pneumonia (26) (Fig. 13).

Bottom Line: Barium studies are useful for the evaluation of mucosal surface lesions but provide little information about the extramucosal extent of disease.Computed tomography and magnetic resonance imaging, on the other hand, permit the assessment of wall thickness, mediastinal involvement, adjacent lymphadenopathy, and distant spread.In diseases such as fibrovascular polyps, duplication cysts, scleroderma, trauma, caustic esophagitis, hiatal hernia, esophageal diverticulum, achalasia, and paraesophageal varices, the findings of imaging studies are specific, obviating the need for further invasive diagnostic work-up.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

ABSTRACT
Benign esophageal lesions occur in various diseases. Barium studies are useful for the evaluation of mucosal surface lesions but provide little information about the extramucosal extent of disease. Computed tomography and magnetic resonance imaging, on the other hand, permit the assessment of wall thickness, mediastinal involvement, adjacent lymphadenopathy, and distant spread. In diseases such as fibrovascular polyps, duplication cysts, scleroderma, trauma, caustic esophagitis, hiatal hernia, esophageal diverticulum, achalasia, and paraesophageal varices, the findings of imaging studies are specific, obviating the need for further invasive diagnostic work-up. The advent of helical computed tomography and its volume data set allows the acquisition of multiplanar images, and magnetic resonance imaging is useful both for this and for tissue characterization. Thus, multiplanar cross-sectional imaging further extends the role of imaging modalities to the evaluation of benign esophageal lesions. Through an awareness of the multiplanar cross-sectional appearances of various benign esophageal lesions, the radiologist can play an important role in the detection, diagnosis, further diagnostic planning, and treatment of the diseases in which they occur.

Show MeSH
Related in: MedlinePlus