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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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Paraesophageal varices in a 45-year-old man with liver cirrhosis.A. Chest radiograph depicts a retrocardiac soft-tissue mass (arrows).B. Mediastinal window of enhanced (5-mm collimation) CT scan obtained at the level of the suprahepatic inferior vena cava shows enhancing tubular structures (arrows) surrounding the esophageal lumen (arrowhead).
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Figure 19: Paraesophageal varices in a 45-year-old man with liver cirrhosis.A. Chest radiograph depicts a retrocardiac soft-tissue mass (arrows).B. Mediastinal window of enhanced (5-mm collimation) CT scan obtained at the level of the suprahepatic inferior vena cava shows enhancing tubular structures (arrows) surrounding the esophageal lumen (arrowhead).

Mentions: In patients with underlying hepatic disease, the most common cause of esophageal and paraesophageal varices is portal hypertension, which leads to hepatofugal venous flow within esophageal or paraesophageal collateral vessels. Downhill varices associated with superior vena caval obstruction have also been reported (32). CT is useful in demonstrating the presence and extent of varices (33, 34) (Fig. 19), the appearance of which varies according to the severity and extent of the disease. At unenhanced CT, thickening of the esophageal walls may be visible, which enhanced CT reveals enhancing structures within the esophageal wall or periesophageal region (33, 34).


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)

Paraesophageal varices in a 45-year-old man with liver cirrhosis.A. Chest radiograph depicts a retrocardiac soft-tissue mass (arrows).B. Mediastinal window of enhanced (5-mm collimation) CT scan obtained at the level of the suprahepatic inferior vena cava shows enhancing tubular structures (arrows) surrounding the esophageal lumen (arrowhead).
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 19: Paraesophageal varices in a 45-year-old man with liver cirrhosis.A. Chest radiograph depicts a retrocardiac soft-tissue mass (arrows).B. Mediastinal window of enhanced (5-mm collimation) CT scan obtained at the level of the suprahepatic inferior vena cava shows enhancing tubular structures (arrows) surrounding the esophageal lumen (arrowhead).
Mentions: In patients with underlying hepatic disease, the most common cause of esophageal and paraesophageal varices is portal hypertension, which leads to hepatofugal venous flow within esophageal or paraesophageal collateral vessels. Downhill varices associated with superior vena caval obstruction have also been reported (32). CT is useful in demonstrating the presence and extent of varices (33, 34) (Fig. 19), the appearance of which varies according to the severity and extent of the disease. At unenhanced CT, thickening of the esophageal walls may be visible, which enhanced CT reveals enhancing structures within the esophageal wall or periesophageal region (33, 34).

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