Esophageal mural thickening

John Barlow

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

Imaging description Esophageal mural thickening is a nonspecific finding by CT chest. Mural thickening may be diffuse, segmental, or focal. It may occur in any segment of the esophagus, although it is more common distally. Intravenous contrast material administration is helpful in the CT evaluation of esophageal mural thickening. Esophagitis is more likely than esophageal carcinoma when uniform, circumferential mural thickening involves a long segment of the esophagus (Figure 41.1) [1]. Esophageal carcinoma is more likely when irregular, asymmetric mural thickening involves a short segment of the esophagus (Figure 41.2). Lymphadenopathy supports the diagnosis of esophageal cancer. Cancers of the mid and upper esophagus typically metastasize to paratracheal lymph nodes; cancers of the lower esophagus typically spread to gastrohepatic ligament lymph nodes [2]. Importance Esophageal mural thickening is never a normal finding. Since mural thickening is not easily diagnosed by esophagram or by endoscopy, it is important that it be included in the CT chest report. Accurate description of the esophageal mural thickening will encourage referring physicians to consider infection, inflammation, and neoplasm – rather than fibrotic stricture or abnormal motility – as the cause of any dysphagia reported by the patient. Over the last decade, eosinophilic esophagitis has gained greater recognition as a cause of esophagitis (Figure 41.3) [3].

Original languageEnglish (US)
Title of host publicationPearls and Pitfalls in Thoracic Imaging
Subtitle of host publicationVariants and Other Difficult Diagnoses
PublisherCambridge University Press
Pages100-103
Number of pages4
Volume9780521119078
ISBN (Electronic)9780511977701
ISBN (Print)9780521119078
DOIs
StatePublished - Jan 1 2011

ASJC Scopus subject areas

  • Medicine(all)

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    Barlow, J. (2011). Esophageal mural thickening. In Pearls and Pitfalls in Thoracic Imaging: Variants and Other Difficult Diagnoses (Vol. 9780521119078, pp. 100-103). Cambridge University Press. https://doi.org/10.1017/CBO9780511977701.042