By C. Daniel Johnson
Delivering 4 instances the quantity of imaging instances provided via competing texts, this reference stands because the premier consultant to universal ailments and radiographic shows chanced on in the gastrointestinal tract-authoritatively masking the full variety of gastrointestinal illnesses to incorporate stipulations affecting the esophagus, belly, duodenum, small bowel, colon, liver, biliary tree, gallbladder, pancreas, spleen, peritoneum, and mesentery.
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Extra info for Mayo Clinic Gastrointestinal Imaging Review
There is a smooth impression on the esophageal contour by a wellcircumscribed mass. The lateral margins of the mass (arrows) extend to the right of the spine. B. Contrast-enhanced CT of the chest. A wellcircumscribed, exophytic, enhancing tumor (arrow) is seen along the right side of the distal esophagus. Differential Diagnosis 1. Gastrointestinal stromal tumor 2. Fibroma, neuroma, neurofibroma, lipoma, hemangioma 3. Duplication cyst 4. Lymphoma Diagnosis Gastrointestinal stromal tumor Discussion The location of the mass in relationship to the esophagus, its smooth surface, and the obtuse angle between the mass and the esophageal lumen suggest a submucosal mass.
Contrast-enhanced CT. Bulky mediastinal and hilar lymphadenopathy is present. Differential Diagnosis 1. Mediastinal adenopathy 2. Esophageal carcinoma B Discussion Lymphomatous involvement of the esophagus is unusual. Usually patients have known generalized lymphoma before esophageal disease is discovered. This disease can affect the esophagus by mass effect or by direct spread from enlarged, contiguous lymph nodes. Lymphomatous involvement of the stomach can spread directly to the esophagus, or a lesion can develop in the esophagus simultaneously with disease elsewhere in the body.
Fixed, smooth narrowing is present in distal esophagus. Proximal esophagus is dilated. At fluoroscopy, narrowing remained unchanged, even after esophagus was half filled with contrast material. B. Abdominal CT with oral contrast. A soft tissue mass (arrows) causing gastric wall thickening is present at the level of the gastroesophageal junction. The mass extends into the distal esophagus. Differential Diagnosis 1. Carcinoma of gastroesophageal junction (pseudoachalasia) 2. Achalasia Diagnosis Carcinoma of the gastroesophageal junction (pseudoachalasia) Discussion Tumors such as this have predominantly submucosal growth and often arise from a gastric primary lesion.
Mayo Clinic Gastrointestinal Imaging Review by C. Daniel Johnson