Читать книгу The Esophagus - Группа авторов - Страница 186

Duplication cysts are not true neoplasms, but they may also appear on esophagography as submucosal masses. Esophageal duplications cysts comprise about 20% of all duplication cysts in the gastrointestinal tract [121]. The cysts are development anomalies in which nests of cells are sequestered from the primitive foregut. Duplication cysts contain multiple layers of the bowel, including a mucosa, submucosa, and muscularis propria. Affected individuals are usually asymptomatic, but symptoms occasionally may be caused by bleeding or infection of the cyst. The cysts generally do not communicate with the esophageal lumen (so‐called non‐communicating cysts) and tend to be located in the right lower mediastinum. As a result, they can sometimes be recognized on frontal chest radiographs by the presence of a mass in the right lower mediastinum [116]. The cysts typically appear on barium studies as smooth submucosal masses indistinguishable from esophageal leiomyomas [116]. When duplication cysts do communicate with the esophageal lumen, they occasionally may be recognized as tubular, branching outpouchings from the esophagus that fill with barium [116] (Figure 6.62). These fluid‐filled cysts usually appear as homogeneous low‐attenuation structures on CT and as high‐signal intensity structures on T2‐weighted magnetic resonance imaging (MRI) [122].

Figure 6.51 Drug‐induced esophagitis. Double‐contrast view shows several small, discrete ulcers (arrows) in the mid esophagus. This patient developed odynophagia after taking tetracycline. Herpes esophagitis could produce similar findings.

Source: Reproduced from Levine MS. Radiology of the esophagus. Philadelphia: WB Saunders; 1989, with permission.