Giant fibrovascular polyp of the esophagus: CT and MR findings.

摘要: A 59-year-old man with a 1 5-year history of intermittent dysphagia for solids presented fatigue and 9.1 -kg (20-mb) weight loss over 2-month period. Physical examination was unremarkable. Admission hemoglobin 6 g/dl. Chest radiography showed superior mediastinal mass on the right. This had increased in size comparison its chest film 2 years earlier. CT revealed large posterior mediastinum both fluid lipid components (Fig. 1A). The produced compression effacement esophageal lumen. proximal esophagus dilated to level mass. An esophagram smooth, rounded intraluminalfilling defect measuring 5.4 cm diameter B). MR cylindrical extending from thoracic inlet esophagogastric junction. contained central elongated region high signal intensity Ti -weighted images, thought represent lipid-containing substance, mucoid secretions, or nonacute blood. second component mass, seen more inferiorly, lower images similar that soft tissue muscle. Superiorly, crescent-shaped area absent represented an air-containing structure (Figs. 1C-i E). Endoscopy mucosa normal. tortuous, without evidence intraluminal long submucosal deformity apparent extended along entire body organ appeared as two thickened folds. ultrasonic endoscope lesion be contiguous muscular layer several views. patient underwent thoracotomy exploration. Palpation suggested could milked up limited myotomy performed midportion esophagus. Contrary endoscopic findings, no intramural masses were seen. esophagotomy then performed, tumor identified. originated pedicle arising wall cervical esophagus, just below cricopharyngeus muscle, it gastroesophageal removed pieces. First, approximately 90% excised through esophagotomy. base clipped obtain hemostasis. left neck exploration performed. at base. 7 long, measured i 8 x 4 cm. Most specimen covered by normal mucosa. Gross microscopic diagnosis giant fibrovascular polyp F).