【双语病例】食管重复囊肿1例X线及CT影像表现

22 10月

History: A 50-year-old man with a history of mild dysphagia.

病史:50岁男性,轻度吞咽困难。

A single-contrast esophagram was performed.

行单对比剂食管造影

【双语病例】食管重复囊肿1例X线及CT影像表现

CT images

A CT scan of the upper abdomen withoral and intravenous contrast was obtained in portal venous phase.

上腹部CT扫描门脉期(口服及静脉注射对比剂)

【双语病例】食管重复囊肿1例X线及CT影像表现

【双语病例】食管重复囊肿1例X线及CT影像表现

【双语病例】食管重复囊肿1例X线及CT影像表现

Findings

Esophagram: The single-contrast esophagram demonstrates smooth, broad-based, extrinsic mass effect on the lower third of the esophagus, displacing the esophagus slightly laterally. There is normal single-contrast appearance of the esophageal walls without evidence of esophageal diverticulum.
CT: There is a hypodense mass with thin walls and no calcifcations located near the gastroesophageal junction, abutting the aorta, in the inferior and posterior mediastinum, displacing the esophagus laterally.

表现:

食管钡餐:单对比剂食管造影示食管下1/3可见光滑的宽基底的外压性占位效应,食管轻度向对侧移位。食管壁正常,未见食管憩室征象。

CT:后下纵隔邻近胃食管连接处及主动脉,可见一低密度肿物,壁薄,无钙化,食管向对侧移位。

Differential diagnosis

  • Esophageal duplication cyst
  • Lymphatic malformation
  • Neurenteric cyst
  • Bronchogenic cyst

鉴别诊断

  • 食管重复囊肿
  • 淋巴管畸形
  • 神经管原肠囊肿
  • 支气管源性囊肿

Diagnosis: Esophageal duplication cyst

诊断:食管重复囊肿


Key points

Esophageal duplication cyst

Pathophysiology

Esophageal duplication cyst is part of a class of lesions termed as foregut duplication cysts.

Foregut duplication cysts may be located adjacently to the esophagus, duodenum, jejunum, or ileum.

They are thought to be due to the persistence of an abnormal embryonic     foregut vacuole.

Up to 50% of cases may contain ectopic gastric mucosa.

病理生理学

食管重复囊肿是前肠重复畸形囊肿一类疾病中的一种;前肠重复畸形囊肿可邻近食管、十二指肠、空肠或回肠。被认为是胚胎前肠液泡的异常残留。多达50%的病例可包含异位胃粘膜。


Epidemiology

These lesions are congenital and nonfatal; therefore, they are present in all age groups. Symptomatic cysts, however, generally present in childhood.

流行病学

病变是先天性的非致命性的,所有年龄段的人群均可发生。然而有症状的囊肿常见于儿童。


Clinical presentation

Esophageal duplication cysts are usually discovered incidentally.

Symptomatic esophageal duplication cysts present with symptoms of mass     effect on the esophagus.

临床表现

食管重复囊肿多为偶然发现;

有症状的表现为食管压迫症状。


Imaging features

Esophagram: May demonstrate extrinsic mass effect on the esophagus.

Ultrasound: Appears as a hypoechoic structure adjacent to the esophagus with posterior acoustic enhancement, consistent with a simple cyst.

CT: Appears as a hypodense lesion adjacent to the esophagus with thin     walls and lack of aggressive features, such as thick sepatations, mural nodularity, or gross invasion of adjacent structures.

MRI: Appears T2 hyperintense, T1 hypointense, with no enhancement, no restricted diffusion, and findings consistent with a simple cyst.

Nuclear medicine: Technetium-99m pertechnetate scan may demonstrate     radiotracer uptake in a portion of the cyst wall, consistent with the presence of ectopic gastric mucosa.

影像表现

食管造影:可见食管受外力所致压迹表现;

超声:表现为邻近食管的低回声结构,后方可见回声增强,与单纯囊肿相一致。

CT:食管旁低密度病灶,壁薄,无侵袭性表现,如厚的分隔、壁结节、周围结构受侵犯。

MRI:表现为T2高信号,T1低信号,增强无强化,无明显弥散受限,与单纯囊肿表现一致。

核医学:锝-99m扫描一部分囊肿壁可见放射性示踪剂摄取,提示有异位的胃粘膜。


Treatment

Treatment is usually unnecessary unless the patient is symptomatic.

Surgical resection is the most common treatment with excellent success.

治疗:

通常无需治疗,除非患者有症状。手术切除是最常用的治疗方法,预后好。


本例图解

【双语病例】食管重复囊肿1例X线及CT影像表现

【双语病例】食管重复囊肿1例X线及CT影像表现

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