Presentation
Three days flu-like symptoms ?pneumonia.
Patient Data
Heart size is within normal limits. Posterior mediastinal density on lateral projection. CT chest recommended.
There is impression of a mid esophageal lesion, measuring 4 x 3 cm in axial diameter, extending over a 4 cm segment just above the level of the carina. The esophagus both above and below this region is mildly dilated, and there is debris within the lumen, possibly a trapped food bolus. No mediastinal, hilar or axillary lymphadenopathy is demonstrated. No suspicious osseous lesions. A small hiatus hernia is noted in the lower esophagus.
Patchy airspace opacity is seen within the superior lingula segment of the left upper lobe, with very mild change in the posterior segment of the right upper lobe. Multiple small pulmonary nodules are seen in both lungs, none larger than 5 mm in diameter.
Old left rib fractures noted. The visualized upper abdominal viscera are within normal limits.
Conclusion:
Partial obstruction of the mid esophagus, suspicious for a primary esophageal carcinoma. Correlation with gastroscopy is suggested.
Case Discussion
The patient had a psychiatric history and refused any further investigations.
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