Findings:

• the cervical and proximal thoracic oesophagus is unremarkable

• there is a long irregular stricture of the distal thoracic oesophagus, approximately 10 cm length, associated with moderate holdup of barium

• transient sliding hiatus hernia, not present on the initial upright views, becoming apparent on the prone and supine views, and remaining on the final upright view

• stomach is otherwise unremarkable

Impression:

• long irregular stricture of the distal thoracic oesophagus, differential including reflux oesophagitis versus malignancy

• endoscopy is recommended

Mediastinum

• there few borderline and subcentimetre lymph nodes in the posterior mediastinum adjacent to the distal oesophagus. No other significant adenopathy by size criteria

Heart and pericardium

• heart size is normal

• coronary artery calcification is demonstrated  

• no pericardial fluid collections

The aorta and major vessels: Trace calcified plaque within the normal calibre aorta  

Lungs and airways

• no airspace consolidation

• peripheral 3 mm nodule associated with an interlobular septum in the anterior aspect right middle lobe, favoured represent an intrapulmonary lymph node

• additional suspected tiny peripheral 2 mm intrapulmonary lymph node posterior aspect right lower lobe

• vo concerning pulmonary nodules demonstrated

• central airways are clear

Pleura: No pleural effusions or nodularity. 

Chest wall: No axillary adenopathy. Chest wall soft tissues are unremarkable.

Oesophagus, stomach and duodenum

• proximal oesophagus is distended with gas 

• the mid to distal oesophagus is abnormal in appearance with irregular circumferential wall thickening

• irregularity oesophagus involves the distal 10 cm of the oesophagus

• there is a suspected small hiatal hernia

• the stomach is collapsed but within normal limits

• normal appearance of the duodenum

Impression:

• marked circumferential soft tissue thickening and irregularity involving the distal 10 cm of the oesophagus. Appearance is consistent with recently diagnosed oesophageal adenocarcinoma

• borderline and subcentimetre lymph nodes in the lower mediastinum which will require continued attention on follow-up

Long segment lower oesophageal mass, probable cancer.