168 Achalasia

CASE 168

image Clinical Presentation

35-year-old man with dysphagia, weight loss, and halitosis

image Radiologic Findings

PA (Fig. 168.1) and lateral (Fig. 168.2) chest radiographs demonstrate a large, elongate middle-posterior mediastinal mass that extends to the paravertebral region, projects to the right of midline, and produces mass effect on the posterior wall of the trachea (Fig. 168.2). Contrast-enhanced chest CT (mediastinal window) (Figs. 168.3, 168.4) shows heterogeneous contents and dependent contrast in a dilated esophagus that produces mass effect on the heart and tracheobronchial tree (Fig. 168.4).

image Diagnosis


image Differential Diagnosis

• Esophageal Dilatation from Progressive Systemic Sclerosis

• Esophageal Dilatation from Acquired Focal Obstruction

image Carcinoma

image Metastatic Disease

image Non-Neoplastic Stenosis


Fig. 168.1


Fig. 168.2

Jan 14, 2016 | Posted by in RESPIRATORY IMAGING | Comments Off on 168 Achalasia

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