Esophagus

Normal Esophageal Anatomy

  • Normal esophageal width = 3 mm

  • Upper 1/3 = striated muscle

  • Middle 1/3 = mixed striated and smooth muscle

  • Lower 1/3 = smooth muscle

  • Extends from cricopharyngeus muscles to the stomach

Malignant Esophageal Masses

  • Malignant masses can easily invade local structures due to lack of serosal covering of the esophagus

  • Look for —> Esophageal wall thickening + Intraluminal mass + Lumen narrowing

  • Squamous cell carcinoma (75%)

  • Adenocarcinoma (25%)

    • Secondary to Barrett’s esophagus and malignant transformation of dysplastic tissue

Benign Esophageal Masses

  • Well circumscribed mass

  • These are the only esophageal masses that can have calcifications (more so leiomyoma than GIST)

  • Leiomyoma

    • Tend to be large (>5 cm)

    • Not FDG-avid

  • GIST

    • FDG-avid

Esophageal Diverticula

Zenker Diverticulum

  • Posterior

  • Just above cricopharyngeus muscle

Killian-Jamieson Diverticula

  • Rarest form of esophageal diverticula

  • Anterolateral wall of cervical esophagus

  • Below cricopharyngeus muscle

  • Usually smaller and obv anterior compared to zenker

Traction Diverticula

Epiphrenic Diverticula

  • Basically just above the GE junction at the diaphragm, hence “phrenic”

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