Unusual presentation of an esophageal foreign body granuloma caused by a fish bone: usefulness of multidetector computed tomography.
A 68-year-old woman had throat pain while eating fish. The pain gradually disappeared with no treatment. She visited her doctor for a medical checkup 1 year later, and an esophageal tumor was suspected. A double-contrast esophagogram revealed luminal stenosis with a mass-like defect in the middle esophagus. Esophagogastroduodenoscopy (EGD) showed smooth-surface stenosis with a retracted fold. Endoscopic ultrasonography (EUS) showed a hypoechoic mass in the submucosal layer and a well-defined linear hyperechoic structure forming a posterior acoustic shadow within the mass. A computed tomography (CT) examination was then performed using an Aquilion 64-detector row CT scanner, and a high attenuation linear structure was found in the lesion that was visualized as a fish bone-like structure on reconstructed CT images. Endoscopic removal of the fish bone was impossible, and a surgical operation would have been too invasive for a lesion suspected of being benign. The patient had no complaint related to the esophageal lesion itself and no sign of gastrointestinal tract complications. Accordingly, regular follow-up was recommended for the esophageal lesion. Follow-up examination including EGD, esophagography, and CT performed 1 year later showed that the lesion had decreased in size with no fish bone-like structure.
Department of Clinical Radiology, Kyushu University, Higashi-ku, Fukuoka, Japan.
Kazufumi
K
Kikuchi
Daisuke
D
Tsurumaru
Kiyohisa
K
Hiraka
Masahiro
M
Komori
Nobuhiro
N
Fujita
Hiroshi
H
Honda
D000368:Aged; D001842:Bone and Bones; D003937:Diagnosis, Differential; D004935:Esophageal Diseases / Q000000981:diagnostic imaging*; D005260:Female; D015745:Granuloma, Foreign-Body / Q000000981:diagnostic imaging*; D006801:Humans; D017747:Seafood; D014057:Tomography, X-Ray Computed / Q000379:methods*
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