2017-11-08 22:12:06 UTC

Image Challenge: An Unusual Cause of Dysphagia in an Elderly Woman

Nov. 8, 2017

What caused a 66-year-old woman, with occurrence of hemoptysis several days before presenting, one month of dysphagia?

Gastroenterology Clinical Image Challenge:  A 66-year-old woman came to the hospital complaining of dysphagia for one month. She denied a family history of gastrointestinal carcinoma and a history of previous surgery. Remarkable previous history of bronchiectasis in the past years and occurrence of hemoptysis several days before was provided. The patient denied alcohol consumption and smoking habits. Upon presentation, no positive findings were found on the physical examination or laboratory studies. Esophagogastroduodenoscopy revealed a smooth, hemispherical, 8-mm diameter lesion on the posterior side of her esophagus at the level of carina (Figure). Using a Miniprobe sonography, an echoless vessel-like structure connected to the thoracic aorta was identified where the lesion was found. Doppler ultrasound imaging demonstrated rich blood flow signals inside the vessel-like structure. These signals originated from the thoracic aorta.

What is the diagnosis?

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