To present a case of a large esophageal schwannoma and highlight the role of spectral CT in its diagnosis and characterization.
Approach:
Patient Presentation: A 48-year-old woman with mild dysphagia and an incidentally detected right mediastinal mass.
Imaging Techniques: Spectral CT was utilized to assess the characteristics of the esophageal mass and associated lymph nodes.
Histopathological Analysis: Post-surgery, histopathology confirmed the diagnosis of schwannoma and reactive lymphoid hyperplasia.
Key Findings:
The esophageal mass measured 83 × 63 × 100 mm and displayed heterogeneous enhancement with an intraluminal air crescent sign.
Spectral CT provided higher absolute attenuation values compared to conventional CT, aiding in the characterization of the mass and demonstrating spectral differences between the primary mass and lymph nodes.
Histopathology revealed a spindle-cell tumor with a prominent peripheral lymphoid cuff, confirming schwannoma and excluding gastrointestinal stromal tumor.
Interpretation:
Limitations:
The study is based on a single case, limiting generalizability.
Potential for misdiagnosis due to overlapping imaging features with other tumors.
Conclusion:
The case illustrates the utility of spectral CT in diagnosing esophageal schwannoma and highlights the importance of histopathological correlation.
