Cancer versus not cancer on esophagram. [Gastrointestinal] [FL]
Quick one today. Take a look at Patient A and Patient B.
Patient A has a smooth focal indentation of the posterior cervical esophagus.
Patient B has a broader indentation that is also irregular and nodular along its contour.
Patient A has a cricopharyngeal bar, which is a prominence caused by the cricopharyngeus muscle that can cause dysphagia if it gets really prominent. Patient B has esophageal squamous cell carcinoma.
Are they swallowing during the X-ray so you can see these features?
Yep. They're in the middle of swallowing some liquid contrast. Take the picture 1 second later and you miss the shot.
Sounds tricky haha. Is it some iodine containing solution?
It's usually barium sulfate, which can have a more viscous consistency that makes it go down a little slower and allows it to stick to things to outline them. But yes, regular iodine contrast can also be used.