CTICasesLung Abscess secondary to Perforated Esophageal Cancer
Imaging findings
Chest CT reveals an abnormal esophagus filled with debris and air, representing an esophageal neoplasm. Directly adjacent to the lower esophagus in the right lung is a large fluid and gas collection with a thick wall, characteristic of a lung abscess. An esophagram demonstrates direct extravasation of oral contrast from the esophageal lumen into the right lung abscess cavity.
Key takeaways
Esophageal carcinoma occasionally presents with atypical complications such as perforation into adjacent structures. Perforation of esophageal cancer directly into the lung parenchyma can lead to the formation of a malignant bronchoesophageal fistula and a subsequent large lung abscess. A swallow study with water-soluble contrast is the preferred initial test to confirm esophageal perforation and define the communication channel.
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