CTICasesEsophageal Traction Diverticulum Secondary to Histoplasmosis
Imaging findings
Esophagram demonstrates a focal, persistent, mid-esophageal out-pouching that fails to empty completely during swallowing. Non-contrast CT chest images show that this tract is a diverticulum directly adjacent to a densely calcified subcarinal lymph node, accompanied by calcified hilar lymph nodes and multiple splenic calcifications.
Key takeaways
Mid-esophageal traction diverticula are acquired structural abnormalities caused by chronic inflammatory processes in adjacent lymph nodes, which pull the esophageal wall outward. While classically associated with tuberculosis, in endemic areas like the US Midwest, chronic granulomatous histoplasmosis is a highly common cause, recognizable on CT by the presence of dense, calcified subcarinal/hilar lymph nodes and splenic granulomas.
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