CTICasesSpontaneous Tracheal Ulcer with Esophageal Prolapse
Imaging findings
CT chest in a patient with cutaneous T-cell lymphoma shows a large, gaping defect (ulcer) in the membranous posterior wall of the trachea, with the esophagus prolapsing anteriorly into the tracheal lumen, associated with aspiration pneumonia.
Key takeaways
Spontaneous tracheal ulcers or fistulas can occur in patients with hematologic malignancies or immunodeficiency. The lack of cartilage in the membranous posterior tracheal wall allows the esophagus to bulge or herniate through the defect. This must be distinguished from iatrogenic intubation injury.
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