Abnormal bronchial artery mimicking esophageal submucosal tumor

An 80-year-old man presented with a subepithelial lesion in the middle esophagus ([Fig. 1]). He reported no significant discomfort. His medical history was unremarkable. Physical examination revealed no significant abnormalities.

Fig. 1 A subepithelial lesion (arrows) in the middle esophagus.

Endoscopic ultrasonography (EUS) with a miniprobe revealed a soft lesion without motion. The esophageal wall was normal, with anechoic tubular structure outside the wall ([Fig. 2]). Doppler sonography suggested an abnormal artery communicating with the aorta ([Fig. 3], [Video 1]). Enhanced computed tomography (CT) confirmed the tortuous and dilated bronchial artery, which was causing esophageal compression ([Fig. 4]). Thus, the patient was diagnosed with abnormal bronchial artery mimicking esophageal submucosal tumor. As the patient reported no dysphagia or other symptoms, regular follow-up was prescribed [1]. The patient remained well during 6 months of follow-up.

Fig. 2 Endoscopic ultrasonography with a miniprobe revealed a soft lesion without motion. The esophageal wall was normal, with anechoic tubular structure (arrows) outside the wall.

Fig. 3 Doppler sonography suggested an abnormal artery communicating (white arrows) with the aorta.

Video 1 Endoscopic ultrasonography with a miniprobe revealed a soft lesion without motion. The esophageal wall was normal, with anechoic tubular structure outside the wall. Doppler sonography suggested an abnormal artery communicating with the aorta.

Fig. 4 Enhanced computed tomography imaging. a, b Imaging confirmed the tortuous and dilated bronchial artery, which was causing esophageal compression.

Esophageal submucosal tumors are commonly encountered during clinical practice. Hemangioma, leiomyoma, granular cell tumor, and cyst are common types [2]. In this case, we reported a rare condition of abnormal bronchial artery mimicking esophageal submucosal tumor. Our experience further demonstrates the importance of routine application of Doppler sonography or enhanced CT for determining the nature of submucosal tumors.

Endoscopy_UCTN_Code_CCL_1AB_2AC_3AH

Competing interests

The authors declare that they have no conflict of interest.

Acknowledgments

We acknowledge the support from Natural Science Foundation of China (Grant No: 82170675), 1·3·5 project for disciplines of excellence, West China Hospital, Sichuan University (Grant No: ZYJC21011), and Science and Technology Bureau of Ya ʼan City 22KJJH0019.

• References

• 1 Walker CM, Rosado-de-Christenson ML, Martínez-Jiménez S. et al. Bronchial arteries: anatomy, function, hypertrophy, and anomalies. Radiographics 2015; 35: 32-49
• 2 Tsai SJ, Lin CC, Chang CW. et al. Benign esophageal lesions: endoscopic and pathologic features. World J Gastroenterol 2015; 21: 1091-1098

Publication History

Article published online:
24 February 2023