Cystic left tracheoesophageal groove lesion may represent a branchial cleft seen on CT: dysphagia, pressure sensation. There is a T2 hyperintense tubular mass adjacent to the left aspect of the cervical esophagus that extends from the level of the C6 to T1 vertebral body levels, measuring 17 AP x 18 RL x 45 SI mm. There is a crenulated pattern of enhancement within the mass, suggestive of digestive track mucosa, and central non-enhancement. In addition, following the administration of oral contrast the center of the mass also enhances, although this may potentially be due to delayed centripetal intravenous contrast enhancement. The trachea and prevertebral space appear to be intact. The mass also appears to be separated from the thyroid gland. There appears to be a mildly prominent, but subcentimeter, right tracheoesophageal groove lymph node, which is nonspecific. There are small posterior disc-osteophytes at C4-5 and C5-6 without spinal cord impingement. The imaged salivary gland are unremarkable.
A left paraesophageal mass measuring up to 45 mm may represent an esophogeal diverticulum or enteric duplication cyst with associated mucosal inflammation, although an underlying neoplastic component is a potential consideration. A vascular malformation or brachial cleft cyst with superimposed inflammation are alternative possibilities, perhaps.