[Contribution of V/Q lung scan to the diagnosis of esophageal carcinoma].

A 57-year-old patient was admitted to the emergency department for a clinical picture of intermittent chest pain, dysphonia and respiratory stridor, having received antibiotic treatment with poor therapeutic response. The only imaging study performed had been a chest X-ray interpreted as normal. The patient had an important history of alcoholism and smoking (>45 packs/year). On clinical suspicion of pulmonary thromboembolism (PTE), a V/Q lung scintigraphy was requested (Fig. 1). The scintigraphic study demonstrated a low probability of acute PTE. In the ventilatory phase of the scan (Technegas) an important focal retention of radiolabeled particles was observed at the tracheal-bronchial level, thereby suggestive of ruling out extrinsic air flow compression above the bronchial bifurcation. A CT scan of the thorax (Fig. 2) was performed, showing a retrotracheal mass of 3.8 cm×5.4 cm×5.9 cm, with invasion of the posterior wall of the distal third of the trachea until 1 cm from the carina and invasion of the esophagus. Esophagoscopy and fibrobronchoscopy1 confirmed that the mass produced irregular esophageal stenosis 20 cm from the