Double-ring esophageal sign: pathognomonic for esophageal lipomatosis

The peculiar appearance of the proximal esophagus on CT attributed to esophageal lipomatosis is not well recognized. We have recently encountered seven cases from over a period of 2 months and report them to reach a broader audience of radiologists who may be unaware of its existence. Its typical CT features should lead to the correct diagnosis and be differentiated from other fatty lesions known to involve the esophagus, namely, lipoma and liposarcoma.