What is the most common benign etiology for mild-to-moderate concentric esophageal wall thickening, such as inflammation, including chronic inflammation, in the absence of prior images for comparison?

Differential Diagnosis for Esophageal Wall Thickening

• Single most likely diagnosis + Chronic esophagitis: This is the most likely diagnosis given the description of concentric and mild-to-moderate esophageal wall thickening. Chronic inflammation from gastroesophageal reflux disease (GERD) or other causes can lead to this appearance.
• Other Likely diagnoses + Eosinophilic esophagitis: This condition is characterized by inflammation of the esophagus due to an allergic reaction, often presenting with similar imaging findings. + Infectious esophagitis: Certain infections, such as those caused by Candida or herpes simplex virus, can cause esophageal wall thickening, especially in immunocompromised patients.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.) + Esophageal cancer: Although less likely, esophageal cancer can present with wall thickening and must be considered, especially in older patients or those with risk factors such as smoking or a history of Barrett's esophagus. + Lymphoma: Gastrointestinal lymphoma can involve the esophagus, leading to wall thickening, and is a critical diagnosis not to miss due to its significant implications for treatment and prognosis.
• Rare diagnoses + Scleroderma: This autoimmune disease can cause esophageal wall thickening and dysmotility, although it is less common than other causes. + Esophageal involvement in systemic diseases (e.g., Crohn's disease, sarcoidosis): These conditions can rarely affect the esophagus, leading to wall thickening, and should be considered in patients with a known history of such diseases.