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Figure 23b.  Esophageal foreign-body granuloma in a 3-year-old boy with cough, stridor, and dysphagia who was admitted in respiratory distress. He had had a choking episode while eating paella with clams 1 month earlier. (a) Posteroanterior chest radiograph shows a foreign body (a clamshell) at the thoracic inlet (arrow). (b, c) Axial CT scan (b) and three-dimensional reconstruction image (c) show the hyperattenuating foreign body (arrow) with a hypoattenuating pseudomass that causes tracheal stenosis.