Pharyngoesophageal diverticulum resembling a thyroid nodule on ultrasound.

Abstract

BACKGROUND:

Ultrasound is routinely used in evaluating thyroid nodules and performing fine-needle aspiration cytology (FNAC). Occasionally, nonthyroidal lesions can mimic thyroid nodules on imaging and get wrongly aspirated.

METHODS:

A 63-year-old woman was reported to have an incidental left thyroid "nodule" on neck ultrasound scan. It was isoechoic with a surrounding hypoechoic rim and contained tiny foci of echogenicity. Similar findings were noted in a second surgeon-performed ultrasound scan.

RESULTS:

An ultrasound-guided FNAC showed abundant squamous cells, bacteria, and vegetable cells with no evidence of thyroid cells or colloid. The suspicion of a pharyngoesophageal diverticulum was confirmed on barium swallow. She remained asymptomatic with no increase in size at 6 months follow-up.

CONCLUSION:

A pharyngoesophageal diverticulum can be mistaken for a posteriorly placed "thyroid nodule" on ultrasound scan if the subtle differentiating signs are missed. An awareness of this condition is important to avoid unnecessary needle biopsies.

• Authors: Reyaz M Singaporewalla, Jagat J Mukherjee, Thomas P Thamboo, Wei K Cheah
• Journal: Head & neck (Head Neck) Vol. 33 Issue 12 Pg. 1800-3 (Dec 2011) ISSN: 1097-0347 [Electronic] United States
• PMID: 20665743 (Publication Type: Case Reports, Journal Article)
• Copyright: Copyright © 2010 Wiley Periodicals, Inc.

Topics

• Biopsy, Fine-Needle
• Diagnosis, Differential
• Female
• Humans
• Middle Aged
• Thyroid Nodule (diagnosis, diagnostic imaging)
• Ultrasonography
• Zenker Diverticulum (diagnosis, diagnostic imaging)