Although the Zenker type of diverticulum is often considered to arise primarily in the esophagus, it is more correct to associate it with the lower portion of the pharynx. As a compromise it is sometimes described as a pharyngoesophageal diverticulum. Because of the fact that this type of diverticulum almost always produces difficulty in swallowing, it is recognized during life much more commonly than diverticula that are of true esophageal origin.Esophageal diverticula are of much commoner occurrence than diverticula which arise from the pharynx, but because esophageal diverticula are usually of the so-called traction type, the apex of the sacculation points upward and rarely becomes of sufficient size to produce any symptoms referable to the esophagus. When these diverticula are found, it is almost always incidentally, at necropsy. Occasionally infection of the sac may occur, with perforation into a bronchus or into the mediastinum, resulting in the formation of an esophagobronchial fistula or mediastinal abscess. A few diverticula of the thoracic portion of the esophagus have attained sufficient size to produce considerable distress. These have been recognized easily on roentgenoscopic examination. Also, smaller diverticula, which did not produce esophageal symptoms have been rec¬ ognized when roentgenoscopic examination has been carried out as part of the routine examination.In a review of diverticula of the thoracic portion of the esophagus, Heacock l found that 85 cases previously had been reported. To this series he added 2 cases that had come under his observation. In 1 of these there were multiple sacculations and the patient had experi¬ enced difficulty in swallowing. In the other case the sac was single and

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It is interesting to note that the larger tumors, as seen in Figure 2, lose their glomerulus-like appearance and take on no definite arrangement. However, the character of the cells is still cuboid, and cylindric columnar epithelium, and the cells are arranged in single and sometimes double layers along the capillaries.