Zenker's Diverticulum Presenting as a Thyroid Nodule

Shanker, Beth Ann; Davidov, Tomer; Young, John S.; Chang, Eric I.; Trooskin, Stanley Z.

doi:10.1089/thy.2009.0177

Cited by 20 publications

(19 citation statements)

References 8 publications

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“…Therefore, bilateral Killian-Jamieson diverticula are rare. Furthermore, these hypopharyngeal diverticula often mimic thyroid nodules on ultrasonography because they are located in the vicinity of the thyroid gland [1, 2, 3]. However, to our knowledge, the incidental co-existence of bilateral Killian-Jamieson diverticula and a thyroid tumor has not been previously described.…”

Section: Discussionmentioning

confidence: 99%

Killian-Jamieson Diverticula Presenting Synchronously with Thyroid Adenoma

Mimatsu

Oida

Kano

et al. 2013

Case Rep Gastroenterol

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Killian-Jamieson diverticulum is a rare hypopharyngeal diverticulum, less commonly encountered compared with Zenker's diverticulum. These hypopharyngeal diverticula that cause dysphagia often mimic a thyroid tumor incidentally detected on neck ultrasonography. However, to our knowledge, Killian-Jamieson diverticula complicated by a thyroid tumor have not been previously described. We experienced a rare case of bilateral Killian-Jamieson diverticula synchronously complicated by a thyroid adenoma in a 74-year-old woman who became aware of dysphagia and a tumor in the left side of her neck. Pharyngoesophagography revealed bilateral diverticula protruding from the lateral wall of the esophagopharyngeal junction, but the appearance of the cricopharyngeal bar representing the cricopharyngeus muscle above the diverticula had become unclear because the thyroid tumor was pressing on the diverticula and the cervical esophagus. However, the diverticula were diagnosed as Killian-Jamieson diverticula because cervical computed tomography showed bilateral diverticula arising from the cervical esophagus just below the level of the cricoid cartilage, and operative finding showed that the diverticula were located above the upper esophageal longitudinal muscle. Radiographic imaging is useful for diagnosis as cause of dysphagia and cervical tumor.

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Section: Discussionmentioning

confidence: 99%

Killian-Jamieson Diverticula Presenting Synchronously with Thyroid Adenoma

Mimatsu

Oida

Kano

et al. 2013

Case Rep Gastroenterol

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“…FNA of a Zenker's diverticulum initially thought to be a thyroid nodule has been very rarely reported [9][10][11][12]. Smears of FNA of Zenker's diverticulum contained combinations of mature squamous cells, associated bacteria (cocci and bacilli), and birefringent material.…”

Section: Discussionmentioning

confidence: 99%

“…Fine needle aspiration (FNA) of the thyroid is the recommended diagnostic test in the initial evaluation of thyroid nodules. FNA of Zenker's diverticulum masquerading as a thyroid nodule has only been reported four times in the literature [9][10][11][12]. Zenker's dverticulum suspected to be a thyroid nodule.…”

Section: Introductionmentioning

confidence: 99%

Zenker's Diverticulum Suspected to be a Thyroid Nodule Diagnosed on Fine Needle Aspiration: A Case Report

Kim

2012

J Med Cases

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Zenker's diverticulum is mimicking thyroid nodule on ultrasonograhy (US). Therefore, it has risk of fine needle aspiration (FNA) on that lesion. There are only four case reports in the literature of fine needle aspiration of Zenker's diverticula masquerading as a thyroid nodule. We report a case of Zenker's dverticulitum suspected to be a thyroid nodule on US and performed US-guided FNA with examination of cytology in this patient. A 53-yr-old woman was referred to our center for FNA of a thyroid nodule. The thyroid US demonstrated a 1.3 × 1.6 cm, poorly-defined nodule containing multiple echogenic foci in the posterior medial aspect of the left thyroid. We performed US-guided FNA on that lesion. Papanicolaou stain showed squamous epithelial cells and numerous bacilli. We diagnosed this patient as having a Zenker's diverticulum, and this was confirmed by esophagram.

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“…[1][2][3][4] Inadvertent fine-needle aspiration (FNA) of a PED masquerading as a thyroid nodule was first reported by Rekhtman et al 5 A small number of case studies with FNA findings have subsequently been reported in the ultrasound literature, [6][7][8][9] and in an additional pathology publication. Killian-Jamieson diverticulum is a less common type of PED, and arises from the anterolateral aspect of the upper esophagus immediately inferior to the cricopharyngeal muscle.…”

Section: Introductionmentioning

confidence: 99%

Pharyngoesophageal diverticula simulating thyroid nodules: An unusual occurrence with unique features

Nauschuetz¹,

Ogden²,

Starling³

et al. 2017

Diagnostic Cytopathology

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Pharyngoesophageal diverticula (PED) of the Zenker's and Killian-Jamieson types arise in close proximity to the thyroid gland, and may rarely be confused with a thyroid nodule on ultrasonography. In this brief report, we detail the cytologic, clinical, and radiologic findings of three PED that were thought to be thyroid nodules, and were subjected to fine-needle aspiration (FNA). The patients were females with an age range of 51-64 years. All three patients had multiple thyroid nodules, and two patients reported symptoms attributable to the diverticulum. Nodule sizes ranged from 1.0 to 2.7 cm, and either the right or left thyroid lobe could be involved. Microcalcifications were present by ultrasonography in all three cases. FNA of these thyroid nodule mimics showed squamous cells with granular or amorphous debris, bacterial and/or fungal colonies, inflammation, and food particles. These cytologic features, particularly the presence of vegetable or meat fragments, are characteristic, and have also been reported in the few previous reports of PED. The presence of a diverticulum was confirmed with imaging studies in all our patients. Although a rare occurrence, the inadvertent FNA of a PED masquerading as a thyroid nodule is important to recognize, as a recommendation for appropriate radiologic studies could potentially avoid inappropriate therapy for thyroid disease.

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Zenker's Diverticulum Presenting as a Thyroid Nodule

Cited by 20 publications

References 8 publications

Killian-Jamieson Diverticula Presenting Synchronously with Thyroid Adenoma

Killian-Jamieson Diverticula Presenting Synchronously with Thyroid Adenoma

Zenker's Diverticulum Suspected to be a Thyroid Nodule Diagnosed on Fine Needle Aspiration: A Case Report

Pharyngoesophageal diverticula simulating thyroid nodules: An unusual occurrence with unique features

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