Ultrasonographic features of pharyngoesophageal diverticulum in a case misdiagnosed as a thyroid nodule: a case report and review of the literature

Killian-Jamieson diverticulum is an infrequent, pulsion type of diverticulum which derived from the anterolateral wall of the cervical esophagus in a gap below the cricopharyngeus and lateral to the longitudinal tendon of the esophagus. Zenker’s diverticulum originates from the posterior wall of the pharyngoesophageal part in a midline zone of weakness above the cricopharyngeus. Diverticulums can mimic thyroid nodule in ultrasonography due to its large size. In this paper, we discuss cases of Killian-Jamieson diverticulum that originate from the esophagus and mimic thyroid nodule, and we present ultrasonographic findings together with literature knowledge in order to prevent unnecessary biopsies. Case Report A 62-year-old female patient was referred from the endocrinology department ward to the ultrasonography unit of radiology clinic for the evaluation of a biopsy because of her previous ultrasonography results, performed at an external center. The women had occasional difficulty in swallowing, no family history of thyroid disease, negative laboratory tests and a normal physical examination. A thyroid ultrasonography was carried out with 10 MHz linear transducer and showed a heterogeneous nodular lesion (21×16 mm) with hypoechoic borders posterior to the left lobe of thyroid gland and a hyperechogenic center that casted shadow behind (Fig. 1). Diverticulum was suspected Case Report