Pharyngoesophageal diverticulum resembling a thyroid nodule on ultrasound.
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.


CONCLUSIONS
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.
Singaporewalla
Reyaz M
RM
Department of Surgery, Alexandra Hospital, Singapore. reyazm@yahoo.com
Mukherjee
Jagat J
JJ
Thamboo
Thomas P
TP
Cheah
Wei K
WK
D044963:Biopsy, Fine-Needle; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008875:Middle Aged; D016606:Thyroid Nodule / Q000175:diagnosis / Q000000981:diagnostic imaging*; D014463:Ultrasonography; D016672:Zenker Diverticulum / Q000175:diagnosis / Q000000981:diagnostic imaging*