title: Zenker diverticulum in the right side of the neck resembling a thyroid mass at ultrasound.
abstract: Zenkers diverticulum represents the most common form of pharyngo-oesophageal diverticula usually occurring on the left side of the neck. Due to its anatomical proximity to the thyroid, it can mimic a thyroid mass. Here we describe the case of an asymptomatic 49-year-old man referred to the Thyroid Clinic of the Policlinico Umberto I Hospital-Sapienza University of Rome for thyroid sonography due to a family history of autoimmune thyroid disease. The patients thyroid blood tests did not reveal any abnormalities. The sonographic examination showed a dishomogeneus and hypoechoic thyroid gland. In addition, in the third middle of the right lobe, a mass (with a diameter greater than 26 mm), with heterogeneous internal echogenicity, hypoechoic margins and internal hyperechoic spots was recorded, with no appreciable flow at the Doppler evaluation. The TI-RADS score was 4c. Hence, the patient underwent ultrasound-guided fine-needle aspiration cytology that revealed the presence of squamous cells without cytological atypia, erythrocytes, muscular and vegetable fibres, colonies of bacteria in the absence of inflammatory infiltrate. This was consistent with the diagnostic hypothesis of oesophagus diverticulum, which was confirmed by means of a barium-swallow oesophagography. This case report underlines the possibility that a suspicious thyroid mass may result from a Zenkers diverticulum, even if located on the right side, especially if the lesion has a heterogeneous echo-texture, a hypoechoic rim and internal hyperechoic spots.
authors.affiliation: Department of Experimental Medicine, Sapienza University of Rome, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Alessandrini
authors.affiliation: Department of Experimental Medicine, Sapienza University of Rome, Italy.
authors.forename: I
authors.initials: I
authors.lastname: Samperi
authors.affiliation: Department of Radiological, Oncological and Anatomo-Pathological Sciences, Sapienza University of Rome, Italy.
authors.forename: F
authors.initials: F
authors.lastname: De Cristofaro
authors.affiliation: Department of Experimental Medicine, Sapienza University of Rome, Italy.
authors.forename: E
authors.initials: E
authors.lastname: D'Armiento
authors.affiliation: Department of Radiological, Oncological and Anatomo-Pathological Sciences, Sapienza University of Rome, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Diacinti
authors.affiliation: Department of Radiological, Oncological and Anatomo-Pathological Sciences, Sapienza University of Rome, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Pernazza
authors.affiliation: Department of Radiological, Oncological and Anatomo-Pathological Sciences, Sapienza University of Rome, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Bosco
authors.affiliation: Department of Radiological, Oncological and Anatomo-Pathological Sciences, Sapienza University of Rome, Italy.
authors.forename: V
authors.initials: V
authors.lastname: Ascoli
authors.affiliation: Department of Surgical Sciences, Sapienza University of Rome, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Ulisse
mesh_terms: D003937:Diagnosis, Differential; D006801:Humans; D008297:Male; D008875:Middle Aged; D016606:Thyroid Nodule / Q000000981:diagnostic imaging*; D014463:Ultrasonography; D016672:Zenker Diverticulum / Q000000981:diagnostic imaging*