Friday, 15 July 2022

CASE 642: ZENKER' S DIVERTICULUM, Dr PHAN THANH HẢI, Dr NGUYỄN TUẤN CƯỜNG, Dr LÊ HỮU LINH, MEDIC MEDICAL CENTER, HCMC, VIETNAM

 A  67 year-old male patient with multinodular goiter in reexamination.

Ultrasound Medic revealed a cystic lesion with air inside that was in posterior of right thyroid lobe. The lesion may be mimicking a calcified thyroid nodule in right lobe.




CT with CE confirmed the cyst captured contrast media which is in connection to esophagus on the right side. A Zenker's diverticulum was noted.


A Zenker's diverticulum is an outpouching that occurs 
at the junction of the lower part of the throat and the
upper portion of the esophagus. The pouch forms 
because the muscle that divides the throat from 
the esophagus, the cricopharyngeal (CP) muscle,
 fails to relax during swallowing. 
https://www.mountsinai.org › zenkers-diverticulum
DISCUSSION:
Zenker's diverticulum is always on left side of the anterior 
neck.
In our case the lesion belongs to right side; and at first 
sight, it looks like a calcified thyroid nodule. But 
we could see some comet tail artifacts below 
the lesion and hence, it does notexist the posterior 
shadowing artifact like in case of a calcified lesion.
CONCLUSION:
We should take different diagnosis for any thyroid lesion 
nearby the esophagus, especially before performing a
 FNAC for a thyroid lesion.









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