Killian-Jamieson Diverticula Mimicking Thyroid Nodule on Ultrasound: Radiographic Findings in Two Patients
Journal of the Korean Radiological Society
The lateral diverticula of the cervical esophagus are called "Killian-Jamieson diverticula." They originate below the transverse portion of the cricopharyngeal muscle at the transition between the pharynx and esophagus, and this position probably represents a site of lower resistance (1). Because they will cause fewer symptoms than Zenker's diverticula, they are often found incidentally on esophagography (2). They can also be detected by neck ultrasound (US), which is popularly used for
... g the thyroid gland. We describe here two cases of Killian-Jamieson diverticula. In the first case, the diverticulum was tentatively identified as a calcified thyroid nodule when it was evaluated by US and, as a consequence, a fine needle aspiration (FNA) procedure was attempted. The aspiration procedure and the subse-quently performed esophagography revealed a Killian-Jamieson diverticulum. The second case was a smallsized Killian-Jamieson diverticulum that was correctly diagnosed by meticulously performed US. The purpose of this report is to describe the sonographic findings of Killian-Jamieson diverticula and to help radiologists avoid unnecessary invasive procedures for such extrathyroidal lesions. Case Report Case 1 A 70-year-old man presented with a calcified thyroid nodule that was detected incidentally at an outside hospital. The physical examination of the patient and the laboratory tests were normal. US was performed using a real-time linear array unit with a 7.5 12 MHz transducer (HDI 5000 SonoCT; Philips Medical Systems, Bothell, WA) with the patient in the supine position and the neck hyperextended. US revealed an approximately 2.5 cm, well-defined, multi-443 Killian-Jamieson diverticula are lateral diverticula in the cervical esophagus. Because of their location, they have been found incidentally during ultrasound (US) and they've sometimes been mistakenly identified for thyroid nodules. We describe here the US findings, the fine needle aspiration (FNA) procedure and the esophagography of a Killian-Jamieson diverticulum in a 70-year-old man. This diverticulum was considered to be a calcified thyroid nodule until we performed FNA. We will discuss the sonographic findings that are helpful for differentiating Killian-Jamieson diverticula from thyroid nodules. In addition, we describe the US findings of a small Killian-Jamieson diverticulum in a 34-year-old woman.