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Updated: Jun 10, 2026

Image Acquisition using Portable Sonography for Emergency Airway Management
Published on: September 28, 2022
Pharyngoesophageal diverticulum resembling a thyroid nodule on ultrasound
Reyaz M Singaporewalla1, Jagat J Mukherjee, Thomas P Thamboo
1Department of Surgery, Alexandra Hospital, Singapore. reyazm@yahoo.com
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.
Conclusion:
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.
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