CLINICAL CASE OF KILLIAN–JAMIESON DIVERTICULUM, SIMULATING A FOCAL LESION IN THYROID GLAND
Abstract
Focal lesions in the thyroid gland are a common finding at ultrasound examinations. A preventive examination of the patient revealed a focal lesion in the thyroid gland. The ultrasound characteristics of the node could match the fifth category of the TI-RADS classification, which required additional examination — a fine needle puncture biopsy with an analysis of cytological material. The performed control ultrasound examination revealed the variability of the ultrasound characteristics, which suggested the extraorgan genesis of the detected node in the thyroid gland and its connection with the cervical esophagus. X-ray examination with artificial contrast application made it possible to confirm the presence of a Killian-Jamieson lateral diverticulum of the pharyngeal-esophageal junction, which mimicked the pathology of the thyroid gland. The correct methodological approach to ultrasound examination made it possible to reject the initial diagnosis, avoid performing an invasive diagnostic procedure, suspect the presence of a diverticulum, and subsequent X-ray examination confirmed the diagnosis.
References
Земляной А.Г. Дивертикулы желудочно-кишечного тракта. Л.: Медицина, Ленингр. отделение; 1970.
Войтёнок Н.К. Диагностика и лечение дивертикулов пищевода. Вестник хирургии. 1988;2:36–38.
Siddiq M.A., Sood S., Strachan D. Pharyngeal pouch. Postgrad Med J. 2001;77(910):506–511. DOI: 10.1136/pmj.77.910.506.
Сакс Ф.Ф., Медведев М.А., Байтингер В.Ф., Рыжов А.И. Функциональная морфология пищевода. М.: Медицина, 1987.
Prisman E., Genden E.M. Zenker diverticulum. Otolaryngol Clin North Am. 2013;46(6):1101–1111. DOI: 10.1016/j.otc.2013.08.011.
Абдураимов А.Б., Хомерики С.Г., Павлов М.В., Афанасьев А.Б., Михайлова З.Ф. Клинико-рентгенологическая диагностика дивертикула Ценкера. Медицинский алфавит. 2018;2(20):37–41.
Liu L.W.C., Andrews C.N., Armstrong D. et al. Clinical Practice Guidelines for the Assessment of Uninvestigated Esophageal Dysphagia. J Can Assoc Gastroenterol. 2018;1:5–19.
Ekberg O., Nylander G. Lateral diverticula from the pharyngo-esophageal junction area. Radiology. 1983;146:117–122.
Иванишина Т.В., Заболотская Н.В., Иванишина Н.С., Мелихова М.В. Ультразвуковая диагностика дивертикула пищевода, имитирующего новообразование щитовидной железы. Ультразвуковая и функциональная диагностика. 2014;5:51–56.
