Pseudo thyroid nodule: Unknown Long standing Zenker’s Diverticulum with Severe Weight loss sent for Thyroid biopsy.

Pseudo thyroid nodule: Unknown Long standing Zenker’s Diverticulum with Severe Weight loss sent for Thyroid biopsy.

Pseudo thyroid nodule: Unknown Long standing Zenker’s Diverticulum with Severe Weight loss sent for Thyroid biopsy.
Large pouch extending to right inferior to the right lobe.

Distinct hyperechoic white line seen.
Hyperechoic line between the thyroid and the pouch
Mass inferior to left lobe


70 pound F with 10 year history of severe weight loss with symptoms for vomiting undigested food and dysphagia has Hashimoto’s thyroiditis and a “thyroid nodule” on outside Ultrasound. Neck examination was negative for a thyroid nodule. TFTs were normal except positive TPO antibodies. My endocrine neck Ultrasound found a mass inferior to the left thyroid lobe. It had a clear hyperechoic line separating it from the thyroid gland. A fine needle biopsy of the mass was consistent with a Zenker’s pouch with squamous cells, She was referred to specialists to treat her Zenker’s diverticulum. She was treated with low dose LT4 for her Hashimoto’s thyroiditis. Her problem was considered a stomach issue not the pouch by all her prior physicians.

UGI with contrast of another case

This is the 5th case of mistaken Zenker pouch for a thyroid nodule. One case came with a note stating the radiologist missed the thyroid nodule and got into the esophagus.

310-393-8860 or email to [email protected]






Ask for Alicia for evaluation information.

Dr.G.

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