Liang Tsung-Jung, Liu Shiuh-Inn, Chiang Chia-Ling
Division of General Surgery, Department of Surgery, Kaohsiung Veterans General Hospital, Kaohsiung 813414, Taiwan.
School of Medicine, National Yang Ming Chiao Tung University, Taipei 112304, Taiwan.
Diagnostics (Basel). 2023 Oct 5;13(19):3128. doi: 10.3390/diagnostics13193128.
A 66-year-old woman presented with an incidental left thyroid nodule during a health examination. She had no voice change, shortness of breath, cough, or dysphagia. Repeated sonography showed a dynamic change of the lesion, which was more evident following soda consumption. A subsequent esophagography confirmed the diagnosis of a Killian-Jamieson diverticulum. This rare left-sided pharyngoesophageal diverticulum is often asymptomatic. On a sonography, air bubbles in the esophageal lumen can cause a ring-down artifact that mimics microcalcifications, which are characteristic of thyroid malignancy, and misdiagnosis may lead to unnecessary interventions, including fine-needle aspiration or thyroidectomy. A dynamic ultrasound, specifically done during soda consumption, offered a simple diagnostic distinction. No surgical intervention was pursued; the patient was monitored in the clinic.
一名66岁女性在健康检查时偶然发现左甲状腺结节。她没有声音改变、呼吸急促、咳嗽或吞咽困难。反复超声检查显示病变有动态变化，饮用苏打水后更明显。随后的食管造影证实为基利安-詹米森憩室。这种罕见的左侧咽食管憩室通常无症状。在超声检查中，食管腔内的气泡可产生类似甲状腺恶性肿瘤特征性微钙化的振铃伪像，误诊可能导致不必要的干预，包括细针穿刺或甲状腺切除术。动态超声检查，特别是在饮用苏打水时进行，提供了一种简单的诊断鉴别方法。未进行手术干预；患者在门诊接受监测。
