Sonographic findings of Zenker diverticula

Objective. The purpose of this study was to describe the sonographic findings of Zenker diverticula. Methods. This study included 6 patients (age, 26-70 years; average, 55.3 years). Three cases were detected incidentally by thyroid sonograms, and 3 cases were transferred from other hospitals for aspiration of a thyroid nodule. All the sonograms and medical records were reviewed retrospectively. Results. All 6 patients had no symptoms, and diverticula were incidentally detected by neck sonography. The masses were located on the posterolateral aspect of the left lobe in 5 patients and the right lobe in the remaining patient. All lesions were located in the upper and mid portions of the thyroid glands and showed echogenic foci similar to those of a microcalcification or an arc-shaped microcalcification. The sonographic findings of a Zenker diverticulum were seen as an isoechoic or a hypoechoic mass with internal or peripheral echogenic foci and a boundary hypoechoic zone at the posterior portion of the thyroid gland on sonography. All lesions appeared connected with the adjacent esophageal wall on sonography. In all cases, diagnoses were confirmed by esophagography. Conclusions. Zenker diverticula had several unique characteristics on sonography. We can, therefore, diagnose Zenker diverticula by careful thyroid sonography, avoiding unnecessary aspiration due to misdiagnosis of a Zenker diverticulum as a thyroid nodule.