The subject was a 71-year-old man with hoarseness and dysphagia. Neck ultrasonography showed an ellipsoidal solid nodule involving the center of the left thyroid lobe. Ultrasound-guided fine needle aspiration (FNA) was performed twice to exclude the possibility of malignancy. The cytologic examination of the second specimen showed a few follicular epithelial cells, saburra, bacteria, necrotic tissue, with no malignancy. Esophagography revealed a barium-filled sac from the left anterolateral wall of the cervical esophagus which led to the diagnosis of a Killian-Jamieson diverticulum. The patient underwent resection of the diverticulum, and his symptoms resolved. Intraoperative endoscopy was effective in identifying the diverticulum which was strongly connected to the thyroid lobe possibly due to previous FNA.
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