Thyroid gland
Miscellaneous non-neoplastic disorders
Killian-Jamieson diverticulum

Author: Andrey Bychkov, M.D., Ph.D. (see Authors page)

Revised: 25 January 2017, last major update May 2015

Copyright: (c) 2015-2017, PathologyOutlines.com, Inc.

PubMed Search: Killian-Jamieson diverticulum thyroid
Cite this page: Killian-Jamieson diverticulum. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/thyroidkjdivert.html. Accessed June 25th, 2017.
Definition / general
  • Permanent protrusion of anterolateral cervical esophagus through anatomically weak muscular gap (Killian-Jamieson triangle) into adjacent area near thyroid (J Clin Ultrasound 2009;37:528)
  • Not a true diverticulum as it does not involve all layers of esophagus
  • Incidentally detected on neck ultrasound and could be misdiagnosed as thyroid nodule (Head Neck 2012;34:599)
Terminology
  • Also called proximal lateral cervical esophageal diverticulum, lateral hypopharyngeal diverticulum or diverticulum from pharyngoesophageal junction area
Epidemiology
  • Uncommon; usually over 50 years old
Sites
Pathophysiology
Clinical features
Diagnosis
  • Based primarily on radiographic findings, not endoscopy
  • Accidentally found in FNA of "thyroid nodules"
Radiology description
  • Barium contrast esophagography, neck CT, neck ultrasound
Case reports
Treatment
  • Transcutaneous surgery for symptomatic or large sized cases
Clinical images

Images hosted on other servers:

Scheme

Smooth walled

Large diverticulum anterolateral side

Large diverticulum

Cervical CT

Gross description
Gross images

Images hosted on other servers:

Operative finding

Diverticular opening (solid), esophageal opening (dotted)

Pharyngoesophagographic findings

Microscopic (histologic) description
Cytology description
  • Abundant bland, mature squamous cells, single and in clusters, with background of inflammatory cells and debris (Thyroid 2009;19:1121)
  • May contain vegetable material, skeletal muscle fibers and bacteria / fungi, consistent with oropharyngeal contents (Head Neck 2012;34:599)
  • No / few follicular cells
Cytology images

Images hosted on other servers:

Fig 1: ultrasound shows apparent nodule in posterior left lobe (arrows)
Fig 2: bland, mature squamous cells
Fig 3: filamentous bacteria and amorphous debris
Fig 4: suggestive of vegetable matter

Differential diagnosis