Thyroid & parathyroid
Other thyroid nonneoplastic
Killian-Jamieson diverticulum
Author: Andrey Bychkov, M.D., Ph.D.
Topic Completed: 1 May 2015
Minor changes: 31 December 2020
Copyright: 2015-2021, PathologyOutlines.com, Inc.
PubMed Search: Killian-Jamieson diverticulum thyroid
Table of Contents
Definition / general | Terminology | Epidemiology | Sites | Pathophysiology | Clinical features | Diagnosis | Radiology description | Case reports | Treatment | Clinical images | Gross description | Gross images | Microscopic (histologic) description | Cytology description | Differential diagnosisCite this page: Bychkov A. Killian-Jamieson diverticulum. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/thyroidkjdivert.html. Accessed December 2nd, 2021.
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
- Most often unilateral and left sided, rarely bilateral (AJR Am J Roentgenol 2001;177:85)
Pathophysiology
- Acquired condition resulting from a functional outflow obstruction in esophagus during swallowing (Gastrointest Endosc 2008;68:790)
Clinical features
- Usually asymptomatic, but up to 20% have dysphagia, cough or epigastric pain (AJR Am J Roentgenol 2001;177:85)
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
- 52 year old woman (Med J Malaysia 2011;66:73)
- 62 year old woman and 64 year old man with suspected thyroid nodule (Arch Pathol Lab Med 2005;129:1497, Thyroid 2009;19:1121)
- 68 year old man with surgical treatment (Korean J Thorac Cardiovasc Surg 2012;45:272)
- 69 year old man with bilateral Killian-Jamieson diverticula (Can J Gastroenterol 2010;24:173)
- 74 year old woman with Killian-Jamieson diverticula presenting synchronously with thyroid adenoma (Case Rep Gastroenterol 2013;7:188)
Treatment
- Transcutaneous surgery for symptomatic or large sized cases
Clinical images
Images hosted on other servers:
Scheme
Smooth walled
Large diverticulum
Cervical CT
Gross description
- Thin walled diverticulum, mean diameter 1.5 cm, range 0.5 - 10 cm (AJR Am J Roentgenol 2001;177:85, Head Neck 2012;34:599)
Gross images
Images hosted on other servers:
Pharyngoesophagographic
findings
Microscopic (histologic) description
- False diverticulum without a muscular layer (Surg Today 2010;40:257)
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
Differential diagnosis
- Fistula of thyroglossal duct or pyriform sinus with oropharyngeal contents
- Zenker's diverticulum: retroesophageal location on contrast esophagography / CT, larger, often symptomatic, 4× more common (AJR Am J Roentgenol 2001;177:85)
