A Case of Paratracheal Air Cyst Mimicking an Upper Esophageal Diverticulum

Jee Hee Yoon; Soo Jeong Kim; Hee Kyung Kim; Ho-Cheol Kang

doi:10.11106/ijt.2016.9.1.51

Journal List > Int J Thyroidol > v.9(1) > 1082756

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Yoon, Kim, Kim, and Kang: A Case of Paratracheal Air Cyst Mimicking an Upper Esophageal Diverticulum

Case Report

Int J Thyroidol 2016;9(1):51-54.

Published online: 20 May 2016

DOI: https://doi.org/10.11106/ijt.2016.9.1.51

A Case of Paratracheal Air Cyst Mimicking an Upper Esophageal Diverticulum

Jee Hee Yoon, Soo Jeong Kim, Hee Kyung Kim, Ho-Cheol Kang

Department of Internal Medicine, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Gwangju, Korea

Correspondence: Ho-Cheol Kang, MD, PhD, Department of Internal Medicine, Chonnam National University Medical School, 160 Baekseo-ro, Dong-gu, Gwangju 61469, Korea Tel: 82-61-379-7620, Fax: 82-61-379-7628, E-mail: drkang@chonnam.ac.kr

Received 21 October 2015 Revised 25 March 2016 Accepted 4 April 2016

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Paratracheal air cyst (PTAC) is a small air collection in the right paratracheal area and mainly diagnosed by computed tomography (CT). Increased with ultrasonographic (US) screening of the thyroid, PTAC can be detected incidentally. However, the US findings of PTAC have not been well described. Herein, we report our experience with a rare instance of a PTAC. A 64-year-old female was referred to our hospital for fine-needle aspiration (FNA) cytology of a thyroid nodule. The lesion was identified as an ovoid, hypoechoic lesion with internal hyperechoic foci, abutting on the inferior pole of the right thyroid lobe. The margin was smooth without hypoechoic rim, which is typical in upper esophageal diverticula. US-guided FNA suggested a benign bronchial epithelial lining cyst. If a hypoechoic neck mass containing air without a thick hypoechoic rim is observed, especially at the right side of the trachea, the possibility of PTAC should be considered.

Keywords: Paratracheal air cyst, Ultrasonography, Computed tomography, Esophageal diverticulum, Fine-needle aspiration cytology

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Fig. 1.

Ultrasonography (US) findings of the lesion. (A) A transverse US scan of the inferior pole of the right thyroid lobe shows a 0.9×0.4×1.1-cm-sized hypoechoic mass with internal hyperechoic dots (arrowheads), just lateral to the trachea. (B) On longitudinal scan, the lesion showed a linear hyperechoic focus with ring-down artifact (arrow), suggesting the presence of air. A hypoechoic boundary zone typically present in esophageal diverticula is absent.

Fig. 2.

Fine-needle aspiration cytology revealed ciliated columnar epithelial cells (inset) in the lymphoid background with no follicular epithelial cells (Papanicolaou stain, ×200).

Fig. 3.

(A) Neck computed tomography (CT) showed an air-filled cyst (arrowhead) in the posterolateral aspect of the trachea. (B) Anatomic location of the lesion (arrow) is displayed in a reconst-ructed coronal CT image.

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