Nine cases of piriform sinus fistula with acute suppurative thyroiditis

Yamada, Hiroyuki; Fujita, Kenichiro; Tokuriki, Toshiharu; Ishida, Ryoji

doi:10.1016/s0385-8146(02)00019-6

Cited by 21 publications

(8 citation statements)

References 5 publications

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“…19,20 If associated with a piriform sinus fistula or thyroglossal duct fistula, pharyngeal contents including squamous epithelium, acute inflammation, and food particles could potentially be seen on aspiration biopsy, similar to the cytologic findings of a PED. Localized swelling within the thyroid may occur in acute thyroiditis, and can potentially appear to be a nodule on ultrasound.…”

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confidence: 92%

“…Localized swelling within the thyroid may occur in acute thyroiditis, and can potentially appear to be a nodule on ultrasound. 19,20 If associated with a piriform sinus fistula or thyroglossal duct fistula, pharyngeal contents including squamous epithelium, acute inflammation, and food particles could potentially be seen on aspiration biopsy, similar to the cytologic findings of a PED. However, these developmental fistulae typically occur in children, and have a different presentation than PED, theoretically making a clinical distinction possible in most cases.…”

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confidence: 92%

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Pharyngoesophageal diverticula simulating thyroid nodules: An unusual occurrence with unique features

Nauschuetz¹,

Ogden²,

Starling³

et al. 2017

Diagnostic Cytopathology

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Pharyngoesophageal diverticula (PED) of the Zenker's and Killian-Jamieson types arise in close proximity to the thyroid gland, and may rarely be confused with a thyroid nodule on ultrasonography. In this brief report, we detail the cytologic, clinical, and radiologic findings of three PED that were thought to be thyroid nodules, and were subjected to fine-needle aspiration (FNA). The patients were females with an age range of 51-64 years. All three patients had multiple thyroid nodules, and two patients reported symptoms attributable to the diverticulum. Nodule sizes ranged from 1.0 to 2.7 cm, and either the right or left thyroid lobe could be involved. Microcalcifications were present by ultrasonography in all three cases. FNA of these thyroid nodule mimics showed squamous cells with granular or amorphous debris, bacterial and/or fungal colonies, inflammation, and food particles. These cytologic features, particularly the presence of vegetable or meat fragments, are characteristic, and have also been reported in the few previous reports of PED. The presence of a diverticulum was confirmed with imaging studies in all our patients. Although a rare occurrence, the inadvertent FNA of a PED masquerading as a thyroid nodule is important to recognize, as a recommendation for appropriate radiologic studies could potentially avoid inappropriate therapy for thyroid disease.

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confidence: 92%

mentioning

confidence: 92%

Pharyngoesophageal diverticula simulating thyroid nodules: An unusual occurrence with unique features

Nauschuetz¹,

Ogden²,

Starling³

et al. 2017

Diagnostic Cytopathology

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“…AST comprises <1% of thyroid diseases [1,3]. In children, this is often secondary to local congenital anatomic defects as third or fourth branchial arch anomalies [4,5], or a piriform sinus fistula [6]. Only 8% of AST occurs in adults [7].…”

Section: Introductionmentioning

confidence: 99%

Acute suppurative thyroiditis with thyroid abscess in adults: clinical presentation, treatment and outcomes

Falhammar

Wallin

Calissendorff

2019

Preprint

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Background: Abscess in the thyroid gland is a rare but severe infectious disease. The condition can have anatomic or iatrogenic underlying causes. If untreated it could be fatal. Pathogens vary considerably. Treatment is intravenous antibiotics, drainage, and sometimes surgery. Methods: The electronic medical records of all adult patients with acute thyroiditis 2003-2017 treated at the Karolinska University Hospital (catchment area 2 million) in Sweden were systematically reviewed.Results: Five patients were found in the catchment area. One patient from another region but known to us was also included. Thus, six patients (aged 28-73 years) were included in the study. Median length of hospital stay was 7.5 days (4-79 days). All were treated with antibiotics (intravenous n=5, oral n=1). Total antibiotic treatment duration was 13.5 days (10-41 days). Blood cultures were positive in three (streptococcus pneumonia, streptococci sanguineous, pepto streptococci), deep tissue culture in three (escherichia coli, candida, hemophilic influenza) and no positive culture at all in two. Drainage was used in three patients. All patients recovered without recurrences. Surgery was performed twice in the acute phase in one. There was no recurrence during 7 years (3-12) of followup, but one patient died after three years (severe heart failure and pneumonia). Conclusion: Thyroid abscess in adults is extremely rare nowadays in the developed world. With prompt antibiotic therapy, drainage and in some cases thyroidectomy the prognosis seems favourable.

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“…7,8 In most cases the infection spreads to thyroid gland via piriform sinus fistula. 9 Diagnosis is based on clinical, laboratory, and imaging findings. The abscess typically occurs on the left side, and it is important to differentiate acute thyroiditis from the more common subacute thyroiditis.…”

Section: Introductionmentioning

confidence: 99%

Outcome of ultrasound guided closed drainage of acute suppurative thyroid abscess as a definitive treatment modality

Ravi

Bhat

2017

Int J Otorhinolaryngol Head Neck Surg

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Background: Thyroid abscess are relatively uncommon conditions in otolaryngology-head and neck surgery because of thyroid glands anatomical and physiological protective barrier. When it occurs it results in significant morbidity with potential mortality. Traditionally, surgical incision and drainage with antibiotics has been the mainstay of treatment. Some reports have suggested that ultrasound guided closed drainage is a less invasive and effective alternative in selected cases. The aim of our study is to evaluate the efficacy of ultrasound guided percutaneous closed drainage in the management of thyroid abscess. Methods: From January 2013 to December 2016, patients presenting with thyroid abscess to the department of otolaryngology at Adichunchanagiri hospital and who subsequently underwent ultrasound guided percutaneous closed drainage were included in the study. Results: Five patients were recruited for the study. After the aspiration of pus under ultrasound guidance, all patients were symptomatically improved and no patients needed open surgical drainage afterwards. After treatment, all patients were cured of their disease completely without any complications and with reduced hospital stay. After discharge, no patient showed any signs of relapse on regular follow-up. Conclusions: Ultrasound guided percutaneous closed drainage of thyroid abscess is an effective and safe procedure because of good clinical outcome, patient satisfaction and reduced hospital stay. It is an effective alternative to open incision and drainage of thyroid abscess.

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Nine cases of piriform sinus fistula with acute suppurative thyroiditis

Cited by 21 publications

References 5 publications

Pharyngoesophageal diverticula simulating thyroid nodules: An unusual occurrence with unique features

Pharyngoesophageal diverticula simulating thyroid nodules: An unusual occurrence with unique features

Acute suppurative thyroiditis with thyroid abscess in adults: clinical presentation, treatment and outcomes

Outcome of ultrasound guided closed drainage of acute suppurative thyroid abscess as a definitive treatment modality

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