Large mottled soft tissue density in the retropharyngeal and retroesophageal soft tissues from C5 to at least T1 level, measuring approximately 2.9 cm AP and
5 cm craniocaudal diameter. Smooth radiolucent stripe consistent with adjacent gas at its superior and posterior aspects. Superiorly, there is a well
demarcated line separating it from the hypopharynx, which is moderately dilated.
The cervical esophagus is displaced anteriorly and appears compressed. Neck soft tissues are otherwise unremarkable. Incidental note is made of anterolisthesis at C3-4, C4-5 and C5-6, likely due to facet joint OA. Multilevel lower cervical degenerative disc disease, most prominent at C5-6.
Large soft tissue density with adjacent gas in the retropharyngeal and retroesophageal soft tissues. Impacted food within a large Zenker's diverticulum is favored. Retropharyngeal abscess is considered unlikely in the absence of supporting clinical features. Further evaluation via barium swallow is recommended.