Tracheal diverticulum

Case contributed by Dr Antonio Rodrigues de Aguiar Neto

Presentation

This patient has no complaints. She has a history of lobectomy of the lower lobe of the left lung for pulmonary cancer's surgical treatment. The chest computed tomography is for oncological follow-up.

Patient Data

Age: 75 years
Gender: Female
CT

CT image demonstrates an ovoid air-filled cyst adjacent to the tracheal's right posterolateral aspect at the thoracic inlet level. This focal outpouching has thin walls and no accumulated secretions, measuring 2.4 x 2.5 x 3.0 cm. There is a slit-like communicating channel of this air-containing cyst to the tracheal lumen at the trachea's posterior wall.

Airways are otherwise normal. No enlarged mediastinal lymph nodes.

Post lobectomy status of the lower lung lobe, with an elevation of the corresponding diaphragmatic dome. Lung and pleural spaces are otherwise clear.

Impression:  The paratracheal air-filled cystic lesion is consistent with tracheal diverticula - an incidental finding in the airways.

Case Discussion

A tracheal diverticulum is asymptomatic in most cases and usually an incidental finding by imaging methods 1-6. Although usually asymptomatic, it may accumulate respiratory secretions that become infected and lead to cough and chronic respiratory infection 2,3-6. The tracheal diverticula's location is usually in the trachea's right posterolateral wall, where there are no cartilage rings, and the esophagus does not provide structural support to the tracheal wall 1-6.

This case demonstrates an asymptomatic tracheal diverticulum as an incidental finding.

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