Presentation
Incidental finding in the airways.
Patient Data
Multiple small pulmonary nodules scattered bilaterally (hard to appreciate on the thick slices), also then showing partial calcification. Bilateral apical pulmonary scars. Lungs and pleural spaces are otherwise clear. A posterior right-sided mid-tracheal diverticulum is noted, multilobulated and air-filled, with thin walls and no accumulated respiratory secretions within, measuring 4.4 x 1.7 x 3.1 cm. There is a tiny point of communication of this lesion to the trachea lumen. Airways are otherwise normal. No enlarged mediastinal lymph nodes. Hiatus hernia is noted. Calcified gallstone within the gallbladder neck is partially imaged. No suspicious bony abnormality identified.
Conclusion: Multiple small calcified pulmonary nodules are non-specific, most likely representing benign granulomatous sequela. Paratracheal air-filled cystic lesion is consistent with a tracheal diverticulum.
Case Discussion
This case demonstrates a tracheal diverticulum as an incidental finding. As in this case, tracheal diverticula usually project posteriorly where the cartilage rings are deficient and usually lies to the right where there is no esophagus supporting the paratracheal tissue.
A direct connection with the trachea is often visible on CT.
The majority of cases are asymptomatic, but it may accumulate respiratory secretions that become infected and lead to cough or tracheobronchitis.
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