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Clinical Problem Solving: Radiology
May 2012

Radiology Quiz Case 2: Diagnosis

Arch Otolaryngol Head Neck Surg. 2012;138(5):520. doi:10.1001/archoto.2012.445b

Diagnosis: Pyriform sinus fistula

The patient underwent a fistulectomy. During the operation, the thyroid-cricoid joint was dislocated, a fistula opening was noted at the inner aspect of the thyroid cartilage, and a tract going into pyriform sinus was seen and ligated (Figure 3). Some sclerotic thyroid tissue of the left superior pole due to previous inflammation was also removed. The pathologic findings showed a sinus tract lined with squamous epithelium (Figure 4).

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