ABSTRACT
INTRODUCTION: An air filled lesion can be a diagnostic dilemma and a careful investigation must be following to clarity any underlining pathology. CASE PRESENTATION: A 62-year old male, ex smoker, with a history of chronic cough was examined with helical CT tomography and an air filled lesion was demonstrated at the right paratracheal region at the thoracic inlet. A narrow connection to trachea lumen was also visible, a critical element to establish the diagnosis of ttracheal diverticulosis. CONCLUSION: This malformation is a rare anomaly with two types, the congenital and the acquired one. It must be included into the differential diagnosis of any air filled lesion at the thoracic inlet. Computed tomography scans (with thin section and reconstructed images) seem the proper imagine. Bronchoscopy can also visualize the diverticulum although sometimes the connection with trachea can't be detected. In most cases is asymptomatic and needs no special treatment. A possible danger of repeated respiratory infections and insufficient intubation and/or ventilation must be in mind.
