Pyramidal Lobe and Esophagus (Prepared by Dr Raul Collado)

            Female patient, 60 year old with history of bilateral small thyroid nodules detected by ultrasound. Thyroid scintigraphy was performed with 99mTc-pertechnectate, noting prominent pyramidal lobe branching out from the isthmus (upper arrows) and esophagus with mild  activity below the left lobe (lower arrows). Reduced background activity. The remaining thyroid parenchyma shows homogeneous uptake without significant areas of increased or decreased contrast.

            In lateral or obliques projections, the pyramidal lobe moves anteriorly, while the esophagus posteriorly.