Thymic carcinoid tumor is a rare mediastinal tumor, which was firstly described by Rosai and Higa in 1972. A carcinoid tumor of the thymus has recently been regarded as a distinct tumor from thymoma, and is probably Kultschizky cell origin. The pathologic diagnosis of thymic carcinoid is made from findings from light microscopy, immunohistochemical studies and electron microscopy. About 50% of thymic carcinoids were seen with endocrinopathies. Recurrences and extrathoracic metastasis are characteristics of thymic carcinoids. Surgical removal of the intial and tumor recurred are considered to be the most effective treatment today. However, the role of the adjuvant radiotherapy and the chemotherapy is still uncertain. Herein we report a case of thymic carcinoid tumor, which was confirmed by operation and pathologic study.
Carcinoid Tumor* ; Diagnosis ; Drug Therapy ; Mediastinal Neoplasms ; Microscopy ; Microscopy, Electron ; Neoplasm Metastasis ; Radiotherapy, Adjuvant ; Recurrence ; Thymoma ; Thymus Gland ; Thymus Neoplasms

Plasmacytomas are a localized proliferation of plasma cells in the bone marrow, and are less frequently seen in extraosseous organs or tissues. Extramedullary plasmacytoma is a rare malignant neoplasm, and is especially uncommon when it arises from the mediastinum. Here, we report on a case of posterior mediastinal extramedullary plasmacytoma in a 64-year-old man. He was admitted with an asymptomatic right apical mediastinal mass, which was provisionally diagnosed as a neurogenic mass. However, a subsequent investigation revealed that this tumor was a rare case of IgG kappa type extramedullary plasmacytoma arising from the posterior mediastinum. The patient was treated with local radiation to the mediastinum and is doing well without further evidence of disease.
Biopsy, Needle ; Bone Marrow ; Diagnosis, Differential ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Male ; Mediastinal Neoplasms/*diagnosis/radiotherapy ; Middle Aged ; Plasmacytoma/*diagnosis/radiotherapy ; Radiography, Thoracic ; Tomography, X-Ray Computed

OBJECTIVETo investigate the clinical features and prognostic factors of primary mediastinal large B-cell lymphoma (PMLBCL).

METHODSThe clinical data of 82 patients with PMLBCL enrolled from January 2000 to January 2008 were retrospectively studied. All these patients were treated in four affiliated hospitals of Central South University,Hunan province. The prognostic factors were investigated.

RESULTSOf the 82 patients, 45 were men and 37 were women, the ratio was 1.22:1. The median age was 29.5 (ranged from 12 to 78) years old. There were 40 (48.78%) patients in stage I/II, 42 (51.22%) in stage III/IV. The complete response (CR) rate was 13.4% (11/82), and the overall response rate 76.83% (63/82). The 5-year overall survival was 58%. The univariate analysis indicated that the poor prognostic factors included stage III/IV(P=0.005), without rituximab (P=0.004), without radiotherapy (P=0.000), LDH ≥ ULN (upper limit of normal) (P=0.000), disease progression (P=0.000), international prognostic index (IPI)≥ 2 (P=0.000) and superior vena cava syndrome (P=0.015). Chemo-therapy alone (P=0.000) predicted poor outcome. Combination therapy (such as chemo-radiotherapy, chemotherapy combined with rituximab) had better prognosis. Compared to second-line treatment, rituximab as the first-line treatment can prolong PFS, but had no effect on the OS. In multivariate analysis, chemo-radiotherapy and IPI were independently related to prognosis.

CONCLUSIONPMLBCL mostly affects young adults, male patients were slightly more than female patients. It presents with a typical bulky mediastinal mass at diagnosis, which constricts surrounding organs. Patients treated with rituximab or radiation therapy had better prognosis. Rituximab is recommended to be used for the first-line treatment.

Adolescent ; Adult ; Aged ; Antibodies, Monoclonal, Murine-Derived ; therapeutic use ; Child ; Female ; Humans ; Lymphoma, Large B-Cell, Diffuse ; diagnosis ; pathology ; therapy ; Male ; Mediastinal Neoplasms ; diagnosis ; pathology ; therapy ; Middle Aged ; Prognosis ; Radiotherapy ; Retrospective Studies ; Rituximab ; Young Adult

Carcinoma ; drug therapy ; genetics ; metabolism ; pathology ; radiotherapy ; Desmoplastic Small Round Cell Tumor ; metabolism ; pathology ; Diagnosis, Differential ; Gene Rearrangement ; Head and Neck Neoplasms ; drug therapy ; genetics ; metabolism ; radiotherapy ; Humans ; Keratin-20 ; metabolism ; Keratin-7 ; metabolism ; Lymphatic Metastasis ; Male ; Mediastinal Neoplasms ; drug therapy ; genetics ; metabolism ; radiotherapy ; Melanoma ; metabolism ; pathology ; Neuroectodermal Tumors, Primitive ; metabolism ; pathology ; Nuclear Proteins ; genetics ; metabolism ; Oncogene Proteins ; genetics ; metabolism ; Oncogene Proteins, Fusion ; genetics ; metabolism ; Rhabdomyosarcoma ; metabolism ; pathology ; Thymus Neoplasms ; drug therapy ; genetics ; metabolism ; radiotherapy