Child ; Female ; Head and Neck Neoplasms ; diagnosis ; pathology ; surgery ; Humans ; Parathyroid Neoplasms ; diagnosis ; pathology ; surgery ; Thymus Gland ; pathology ; surgery ; Thymus Neoplasms ; diagnosis ; pathology ; surgery

Humans ; Pathology, Molecular ; Prognosis ; Thymoma ; diagnosis ; pathology ; Thymus Neoplasms ; diagnosis ; pathology

Child ; Choristoma ; pathology ; Diagnosis, Differential ; Follow-Up Studies ; Humans ; Male ; Neoplasms, Glandular and Epithelial ; pathology ; Thymus Gland ; pathology ; Thymus Neoplasms ; pathology ; Thyroid Neoplasms ; pathology

Mucoepidermoid carcinoma of the thymus is an extremely rare malignant mediastinal neoplasm, and to our knowledge, only 13 cases have been reported. We report a case of mucoepidermoid carcinoma of the thymus that was seen in a 53-yr-old man with right chest pain. Chest CT scan showed a huge, cystic mass having a focal solid portion with direct invasion of the adjacent anterior chest wall and pericardium in the anterior mediastinum. Mucoepidermoid carcinoma of the thymus should be included in the differential diagnosis for masses of the anterior mediastinum associated with extensive cystic changes, although the carcinoma is exceedingly rare.
Carcinoma, Mucoepidermoid/*diagnosis/pathology ; Fatal Outcome ; Humans ; Male ; Mediastinal Neoplasms/*diagnosis/pathology ; Middle Aged ; Thymus Neoplasms/*diagnosis/pathology

OBJECTIVETo discuss the pathological and biological characteristic and the clinic-pathological relevance of combined thymoma (AB + B).

METHODSAccording to the WHO Histological Typing of Thymic Tumors, the clinical features and pathological characteristics of AB + B thymomas were analyzed in a series of 141 thymic epithelial tumors (TET) collected in Shanghai Chest Hospital and analyzed statistically with clinical therapy and follow-up data.

RESULTSSeven cases of type A (5.0%), 48 cases of type AB (34.0%), 14 cases of combined thymoma (AB + B) (9.9%), 9 cases of type B1 (6.4%), 22 cases of type B2 (15.6%), 21 cases of type B3 (14.9%) and 20 cases of type C (14.2%) were classified. The overall postoperative survival data showed highly significant differences amongst the histological subtypes. Combined thymoma (AB + B) showed distinctive histopathological characteristics, their prognostic properties were between A, AB and B1-B3, the differences between them being highly significant (log rank: chi(2) = 48.18, P < 0.001). Seventy-three patients (51.8%) were in stage I, 16 (11.3%) were in stage II, 44 (31.2%) were in stage III, and 8 (5.7%) were in stage IV. The association between histological subtype and invasive stage was significant (chi(2) = 71.3, P < 0.001). Combined thymoma (AB + B) was grouped to grade II thymoma. Thymoma grading has a positive relationship with therapy and prognosis (log rank: chi(2) = 57.49, P < 0.001).

CONCLUSIONSIt is proposed that combined thymoma (AB + B) may be named as the borderline thymoma. It has a distinctive histopathological definition and criteria and may be grouped as a subtype of thymoma. Its pathological and biological properties are between benign and malignant thymomas, and have significant differences.

Adolescent ; Adult ; Aged ; Diagnosis, Differential ; Female ; Humans ; Male ; Middle Aged ; Survival Rate ; Thymoma ; diagnosis ; mortality ; pathology ; Thymus Neoplasms ; diagnosis ; mortality ; pathology

Breast metastasis from nonmammary malignant neoplasms is uncommon, and it accounts for approximately 2% of all breast tumors. Distant metastasis of thymoma is very rare, and especially to extrathorcic areas. We report a female who had a metastatic thymoma in her breast 20 years after undergoing resection for a non-invasive thymoma. She presented with a palpable mass in her left breast. Mammography and ultrasonogram showed a lobular mass at the anterior glandular portion. Histological examination after surgical excision revealed a metastatic thymoma.
Breast Neoplasms/diagnosis/*secondary/surgery ; Female ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Thymoma/diagnosis/*secondary/surgery ; Thymus Neoplasms/diagnosis/*pathology/surgery ; Tomography, X-Ray Computed ; Ultrasonography, Mammary

OBJECTIVETo investigate clinicopathologic features and optimal treatment of primary thymic lymphoma.

METHODSClinical records of 27 primary thymic lymphoma patients treated from 1990 to 2007 were reviewed.

RESULTSOf the 27 patients, 8 received mastectomy and chemotherapy, 12 received excision of the thymic lesion and chemotherapy, 5 received chemotherapy alone, and 2 received lesion excision alone. 24 achieved complete remission after scheduled treatment, 1 achieved partial remission, and 2 patients had progressive disease. With a follow-up of 10 years and median 38 months, the 5-year overall and disease-free survival rates of the 27 patients were 47% and 23% respectively.

CONCLUSIONThe main subtypes of primary thymic lymphoma are diffuse large B-cell lymphoma and peripheral T-cell lymphoma. The optimal sequence is radical operation followed by standard anthracycline-based regimens and radiotherapy.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Combined Modality Therapy ; Female ; Humans ; Lymphoma ; diagnosis ; pathology ; therapy ; Male ; Middle Aged ; Thymus Neoplasms ; diagnosis ; pathology ; therapy ; Young Adult

OBJECTIVETo review the presentation, diagnosis, staging and treatment of thymoma.

DATA SOURCESData were obtained from papers on thymoma published in English within the last 30 years. No formal systematic review was conducted, but an effort was made to be comprehensive.

STUDY SELECTIONStudies were selected if they contained data relevant to the topic addressed in the particular section. In particular, standards adopted by the International Thymic Malignancies Interest Group through a formal process of achieving worldwide consensus are featured. Because of the limited length of this article, we have frequently referenced recent reviews that contain a comprehensive amalgamation of literature rather than the actual source papers.

RESULTSThymomas are rare malignant tumors. They account for about half (47%) of anterior mediastinal tumors. About one third of these are associated with myasthenia gravis. Computed tomography with intravenous contrast is the standard diagnostic modality. Thymomas appear as round or oval masses in early stages but irregular shapes with calcifications occurring in later stages. They can invade surrounding structures including mediastinal fat, pleura, major blood vessels and nerves. Fine needle aspiration, core needle biopsy or open biopsy is used to obtain tissue diagnosis. Masaoka-Koga classification is currently used to stage thymomas. All thymomas should be considered for resection due to their malignant potential. A complete resection is a major prognostic factor and every effort should be made to achieve this even if this means resection and reconstruction of a major thoracic structure. Median sternotomy is the standard approach for thymoma resection. A number of minimally invasive techniques are used in selective centers. While stage I and II tumors undergo primary surgery, preoperative chemotherapy appears to increase the chances of complete resection for stage III and IVa tumors. Postoperative radiation could be considered for patients with residual disease. Excellent 5 and 10-year survival rates are noted for completely resected early stage thymomas.

CONCLUSIONSThymic malignancies are rare tumors. Standards have recently been achieved to allow better communication and promote collaborative research. Surgical resection is the mainstay of treatment, but a multimodality approach is useful for many patients.

Humans ; Incidence ; Neoplasm Recurrence, Local ; therapy ; Neoplasm Staging ; Thymoma ; diagnosis ; pathology ; therapy ; Thymus Neoplasms ; diagnosis ; pathology ; therapy ; Tomography, X-Ray Computed

OBJECTIVETo describe the pathologic features and differential diagnosis of carcinoma showing thymus-like differentiation (CASTLE) of thyroid.

METHODSThe clinical findings, morphologic features and immunohistochemistry (EnVision) of 2 cases of CASTLE were studied.

RESULTSMacroscopically, the tumor appeared as a hard grayish-white and slightly lobulated mass. Histologic examination revealed well-circumscribed islands of tumor cells associated with desmoplastic stroma. The tumor cells were polygonal to spindle in shape and contained lightly eosinophilic cytoplasm, oval nuclei and small distinct nucleoli. The nuclear atypia was mild to moderate and the mitotic count measured 1 to 2 per 10 high-power fields. Immunohistochemical study showed that the tumor cells expressed CD5 and CD117.

CONCLUSIONSCASTLE is a rare type of thyroid carcinoma with distinctive morphologic findings. It needs to be distinguished from undifferentiated thyroid carcinoma, squamous cell thyroid carcinoma, metastatic lymphoepithelioma-like carcinoma and follicular dendritic cell sarcoma. Immunohistochemical staining for CD5 and CD117 is helpful in confirming the diagnosis.

Adult ; Aged ; CD5 Antigens ; metabolism ; Carcinoma ; metabolism ; pathology ; Carcinoma, Squamous Cell ; pathology ; Cell Differentiation ; Diagnosis, Differential ; Female ; Humans ; Male ; Proto-Oncogene Proteins c-kit ; metabolism ; Sarcoma ; pathology ; Thymoma ; metabolism ; pathology ; Thymus Gland ; pathology ; Thymus Neoplasms ; pathology ; Thyroid Gland ; pathology ; Thyroid Neoplasms ; metabolism ; pathology

Adult ; CD5 Antigens ; metabolism ; Carcinoma, Papillary ; metabolism ; pathology ; Carcinoma, Squamous Cell ; metabolism ; pathology ; surgery ; Choristoma ; metabolism ; pathology ; Diagnosis, Differential ; Female ; Hamartoma ; metabolism ; pathology ; Humans ; Proto-Oncogene Proteins c-kit ; metabolism ; Thymoma ; metabolism ; pathology ; Thymus Gland ; pathology ; Thymus Neoplasms ; metabolism ; pathology ; Thyroid Neoplasms ; metabolism ; pathology ; surgery ; Thyroidectomy ; methods