Thymoma: Difference between revisions

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{{ Infobox diagnosis
| Name      = {{PAGENAME}}
| Image      = Thymoma type B1 -- intermed mag.jpg
| Width      =
| Caption    = Thymoma (right of image) and remnant of normal thymus (left of image). [[H&E stain]]. (WC)
| Synonyms  =
| Micro      =
| Subtypes  = A, AB, B1, B2, B3
| LMDDx      = [[lymphoma]], [[squamous cell carcinoma]] (esp. [[squamous cell carcinoma of the lung]], [[head and neck squamous cell carcinoma]]), [[follicular dendritic cell sarcoma]]
| Stains    =
| IHC        =
| EM        =
| Molecular  =
| IF        =
| Gross      = light brown/tan, usually encapsulated
| Grossing  =
| Staging    = [[thymus staging]]
| Site      = [[thymus]]
| Assdx      = myasthenia gravis
| Syndromes  =
| Clinicalhx =
| Signs      =
| Symptoms  =
| Prevalence = uncommon overall, common for thymic tumours
| Bloodwork  =
| Rads      =
| Endoscopy  =
| Prognosis  = benign
| Other      =
| ClinDDx    = [[mediastinum|mediastinal mass]]
| Tx        = excision
}}
'''Thymoma''' is a common tumour of the [[thymus]].
'''Thymoma''' is a common tumour of the [[thymus]].


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Note:
Note:
*Neoplastic cells derived from the thymus with cytologic features of malignancy are [[thymic carcinoma]]s.
*Neoplastic cells derived from the thymus with cytologic features of malignancy are [[thymic carcinoma]]s.
Images:
<gallery>
Image:Thymoma_type_B1_(1).JPG | Thymoma Type B1. (WC/KGH)
Image:Thymoma_B1_(2).JPG | Thymoma Type B1. (WC/KGH)
Image:Thymoma_B1_(3)_CK_CAM5-2.JPG | Thymoma Type B1 - CAM5.2. (WC/KGH)
</gallery>


==Gross==
==Gross==
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Image:
Image:
*[http://www.sciencephoto.com/media/253251/enlarge Thymoma (sciencephoto.com)].
*[http://www.sciencephoto.com/media/253251/enlarge Thymoma (sciencephoto.com)].
Note:
*The line between ''thymoma'' and ''persistent normal thymus in the adult'' is not well-defined in the radiologic context.<ref name=pmid25925358>{{Cite journal  | last1 = Araki | first1 = T. | last2 = Nishino | first2 = M. | last3 = Gao | first3 = W. | last4 = Dupuis | first4 = J. | last5 = Hunninghake | first5 = GM. | last6 = Murakami | first6 = T. | last7 = Washko | first7 = GR. | last8 = O'Connor | first8 = GT. | last9 = Hatabu | first9 = H. | title = Normal thymus in adults: appearance on CT and associations with age, sex, BMI and smoking. | journal = Eur Radiol | volume = 26 | issue = 1 | pages = 15-24 | month = Jan | year = 2016 | doi = 10.1007/s00330-015-3796-y | PMID = 25925358 }}</ref>


==Microscopic==
==Microscopic==
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**Spindle cells - Type A.
**Spindle cells - Type A.
**Epithelioid cells - Type B.
**Epithelioid cells - Type B.
Notes:
*Perivascular edema is typical of thymoma.


DDx:
DDx:
*[[Squamous cell carcinoma]].
*[[Squamous cell carcinoma]].
*[[Lymphoma]].
*[[Lymphoma]].
*[[Follicular dendritic cell sarcoma]].
*Normal persistent [[thymus]].
===Images===
<gallery>
Image:Thymoma_type_B1_(1).JPG | Thymoma Type B1. (WC/KGH)
Image:Thymoma_B1_(2).JPG | Thymoma Type B1. (WC/KGH)
Image:Thymoma_B1_(3)_CK_CAM5-2.JPG | Thymoma Type B1 - CAM5.2. (WC/KGH)
</gallery>
====Case 1====
<gallery>
Image: Thymoma type B1 -- low mag.jpg | Thymoma B1 - low mag.
Image: Thymoma type B1 -- intermed mag.jpg | Thymoma B1 - intermed. mag.
Image: Thymoma type B1 -- high mag.jpg | Thymoma B1 - high mag.
Image: Thymoma type B1 -- very high mag.jpg | Thymoma B1 - very high mag.
Image: Thymoma type B1 - alt -- very high mag.jpg | Thymoma B1 - very high mag.
</gallery>
====Case 2====
<gallery>
File:5 404717367 sl 1.png|Thymoma type B1
File:5 404717367 sl 2.png|Thymoma type B1
File:5 404717367 sl 3.png|Thymoma type B1
File:5 404717367 sl 4.png|Thymoma type B1
File:5 404717367 sl 5.png|Thymoma type B1
File:5 404717367 sl 6.png|Thymoma type B1
</gallery>
Thymoma type B1 in a 33 y man, 384 gram 9 x 10 x 8 cm. A. Blue tumor shows a starry sky pattern (red square), as well as occasional fibrous bands (red arrows). B. Epithelial component, impossible to see on H&E at lower power, is readily identified, here with immunostain for CK7. C. CK7 positivity favors B over type A. Note that where the nuclei are visible the tumor cells are round, proving type B. The predominance of lymphoid cells makes this tumor B1. D. Lymphoid cells are uniform and small. Arrows show the tangible body macrophages that gave the low power starry sky appearance. E. Lymphoid cells are CD5 positive. F. Lymphoid cells are TdT positive.


Images:
====Case 3====
*[http://commons.wikimedia.org/wiki/File:Thymoma_B1_%282%29.JPG Thymoma (WC)].
<gallery>
Image: Thymoma type B2 -- low mag.jpg | Thymoma type B2 - low  mag.
Image: Thymoma type B2 -- intermed mag.jpg | Thymoma type B2 - intermed.  mag.
Image: Thymoma type B2 -- high mag.jpg | Thymoma type B2 - high  mag.
Image: Thymoma type B2 -- very high mag.jpg | Thymoma type B2 - very high  mag.
</gallery>


===Staging===
===Staging===
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A panel:
A panel:
*TdT, CD1a, CD3, CD5, CD20, Ki-67, CD117, p63, CK5/6.
*TdT, CD1a, CD3, CD5, CD20, Ki-67, CD117, [[p63]], [[CK5/6]].


==Sign out==
==Sign out==
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==See also==
==See also==
*[[Thymus]].
*[[Thymus]].
*[[Thymus staging]].


==References==
==References==
Retrieved from "https://librepathology.org/wiki/Thymoma"