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'''Thymus''' is | [[Image:Thymic corpuscle.jpg|thumb|right|225px|[[Micrograph]] of a thymic corpusle (Hassall's corpusle). [[H&E stain]].]] | ||
'''Thymus''' is a little organ that is in the [[mediastinum]]. It is often removed in pediatric cardiac surgery 'cause it is in the way. In adults, it is commonly removed 'cause the patient has myasthenia gravis. | |||
=Overview= | =Overview= | ||
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*One of two ''[[primary lymphoid organs]]'' - the other one is the [[bone marrow]].<ref>URL: [http://www.life.umd.edu/classroom/bsci423/song/Lab1.html http://www.life.umd.edu/classroom/bsci423/song/Lab1.html]. Accessed on: 28 March 2012.</ref> | *One of two ''[[primary lymphoid organs]]'' - the other one is the [[bone marrow]].<ref>URL: [http://www.life.umd.edu/classroom/bsci423/song/Lab1.html http://www.life.umd.edu/classroom/bsci423/song/Lab1.html]. Accessed on: 28 March 2012.</ref> | ||
*Thymus involutes after childhood. | *Thymus involutes after childhood. | ||
**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> | |||
*May be absent due to genetic abnormalities, e.g. [[DiGeorge syndrome]]. | *May be absent due to genetic abnormalities, e.g. [[DiGeorge syndrome]]. | ||
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Anatomically in contact with: | Anatomically in contact with: | ||
*Pericardium. | *[[Pericardium]]. | ||
*Medistinal pleural. | *Medistinal pleural. | ||
==Normal histology== | ==Normal histology== | ||
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==IHC and thymus== | ==IHC and thymus== | ||
Types A, AB, B:<ref>CJS. January 2010.</ref> | Types A, AB, B:<ref name=cjs>CJS. January 2010.</ref> | ||
*CK7-, CK20-, CAM5.2+, CK5/6+, p63+, CD5-. | *[[CK7]] -ve, [[CK20]] -ve, CAM5.2 +ve, [[CK5/6]] +ve, [[p63]] +ve, CD5 -ve. | ||
Type C:<ref>CJS. January 2010.</ref> | Type C: | ||
* | *CD5 +ve.<ref name=cjs>CJS. January 2010.</ref> (???) | ||
*D2-40 +ve.<ref name=pmid24649128>{{Cite journal | last1 = Yokota | first1 = K. | last2 = Tateyama | first2 = H. | last3 = Yano | first3 = M. | last4 = Moriyama | first4 = S. | last5 = Hikosaka | first5 = Y. | last6 = Okuda | first6 = K. | last7 = Shitara | first7 = M. | last8 = Okumura | first8 = M. | last9 = Yokoi | first9 = K. | title = Clinicopathological analysis of small-sized thymoma with podoplanin and Ki 67 expression analysis. | journal = Mol Clin Oncol | volume = 1 | issue = 1 | pages = 88-92 | month = Jan | year = 2013 | doi = 10.3892/mco.2012.2 | PMID = 24649128 }}</ref> | |||
All types:<ref>CJS. January 2010.</ref> | All types:<ref name=cjs>CJS. January 2010.</ref> | ||
*CD1a (immature T cells, Langerhans cells, dendritic cells<ref>URL: [http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1886385/pdf/amjpathol00102-0156.pdf http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1886385/pdf/amjpathol00102-0156.pdf]. Accessed on: 26 August 2010.</ref>), CEA +ve (focal), vimentin -ve. | *CD1a +ve (immature T cells, Langerhans cells, dendritic cells<ref>URL: [http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1886385/pdf/amjpathol00102-0156.pdf http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1886385/pdf/amjpathol00102-0156.pdf]. Accessed on: 26 August 2010.</ref>), CEA +ve (focal), vimentin -ve. | ||
Others (immature T cells): | Others (immature T cells): | ||
*TdT. | *TdT +ve. | ||
*CD99. | *CD99 +ve. | ||
==Anterior mediastinum mass DDx== | ==Anterior mediastinum mass DDx== | ||
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Associations:<ref name=Ref_PBoD707-8>{{Ref PBoD|707-8}}</ref> | Associations:<ref name=Ref_PBoD707-8>{{Ref PBoD|707-8}}</ref> | ||
*Myasthenia gravis. | *Myasthenia gravis. | ||
*Graves' | *[[Graves' disease]]. | ||
*[[Systemic lupus erythematosus]] (SLE). | *[[Systemic lupus erythematosus]] (SLE). | ||
*[[Rheumatoid arthritis]]. | *[[Rheumatoid arthritis]]. | ||
*Other autoimmune diseases. | *Other [[autoimmune diseases]]. | ||
==Thymoma== | ==Thymoma== | ||
{{Main|Thymoma}} | |||
==Metaplastic thymoma== | ==Metaplastic thymoma== | ||
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DDx: | DDx: | ||
*[[Thymic carcinoma]] with sarcomatoid differentiation. | *[[Thymic carcinoma]] with sarcomatoid differentiation. | ||
====Images==== | |||
www: | |||
*[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3479700/figure/F1/ Metaplastic thymoma (nih.gov)].<ref>{{Cite journal | last1 = Kang | first1 = G. | last2 = Yoon | first2 = N. | last3 = Han | first3 = J. | last4 = Kim | first4 = YE. | last5 = Kim | first5 = TS. | last6 = Kim | first6 = K. | title = Metaplastic thymoma: report of 4 cases. | journal = Korean J Pathol | volume = 46 | issue = 1 | pages = 92-5 | month = Feb | year = 2012 | doi = 10.4132/KoreanJPathol.2012.46.1.92 | PMID = 23109986 }} | |||
</ref> | |||
===IHC=== | ===IHC=== | ||
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==Thymic carcinoma== | ==Thymic carcinoma== | ||
{{Main|Thymic carcinoma}} | |||
=See also= | =See also= |
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