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thymic neoplasm

Silvia Uccella, Stefano La Rosa, Marco Volante, Mauro Papotti
Neuroendocrine neoplasms (NENs) are a heterogeneous group of epithelial neoplastic proliferations that irrespective of their primary site share features of neural and endocrine differentiation including the presence of secretory granules, synaptic-like vesicles, and the ability to produce amine and/or peptide hormones. NENs encompass a wide spectrum of neoplasms ranging from well-differentiated indolent tumors to highly aggressive poorly differentiated neuroendocrine carcinomas. Most cases arise in the digestive system and in thoracic organs, i...
March 9, 2018: Endocrine Pathology
Alexander Brobeil, Florian Wagenlehner, Stefan Gattenlöhner
Seminomas are the most frequent testicular tumors and in spite of specific markers some histological subtypes can be diagnostically challenging due to the potential overlap of morphologic features and a variant antigen expression. Terminal deoxynucleotidyl transferase (TdT) is a DNA polymerase present in hematogones, thymic T cells, lymphoblastic lymphoma/leukemia (LBL), and in some cases of acute myeloid leukemia but so far has not been described to be expressed in seminomas. After observing a reactivity of TdT in one case of seminoma, we analyzed ten additional tumors by immunohistochemistry to determine their spectrum of reactivity for TdT...
February 18, 2018: Virchows Archiv: An International Journal of Pathology
Jibran Durrani, Faizan Malik, Naveed Ali, Syed Imran Mustafa Jafri, Mohsin Hamid
Representing a mere 2-5% of the total thymic malignancies and 0.4% of total carcinoid tumors, primary thymic neuroendocrine tumors (NETs) are the zebras of the thymic neoplasms. They were initially characterized as 'epithelial thymomas'; later, the term carcinoid tumors was coined by Rosai and Higa. These tumors are highly unpredictable in their presentation and prognosis. Coupled with variable clinical presentation, rare pathologic diagnosis and absence of diagnostic and prognostic parameters, it is a challenge for both patients and clinicians...
2018: Journal of Community Hospital Internal Medicine Perspectives
Vito A G Ricigliano, Barbara Fossati, Lorenzo Saraceno, Michele Cavalli, Elena Bazzigaluppi, Giovanni Meola
Thymoma is a tumor originating from thymic gland, frequently manifesting with paraneoplastic neurological disorders. Its association with paraneoplastic dysautonomia is relatively uncommon. Here, we describe the challenging case of a 71 year-old female who developed subacute autonomic failure with digestive pseudo-obstruction, dysphagia, urinary tract dysfunction and orthostatic hypotension complicating an underlying extrapyramidal syndrome that had started 3 months before hospital admission. Autonomic symptoms had 2-month course and acutely worsened just before and during hospitalization...
2018: Frontiers in Neuroscience
Rintaro Ohe, Naing Ye Aung, Yosuke Shiono, Aya Utsunomiya, Takanobu Kabasawa, Nobuyuki Tamazawa, Yuka Tamura, Tomoya Kato, Akane Yamada, Shin Hasegawa, Keiko Aizawa, Kyoko Inokura, Satoshi Ito, Tomomi Toubai, Yuichi Kato, Takahiko Tsunoda, Kosuke Onami, Tamio Suzuki, Kenichi Ishizawa, Mitsunori Yamakawa
Blastic plasmacytoid dendritic cell (pDC) neoplasm (BPDCN) is a relatively rare hematological malignancy with significantly complex clinicopathological features that are still unclear. This study aimed to analyze the clinicopathological data of BPDCN and evaluate immunohistochemical detection of minimal bone marrow (BM) involvement. In this study, we examined skin and BM lesions from 6 patients with BPDCN. Neoplastic cells tested positive for CD303 (polyclonal, 100%; monoclonal, 40%) in the skin lesions and for CD303 (polyclonal, 100%; monoclonal, 67%) in the BM clots...
February 8, 2018: Journal of Clinical and Experimental Hematopathology: JCEH
Wieslawa Grajkowska, Ewa Matyja, Jacek Kunicki, Sylwia Szymanska, Alexander Marx, Cleo-Aron Weis, Renata Langfort, Malgorzata Szolkowska
An atypical type A thymoma is a newly added entity to the last World Health Organization (WHO) histological classification [2015] of uncertain prognosis. The conventional type A and AB thymomas are usually locally aggressive neoplasms that rarely metastasize with distant metastases to the central nervous system (CNS) occurring extremely exceptionally. We present a history of a woman with a mediastinal tumor originally considered to be a Masaoka-Koga stage II "mixed thymoma with well-differentiated thymic carcinoma component" according to the historic Müller-Hermelink nomenclature...
September 2017: Journal of Thoracic Disease
Paola Cavalcante, Stefania Marcuzzo, Sara Franzi, Barbara Galbardi, Lorenzo Maggi, Teresio Motta, Raffaella Ghislandi, Antonella Buzzi, Luisella Spinelli, Lorenzo Novellino, Fulvio Baggi, Carlo Antozzi, Fabio Conforti, Tommaso Martino De Pas, Massimo Barberis, Pia Bernasconi, Renato Mantegazza
The thymus plays a key role in myasthenia gravis (MG), a B cell-mediated autoimmune disorder affecting neuromuscular junction. Most MG patients have thymic abnormalities, including hyperplasia and thymoma, a neoplasm of thymic epithelial cells. Epstein-Barr virus (EBV) is associated with autoimmune diseases and tumors. Recently, we showed EBV persistence and reactivation in hyperplastic MG thymuses, suggesting that EBV might contribute to intra-thymic B cell dysregulation in MG patients. Here, we investigated EBV involvement in thymoma-associated MG, by searching for EBV markers in MG (n=26) and non-MG (n=14) thymomas...
November 10, 2017: Oncotarget
Irvin M Modlin, Mark Kidd, Pier-Luigi Filosso, Matteo Roffinella, Anna Lewczuk, Jaroslaw Cwikla, Lisa Bodei, Agnieska Kolasinska-Cwikla, Kyung-Min Chung, Margot E Tesselaar, Ignat A Drozdov
Thoracic NETs [bronchopulmonary NETs (BPNETs) and thymic NETs (TNET)] share a common anatomic primary location, likely a common cell of origin, the "Kulchitsky cell" and presumably, a common etiopathogenesis. Although they are similarly grouped into well-differentiated [typical carcinoids (TC) and atypical carcinoids (AC)] and poorly differentiated neoplasms and both express somatostatin receptors, they exhibit a wide variation in clinical behavior. TNETs are more aggressive, are frequently metastatic, and have a lower 5-year survival rate (~50% vs ...
November 2017: Journal of Thoracic Disease
Mark R Wick
Several primary pathologic entities in diverse anatomic locations have the potential to simulate metastatic neoplasms histologically. Their misinterpretation as such may result in needless and extensive clinical evaluations that are intended to detect a presumed malignancy at another site. More importantly, mistakes of this type can deprive patients of surgical excisions that could be curative. This presentation considers a review of selected primary lesions that can simulate metastases. They include hemangioblastoma, glioblastoma and meningioma with epithelial metaplasia, choroid plexus carcinomas, primary neuroendocrine carcinomas in unusual locations, special forms of sinonasal and salivary glandular adenocarcinoma, clear-cell thyroid carcinomas, unusual microscopic subtypes of pulmonary adenocarcinoma, epithelioid myomelanocytomas ("sugar tumors"), mesotheliomas, primary thymic carcinomas, endodermal choristomas of the interatrial myocardium, peripheral cholangiocarcinoma, adrenocortical carcinoma, adenocarcinomas of the urinary bladder, mucinous and "rhabdoid" tumors of the ovaries, rete testis adenocarcinomas, interdigitating dendritic-cell sarcoma of lymph nodes, selected sweat gland carcinomas, cutaneous Merkel cell carcinoma, primary dermal and subcutaneous melanoma, mucosal and visceral melanomas, epithelioid sarcoma, clear-cell sarcoma, and adamantinoma of long bones...
March 2018: Seminars in Diagnostic Pathology
James F Howard, Kimiaki Utsugisawa, Michael Benatar, Hiroyuki Murai, Richard J Barohn, Isabel Illa, Saiju Jacob, John Vissing, Ted M Burns, John T Kissel, Srikanth Muppidi, Richard J Nowak, Fanny O'Brien, Jing-Jing Wang, Renato Mantegazza
BACKGROUND: Complement is likely to have a role in refractory generalised myasthenia gravis, but no approved therapies specifically target this system. Results from a phase 2 study suggested that eculizumab, a terminal complement inhibitor, produced clinically meaningful improvements in patients with anti-acetylcholine receptor antibody-positive refractory generalised myasthenia gravis. We further assessed the efficacy and safety of eculizumab in this patient population in a phase 3 trial...
December 2017: Lancet Neurology
Joanne Michelle Dumlao Gomez, Gulrana Syed, Michael Lawrenz Ferreras Co, Mohamed Bayoumi, Richard Abrams
Lymphoepithelioma-likethymic carcinoma is a rare neoplasm that presents with compressive symptoms or as an incidental radiological finding of an anterior mediastinal mass. It is an aggressive carcinoma with a high rate of invasion, metastasis and recurrence. Its diagnosis usually carries a poor prognosis largely due to propensity for late diagnosis. To date, guidance for treatment remains limited. This is a case of lymphoepithelioma-like thymic carcinoma in a young male adult who presented initially with back pain...
September 23, 2017: BMJ Case Reports
Kimiya Sato, Lester D R Thompson, Kosuke Miyai, Takako Kono, Hitoshi Tsuda
Ectopic hamartomatous thymoma (EHT) is a rare benign neoplasm of the lower neck suggesting branchial origin. Despite use of the term thymoma in the nomenclature, there is no evidence of thymic origin or differentiation. It affects middle-aged adults with a remarkable male predominance. To date less than 80 cases have been reported in the English literature. We present here two additional cases of EHT. The first is a benign case in a 31-year-old man, showing typical histological features. The second is a malignant case in a 70-year-old woman, showing intraductal carcinoma arising in intimate association with an EHT...
September 6, 2017: Head and Neck Pathology
J Vogel, L Lin, L A Litzky, A T Berman, C B Simone
PURPOSE: Thymic malignancies are the most common tumors of the anterior mediastinum. The benefit of adjuvant radiation therapy for stage II disease remains controversial, and patients treated with adjuvant radiation therapy are at risk of late complications, including radiation-induced secondary malignant neoplasms (SMNs), that may reduce the overall benefit of treatment. We assess the risk of predicted SMNs following adjuvant proton radiation therapy compared with photon radiation therapy after resection of stage II thymic malignancies to determine whether proton therapy improves the risk-benefit ratio...
October 1, 2017: International Journal of Radiation Oncology, Biology, Physics
Tatsuo Furuya, Daishiro Kato, Sanae Yamazaki, Naoko Miyata, Hiroaki Tsunezuka, Satoru Okada, Junichi Shimada, Akio Yanagisawa, Masayoshi Inoue
A 75-year-old asymptomatic man presented with an anterior mediastinal cyst without a solid component on computed tomography. Pathologic examination of the specimens obtained by thoracoscopic resection showed a thymic cyst with a 1.6-mm type A microthymoma in the surrounding thymic tissue. In addition, there were multiple hyperplastic nodules smaller than 1 mm histologically corresponded to microscopic thymomas. The patient underwent completion thymectomy through median sternotomy; thereafter, there was no residual thymic neoplasm detected...
August 5, 2017: General Thoracic and Cardiovascular Surgery
Brett W Carter, Sonia L Betancourt, Marcelo F Benveniste
The mediastinum contains vital vascular and nonvascular structures and organs, and a wide variety of abnormalities may arise from this region of the thorax. Although mediastinal masses may be initially detected on chest radiography, cross-sectional imaging plays an important role in the identification and evaluation of mediastinal lesions, enabling the formulation of focused differential diagnoses and ultimately guiding management. Computed tomography (CT) is considered the imaging modality of choice for evaluating most mediastinal masses; however, the role of magnetic resonance (MR) imaging continues to expand, as it is superior to CT in differentiating between cystic and solid masses, identifying cystic and solid components within complex lesions, and distinguishing thymic hyperplasia and normal thymus from thymic epithelial neoplasms and other neoplasms...
August 2017: Topics in Magnetic Resonance Imaging: TMRI
Nicholas Ward, Junaid Baqai, Alexandra Zehnpfennig, Nancy Fine, James Huang, Marc D Smith
Anterior mediastinal biopsies consisting predominantly of small lymphocytes can be a diagnostic challenge, especially in small core biopsies. In these cases, immunophenotyping is often employed using flow cytometry, and/or immunohistochemistry. However, due the overlap in T-cell phenotype between thymic neoplasm/hyperplasia (THY), T lymphoblastic lymphoma (T-LBL) and reactive lymph nodes (RLN), biopsies consisting predominantly of T-cells may still be difficult to differentiate. Previous studies have shown a specific CD3/bcl-2 staining pattern in thymic T cells of humans and mice using flow cytometry...
July 17, 2017: Cytometry. Part B, Clinical Cytometry
Kevin Wood, Elizabeth Byron, Linda Janisch, Ravi Salgia, Manish R Sharma
OBJECTIVES: For patients with unresectable or metastatic thymic epithelial neoplasms, few therapy options are available and outcomes are poor. This case series demonstrates that the combination of capecitabine and celecoxib may be a promising therapeutic option for these patients. MATERIALS AND METHODS: The current report describes the outcomes of 5 patients with thymic neoplasms treated on a drug-drug interaction study of capecitabine and celecoxib in patients with advanced solid malignancies (NCT01705106) conducted at the University of Chicago, plus a sixth patient treated with the same regimen outside of the protocol...
June 26, 2017: American Journal of Clinical Oncology
Kenji Ikemura, Diana Murro Lin, Colin P Martyn, Ji-Weon Park, Christopher W Seder, Paolo Gattuso
PURPOSE: Bronchial brushings (BB) commonly aid in the diagnosis of primary lung cancer. However, the utility of this method in diagnosing endobronchial metastases (EBM) from extrapulmonic malignancies has not been thoroughly evaluated. The purpose of this study is to evaluate the sensitivity of BB in diagnosing EBM. METHODS: An institutional database was queried for all patients with cytologically or histologically confirmed extrapulmonary EBM identified by endobronchial biopsy between 1978 and 2013...
October 2017: Lung
Eun Kyung Jung, Young Yoon Kim, Dong Hoon Lee, Kyung Hwa Lee, Joon Kyoo Lee
RATIONALE: Solitary fibrous tumor (SFT) is a rare benign soft tissue mesenchymal neoplasm. There have been a few reports of extrapleural SFTs although it can occur anywhere in the body. PATIENT CONCERNS: A 30-year-old male presented with an anterior neck mass since one month. DIAGNOSES: Based on physical and radiologic examination, preliminary differential diagnosis was thymic neoplasm or intrathoracic goiter. INTERVENTIONS: We performed surgical excision of the neck mass...
May 2017: Medicine (Baltimore)
Brett W Carter, Marcelo F Benveniste, Rachna Madan, Myrna C Godoy, Patricia M de Groot, Mylene T Truong, Melissa L Rosado-de-Christenson, Edith M Marom
Thymic epithelial neoplasms are rare malignancies that arise from the thymus and include thymoma, thymic carcinoma, and thymic neuroendocrine tumors. At least 15 different stage classifications have been proposed for thymic epithelial neoplasms and used to varying degrees in clinical practice, many of which have been constructed from small groups of patients. Traditionally, the Masaoka and Masaoka-Koga staging systems have been the schemes most commonly employed, and the latter has been recommended for use by the International Thymic Malignancy Interest Group (ITMIG)...
May 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
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