1/5. Thymic carcinoma: a clinicopathological and immunohistological study of 19 cases.AIMS: To study 19 cases of primary thymic carcinoma in order to define the clinicopathological features and the precise histochemical profile of this rare and heterogeneous group of tumours of the anterior mediastinum. methods AND RESULTS: The study group consisted of 13 males and six females, with a mean age of 58.5 years (range 29-75 years). superior vena cava syndrome and chest pain were the main presenting symptoms. Three patients were asymptomatic. No patient had myasthenia gravis. Six different histological types were identified: neuroendocrine tumours (six patients), epidermoid carcinoma (five patients), sarcomatoid carcinoma (three patients), lymphoepithelioma-like carcinoma (two patients), mucoepidermoid carcinoma, clear cell carcinoma, and undifferentiated carcinoma (one patient each). The clear cell carcinoma was associated with a thymic cyst. No association with thymoma was observed. Surgical resection, performed in 10 cases, was complete in two. Sixteen patients received thoracic radiation, and 11 received systemic chemotherapy. Follow-up information was available in 16 cases; 12 patients presented with local or metastatic relapse, and 10 patients died of their tumour. The overall 5-year survival was 14.5%. CONCLUSION: Primary thymic carcinoma is a very heterogeneous group of tumours of the anterior mediastinum with an aggressive clinical behaviour, and a poor overall prognosis.- - - - - - - - - - ranking = 1keywords = behaviour (Clic here for more details about this article) |
2/5. limbic encephalitis associated with malignant thymoma.A case of limbic encephalitis associated with recurrent malignant thymoma in a 41-year-old male is described. The patient presented with confusion, loss of memory, hallucinations, abnormal behaviour, tachycardia and profuse sweating. Investigations were unrewarding and the patient's clinical state deteriorated until his death 1 month after presentation. The diagnosis was made at autopsy when bilateral extensive neuronal loss with reactive gliosis, confined to the medial temporal cortex and Ammon's horn, was revealed.- - - - - - - - - - ranking = 1keywords = behaviour (Clic here for more details about this article) |
3/5. Neuromuscular, autonomic and central cholinergic hyperactivity associated with thymoma and acetylcholine receptor-binding antibody.Two cases of a neuromuscular hyperactivity syndrome associated with a proliferative thymoma and high serum titres of acetylcholine receptor (AChR) antibody with no signs of myasthenia are reported. The clinical and electrodiagnostic findings indicated generalized cholinergic hyperactivity at the neuromuscular junction and in the autonomic and central nervous system, resulting in generalized myokymia, excessive sweating and intermittent psychotic behaviour. The association with thymoma and raised AChR antibody suggests that this syndrome represents a unique type of autoimmune disease, in which antibodies against the AChR facilitate rather than inhibit cholinergic action. This conclusion is supported by the remission of symptoms after thymectomy and with immunosuppressive therapy in one case.- - - - - - - - - - ranking = 1keywords = behaviour (Clic here for more details about this article) |
4/5. Metastasizing ectopic thymoma arising in the right thoracic cavity and mimicking diffuse pleural mesothelioma--an autopsy study of a case with review of literature.A case of metastasizing ectopic thymoma arising in the right thoracic cavity and infiltrating the right lung and pleura in a fashion reminiscent of diffuse pleural mesothelioma is presented. An involuted, non-neoplastic thymus was demonstrated microscopically in the anterior mediastinum. No case of thymoma showing the combination of ectopic location and biological malignancy has yet been reported in the literature. The pathogenesis of ectopic thymuses and thymomas is discussed from an embryological standpoint. The discrepancy between morphology and biological behaviour of thymomas is also mentioned with a review of the literature.- - - - - - - - - - ranking = 1keywords = behaviour (Clic here for more details about this article) |
5/5. Recurrent thymoma: evidence for histological progression.The clinicopathological features of nine cases of recurrent thymomas have been studied. At presentation, all cases were histologically classified as thymomas with cortical differentiation, including predominantly cortical thymoma, cortical thymoma and well-differentiated thymic carcinoma. In five cases the morphological features of the recurrence(s) were suggestive of a histological progression of the tumour from predominantly cortical thymoma to cortical thymoma and/or well-differentiated thymic carcinoma, usually associated with a more advanced clinical stage, the latter indicating a clinical progression. These findings suggest that all types of thymoma with cortical differentiation are histologically and histogenetically related neoplasms, associated with a more aggressive clinical behaviour and a significant risk of recurrence. The overall outcome of patients with recurrent thymoma in this series was poor, since six patients (66.6%) died due to the disease, 2-14 years after the first diagnosis. The clinical implication of our findings is that thymomas with cortical differentiation always need careful follow-up, even in those cases which are not obviously invasive at onset.- - - - - - - - - - ranking = 1keywords = behaviour (Clic here for more details about this article) |