1/23. Thymohemangiolipoma, a rare histologic variant of thymolipoma: a case report and review of the literature.We report a case of a thymic neoplasm in an 18-year-old woman who presented with chest discomfort and an anterior mediastinal mass. The surgically resected tumor showed abundant adipose tissue admixed with thymic tissue and numerous medium-caliber blood vessels. We consider this tumor a rare variant of thymolipoma and designate it as thymohemangiolipoma. Because of its benign nature, it should be distinguished from other mediastinal lesions.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
2/23. Benign symptomatic thymic tumors.Benign tumors of the thymic gland are relatively rare. Although most of these lesions are asymptomatic in nature, they may result in respiratory distress. This report describes 2 cases of benign thymic tumors presenting with respiratory symptoms that resolved after operative excision.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
3/23. Minimal change nephrotic syndrome associated with malignant thymoma: case report and literature review.We report on a patient with nephrotic syndrome with myasthenia gravis and malignant thymoma status post thymectomy and radiotherapy. This 44-year-old woman underwent a thymectomy and localized radiotherapy for invasive thymoma in 1991. She also took azathioprine and pyridostigmine regularly for the control of her symptoms of myasthenia gravis following thymectomy. Neither evidence of recurrence of myasthenia gravis, nor enlargement of residual thymoma was noted following treatment in 1991. Unfortunately, this patient developed a pronounced nephrotic syndrome in 1999, a renal biopsy revealing a minimal-change glomerulonephritis as being present. The patient entered remission subsequent to steroid and cyclosporin therapy, whereas many previously-reported cases of a similar nature either died or remained with a persistent proteinuria. Herein, we review the literature pertaining to examples of nephrotic syndrome for those patients diagnosed with malignant thymoma, and discuss the possible mechanisms for this association, and emphasize the need for the aggressive treatment of the condition, recommending the early use of steroids and cyclosporins.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
4/23. Thymic sarcomatoid carcinoma with skeletal muscle differentiation: report of two cases, one with cytogenetic analysis.AIMS: Malignant thymic tumour histologically resembling a soft tissue sarcoma is extremely rare and defined as sarcomatoid carcinoma in the recent world health organization (WHO) classification. We report two such cases in which the tumour cells showed a prominent rhabdomyoblastic differentiation and analyse whether these tumours retain an epithelial nature at least in part. methods AND RESULTS: One tumour occurred in a 51-year-old man (Case 1) and the other in a 40-year-old woman (Case 2). Microscopically, both tumours consisted essentially of two types of tumour cells: spindle and large round cells, with no apparent epithelial components. Osteosarcomatous small foci were also found in Case 2. Immunohistochemically, desmin and muscle-specific actin were positive in the majority of both types of tumour cells, whereas myogenin was predominant in the spindle cells and myoglobin in the large round cells. Some of both types of cells expressed cytokeratin with co-expression of myoglobin in the large round cells, but with no myogenin in the spindle cells. Some cytokeratin-positive spindle cells were also negative for desmin. Ultrastructural examination of a recurrent tumour in Case 2 revealed some epithelial features among the spindle cells. Cytogenetic study of the same tumour showed a complex abnormality including der(16)t(1;16)(q12;q12.1), an identical pattern previously reported in a case of thymic squamous cell carcinoma. CONCLUSIONS: The findings support the definition in the WHO classification of sarcomatoid carcinoma that includes purely sarcomatous tumour as in the present cases. Occurrence of this type of tumour may indicate a relationship between thymic epithelial cells and myoid cells and/or a potential for divergent differentiation in thymic epithelial tumours.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
5/23. Epithelio-reticular cell thymoma with lymphocytic "emperipolesis." An ultrastructural study.The ultrastructure of an epithelio-reticular cell thymoma associated with myasthenia gravis is described. The neoplastic cells of an epithelio-reticular nature were dominant in the neoplasm, being closely associated with lymphocytes and scattered non-neoplastic macrophages. The thymic epithelio-reticular cell showed abundant glycogen and some lipid droplets inside the cytoplasm, which was vacuolated and had many elongated processes attached to desmosomes and a very prominent nucleolus. The appearance was similar to that of the immature embryonic epithelial cell of the thymus seen in mammals. Very close contacts existed between the thymic lymphocytes and the epithelio-reticular cells, the appearance being suggestive of the phenomenon of "emperipolesis." cell death occurred secondarily through nuclear pyknosis and chromatolysis. Lymphocytic debris appeared inside the epithelio-reticular cells and, to some extent, in the cytoplasm of the mesenchymal marcrophages not directly involved in the phenomenon of "emperipolesis."- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
6/23. thymoma and myotonic dystrophy: successful treatment with chemotherapy and radiation: case report and review of the literature.We present the case of a 42-year-old woman with myotonic dystrophy and thymoma. She was treated with combination chemotherapy followed by external beam radiation, and remains in remission 19 months after thymoma was diagnosed. The myotonic dystrophy is unchanged. Only six cases of this nature have been reported in the literature, and this patient is the first to be successfully treated with combined modality therapy.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
7/23. Synchronous independent bifocal orthotopic thymomas. A case report.A case of synchronous multiple thymomas is reported. The patient was an 81-year-old woman with 2 separate thymomas in the anterior mediastinum. A histological study revealed that both thymomas consisted of dense lymphocyte infiltration in the stroma and a small number of polygonal epithelial tumor cells with clear nuclei and distinct nucleoli. Immunohistochemical staining using the antibodies to 2 antigens, bcl-2, and MIB-1 showed identical staining patterns. In spite of these findings, we considered their origin to be synchronous multicentric development rather than intra-thymic metastasis, based on the non-invasive nature of these tumors.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
8/23. Metastatic thymic carcinoid: a case report.Thymic neuroendocrine carcinomas (carcinoid) are rare tumors. They have malignant potential, the capacity for distant metastasis, and often present with associated endocrinopathies. This report describes a patient who was diagnosed with thymic carcinoid and cushing syndrome at age 19 that, despite complete surgical excision of his tumor, developed local recurrence with distant metastases to his brain, lungs, and bone. We discuss the evolution of this patient's illness as well as the therapies used in his care. Due to the nature of these tumors to recur both locally and distant, the importance of aggressive surgical management is emphasized. We also discuss the role of adjuvant therapy, which in our case consisted of chemotherapy, radiotherapy, and several new therapies including an antiangiogenesis agent and a tyrosine kinase inhibitor.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
9/23. thymoma arising within cardiac myxoma.Hematopoietic, glandular, and mesenchymal elements can be found within cardiac myxomas; ectopic endocrine tissues and "thymic rests" have also rarely been described. Atrial tumors (one right and one left) from 2 patients (a 69-year-old man and a 77-year-old woman) were encountered among the atrial myxoma cases in one of the author's consultation files. Both tumors were comprised of classic cardiac myxoma (with characteristic rings and syncytial chains of myxoma cells in a loose myxoid matrix) and cellular thymoma-like elements (characterized by a lobulated sheet-like growth of epithelioid spindle cells admixed with small lymphocytes punctuated by vessels with prominent perivascular spaces). Neither patient had evidence of thymoma elsewhere. Immunophenotypically, the thymoma-like component reacted strongly with antibodies to keratins (AE1/AE3, Cam 5.2, wide spectrum, CK19, CK7) and CD57 and weakly with antibodies to CD31, CD34, and calretinin. This intermediate phenotypic expression of both epithelial and vascular antigens likely reflects the multipotential nature of the cells comprising this lesion. The most likely explanation for this extremely unusual finding is neoplastic transformation of thymic rests within a myxoma.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
10/23. Hypereosinophilia in a patient with invasive thymoma with clonal T-lymphocyte expansion expressing CD4, CD8, and CD25 antigens.We report the case of a patient with hypereosinophilia and invasive thymoma harboring probable clonal proliferation of CD4 , CD8 , and CD25 t-lymphocytes. A 64-year-old woman had eosinophilia (14.1 x 10(9)/L) and an anterior mediastinal tumor with elevated levels of serum immunoglobulin e (609.8 mg/dL) and interleukin 5 (239 pg/mL). bone marrow aspirate showed marked infiltration by morphologically normal eosinophils with a normal karyotype but no FIP1L1-PDGFRA fusion gene. Flow cytometric analysis revealed an increasing number of CD3 /CD25 lymphocytes in the peripheral blood, and the resected thymoma had infiltrated lymphocytes with CD4/CD8/CD25 antigens. Moreover, the thymoma had T-cell receptor rearrangements with a cytogenetically clonal nature, ie, t(2;4)(p22;q26). Although the number of patients with thymoma showing hypereosinophilia is small, this case suggests that a subset of patients with thymoma may have clonal expansion of t-lymphocytes with abnormal phenotypes that affect clinical manifestations, including hypereosinophilia.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
| | Next -> |