1/10. Minimally invasive thymoma with extensive intravascular growth.A 70-year-old male with grossly non-invasive thymic tumor associated with myasthenia gravis was subjected to thymothymectomy. Microscopic examination showed extensive intravascular tumor extensions into veins of thymic tissue and surrounding muscles and a minute direct invasion of the thymic tissue. Histologically, the tumor showed mixed-type thymoma with polygonal epithelial cells. These pathological findings indicated that the tumor cells extended mainly into vessels beyond the tumor capsule via tumor drainage veins rather than invading neighboring structures. After chemotherapy and mediastinal irradiation, the patient is now in complete remission of myasthenia gravis and is recurrence-free 15 months after surgery.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
2/10. Thymic carcinoma with tumor thrombus into the superior vena cava.Tumor thrombus into the vena cava have been reported in cases with renal cell carcinoma, thyroid tumor and in those with thymoma. These tumors are frequently invasive and continuous from the main tumor that shows direct vessel wall invasion. Here, we report a case of thymic carcinoma with superior vena cava syndrome, which was caused by a tumor thrombus in the superior vena cava without vessel wall invasion. The main mediastinal tumor did not show innominate vein invasion, and the superior vena cava syndrome was a result of separate tumor thrombus that was free of vessel wall invasion. The tumor thrombus could be removed through a simple venotomy. To prevent stenosis in the superior vena cava and the left innominate vein, we used a pericardial patch to close the venotomy site.- - - - - - - - - - ranking = 3keywords = vessel (Clic here for more details about this article) |
3/10. Tc-99m MIBI, Tc-99m tetrofosmin, and Tc-99m (V) DMSA accumulation in recurrent malignant thymoma.thymoma is the most common primary tumor of the anterior mediastinum, accounting for 20% to 30% of all mediastinal tumors. The recurrence rate after total resection of the thymoma ranges from 8% to 18%. The authors describe a patient with recurrent malignant thymoma imaged with Tc-99m MIBI, Tc-99m tetrofosmin, and Tc-99m (V) DMSA. Early and delayed Tc-99m MIBI and Tc-99m tetrofosmin scintigraphy showed increased uptake in the mediastinal area, as did Tc-99m (V) DMSA scintigraphy. Coronal SPECT images obtained with Tc-99m MIBI, Tc-99m tetrofosmin, and Tc-99m (V) DMSA showed increased uptake in the mediastinal lesion seen on a computed tomograph of the chest. However, the normal blood-pool activity of the heart and great vessels imaged with Tc-99m (V) DMSA obscured the recurrent malignant thymoma. Although Tc-99m (V) DMSA is a useful tumor-seeking agent, Tc-99m MIBI and Tc-99m tetrofosmin SPECT are preferred to Tc-99m (V) DMSA to detect primary and recurrent malignant thymoma.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
4/10. Cancer-associated retinopathy associated with invasive thymoma.PURPOSE: To report a case of cancer-associated retinopathy associated with invasive thymoma. DESIGN: Interventional case report. METHOD: A 41-year-old Japanese woman was observed between February 1998 and May 2001. Ophthalmologic examinations and systemic examinations were performed. The patient received treatment including corticosteroid pulse therapy, plasmapheresis, and thymectomy. RESULTS: The patient developed progressive visual dysfunction including bilateral visual acuity loss, concentric contraction of visual fields, and color vision loss. In both eyes, retinal vessel attenuation and retinal pigment epithelium degeneration were observed with fundus ophthalmoscopy and fluorescein angiography. Response in electroretinogram was reduced, suggesting both rod and cone dysfunction. Autoantibody against 23-kD cancer-associated retinopathy (CAR) antigen (antirecoverin antibody) was detected in the patient's serum. A mediastinal tumor that was histopathologically diagnosed as invasive thymoma was detected and was surgically resected. During more than 3 years of follow-up, no other malignancy was detected despite extensive systemic evaluation. The patient also suffered from subclinical myasthenia gravis. Although temporary improvement of visual function was observed after treatment with steroid pulse therapy and plasmapheresis' light perception of each eye was lost in the end. CONCLUSIONS: The patient was diagnosed as having CAR. Invasive thymoma was considered to be the causative tumor because there had been no evidence that suggested other systemic malignancy during more than 3 years of follow-up.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
5/10. Thymic carcinoma presenting as an intraluminal growth into the great vessels and the cardiac cavity.A rare case of thymic carcinoma with an intraluminal growth to the left brachiocephalic vein, the superior vena cava and the right atrium is described. Venogram and cardiac echogram were useful for evaluating the vascular permeation of the tumor. The patient underwent successful enbloc excision of the tumor under conditions of cardiopulmonary bypass.- - - - - - - - - - ranking = 4keywords = vessel (Clic here for more details about this article) |
6/10. 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 = vessel (Clic here for more details about this article) |
7/10. Intracaval and intracardiac extension of malignant thymoma: CT diagnosis.There is disagreement about the ability of CT to detect isolated invasion of mediastinal vessels by malignant thymoma. diagnosis usually depends on the absence of intact fat planes between the tumor mass and the adjacent vessel. We describe a rare case of CT demonstration of direct intraluminal invasion of a malignant thymoma into the superior vena cava and the right atrium.- - - - - - - - - - ranking = 2keywords = vessel (Clic here for more details about this article) |
8/10. thallium-201 uptake in a benign thymoma.A 68-year-old woman was admitted with atypical angina. A chest radiograph showed an anterior mediastinal mass that was confirmed on CT. The mass was relatively avascular and separate from the heart and great vessels. She underwent stress thallium testing that demonstrated no exercise-induced ischemia; however, an abnormal focus of thallium activity was present in the anterior mediastinum on stress and redistribution images. cardiac catheterization demonstrated a normal left ventriculogram, coronary arteries and thoracic aorta. Subsequent surgery and pathologic examination revealed the mass to be a benign thymoma arising in the right lobe of the thymus gland.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
9/10. Use of a dacron prosthesis for relief of superior vena cava obstruction in a child with thymoma.A case of thrombosis of superior vena cava in a child with thymoma is reported and the necessity of an exact definition of vascular lesions in thymopathies underlined. The innominate veins and the superior vena cava should be visualized preoperatively to program an appropriate radical surgical treatment particularly when these vessels are affected by the tumor.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
10/10. Differential diagnosis of anterior upper mediastinal expansions by contrast-enhanced computed tomography.This study investigated the potential of contrast-enhanced CT in the differential diagnosis of the most common anterior upper mediastinal expansions. CT examinations of 29 patients with an upper anterior mediastinal mass lesion of unknown origin were reviewed retrospectively and compared with the clinical data obtained. The density, contrast enhancement and invasive nature of the tumors were recorded. Thyroid tissue was enhanced most and lymphomas least. Contrast medium injection helped to distinguish great vessels and cystic lesions from surrounding areas. Thyroid tissue was most heterogeneous and lymphomas most homogeneous. All except one of the malignant neoplasms (a lymphoid mass lesion) were infiltratory in nature. Contrast-enhanced CT gives clues as to the origin of a neoplasm and whether it is benign or malignant.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
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