1/13. 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) |
2/13. 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 = vessel (Clic here for more details about this article) |
3/13. Kaposiform hemangioendothelioma of the thymus.Kaposiform hemangioendothelioma is a rare pediatric neoplasm that presents most commonly in the soft tissues. We report the case of a 1-month-old infant who presented with stridor and was found to have a diffusely infiltrating tumor in the thymus that extended into the pericardium and up the carotid sheaths. Histologic examination revealed a vascular tumor infiltrating among the lobules of the lymphocyte-depleted thymus. The lesion had features of both a capillary hemangioma and Kaposi sarcoma. Immunoperoxidase studies on formalin-fixed, paraffin-embedded tissue demonstrated the neoplastic endothelial cells to be positive for vascular markers CD31 and CD34. Antibody to factor viii-related antigen labeled feeding vessels, but failed to stain the lobules of tumor. Although these tumors have been treated in a fashion similar to capillary hemangiomas in the past, it may be important to differentiate Kaposiform hemangioendotheliomas because of their association with kasabach-merritt syndrome and recent success with more aggressive chemotherapy regimens.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
4/13. 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) |
5/13. Complete resection of recurrent thymic carcinoid using cardiopulmonary bypass.We report a case of recurrent thymic carcinoid (multiple episodes of recurrence over a 14-year period) invading the right atrium and superior vena cava, which was resected using cardiopulmonary bypass. In our case with dense adhesion between the great vessels and the sternum as a result of repeated operations and therapeutic irradiation, the innominate artery was injured while re-sternotomy, which was successfully repaired under deep hypothermic circulatory arrest. Repeated aggressive surgical resection might improve prognosis of the recurrent thymic carcinoid even in patients with extended lesions, which could be completely resected only on cardiopulmonary bypass.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
6/13. 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) |
7/13. 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) |
8/13. 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) |
9/13. 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) |
10/13. 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) |
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