Evaluation of clinical, morphological and pathohistological characteristics of thymomas - our ten year experience

Aleksandra Lovrenski,Dragana Tegeltija,Dejan Ðuric,Milorad Bijelovic,Milana Panjkovic,Ivana Jelicic

doi:10.2298/aoo1702020l

Abstract

Background. Thymomas are rare neoplasms arising from tissue elements of the thymus. The objective of the study was to analyse clinical characteristics of patients with thymoma, as well as morphological and patohistological features of neoplasms. Methods: Retrospectively we studied 41 medical records and patohistological material of patients reffered to the Institute for pulmonary diseases of Vojvodina between the January 2005 and December 2014. Results: Patient age at presentation ranged from 19 to 77 years. A slight female preponderance was detected, with 24 (58.5%) females and 17 (41.5%) males being affected. All types of thymoma more often occured in males, accept subtype B1. Patients with type A thymoma and subtype B1 were mainly asymptomatic, while patients with subtype B2 and type presented with dyspnea, dysphagia, pain and cough. Myasthenia gravis often was associated with type A (40%). The most common histologic type was subtype B1. Twenty three (56%) patients had a tumor diameter between 5 and 10 cm. Five patients had malignant thymoma, and the most common types of thymoma that showed signs of capsula invasion or pleural and pericardial implants were type (60%) and subtype B2 (50%). Biopsies of suspected tissue were obtained through a sternotomy, video-assisted thoracoscopy surgery, and video-assisted mini thoracotomy, and after setting a diagnosis on ex tempore analysis, the lesions were removed by thymectomy or extirpation of the tumor mass. Conclusion: Thymomas have variable clinical presentations. Clinical outcome correlates with histological type, size and clinical stage, as well as the ability to achieve complete tumor resection.

Highlights

Thymomas are rare neoplasms arising from tissue elements of the thymus and developing in the anterior mediastinum with an annual incidence of only 0.15 cases per 100.000 person-years [1,2]
One patient died before investigations could be performed, but malignant thymoma was diagnosed on autopsy
A rare neoplasm arising from the epithelial cells of the thymus gland is variable in its presentation ranging from an asymptomatic incidental finding on chest radiography to signs and symptoms consistent with a local mediastinal disorder, and an unusual paraneoplastic syndrome [3,4,5,6]

Summary

Introduction

Thymomas are rare neoplasms arising from tissue elements of the thymus and developing in the anterior mediastinum with an annual incidence of only 0.15 cases per 100.000 person-years [1,2] They can be associated with a variety of systemic and autoimmune disorders, such as pure red cell aplasia, pancytopenia, hypogammaglobulinemia, collagen-vascular disease, and most commonly with myasthenia gravis [3,4,5,6]. Subtype B1 is characterized by predominance of lymphocytes and inconspicuous epithelial component made of oval cells with small pale nuclei and This work is licensed under a Creative prominent nucleoli (Figure 2). Subtype B2 is made of conspicuous Commons Atribution 4.0 license epithelial component of oval cells with vesicular nuclei and centrally www.onk.ns.ac.rs/Archive Vol 23, No 2, 2017 placed nucleoli (Figure 3). Type AB thymomas are transitional histological types of thymoma which contain the main features of thymoma type A and type B (Figure 4)

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