We herein describe a rare case of multilocular thymic cysts (MTCs) with follicular hyperplasia. The patient was a 50-year-old man, who was symptom-free. A mediastinal mass was found on chest computed tomography (CT) f...We herein describe a rare case of multilocular thymic cysts (MTCs) with follicular hyperplasia. The patient was a 50-year-old man, who was symptom-free. A mediastinal mass was found on chest computed tomography (CT) followed after pancreatitis. Chest CT revealed a 30 × 10 mm anterior mediastinal mass with multiple cystic lesions. Magnetic resonance imaging showed an anterior mediastinal cystic mass with low-signal intensity on T1-weighted image and on high-signal intensity T2-weighted image. Thus we made a preoperative diagnosis of MTCs with thymoma within the cyst wall. The lesion was resected by thymectomy. Intraoperatively, multiple cysts and swelling of mediastinal lymph nodes were noted throughout the entire thymus. Histopathological findings revealed lymphoid follicular hyperplasia of thymic tissues but no neoplastic lesions. Based on these findings, a diagnosis of MTCs associated with thymic hyperplasia was made. This is a rare case that preoperatively was difficult to diagnose.展开更多
BACKGROUND Micronodular thymic tumors with lymphoid stroma include micronodular thymoma with lymphoid stroma(MNT)and micronodular thymic carcinoma with lymphoid hyperplasia(MNC),whose micromorphological features are l...BACKGROUND Micronodular thymic tumors with lymphoid stroma include micronodular thymoma with lymphoid stroma(MNT)and micronodular thymic carcinoma with lymphoid hyperplasia(MNC),whose micromorphological features are lymphoid stromal hyperplasia and nodular arrangement of tumor epithelial cells.This type of tumor is rare;therefore,the corresponding clinical guidelines,histopathological diagnostic criteria,prognostic factors,and therapeutic regimens have not been established.CASE SUMMARY This study covers a novel presentation of MNC in a patient and summarizes the clinicopathological characteristics of this type of tumor by using pooled-analysis methods.Morphologically,this tumor type is a series of benign to malignant pedigrees.We establish the following criteria for the classification of micronodular thymic tumors with lymphoid stroma:(1)Tumor cells with moderate-to-severe dysplasia;(2)Tumor cell mitotic figures>2/10 high-power fields;(3)Appearance of neoplastic necrosis;(4)No terminal deoxynucleotidyl transferase-positive immature T lymphocytes within the tumor;(5)Tumor cells with a Ki-67 index≥10%;and(6)Tumor cells express CD5.Cases that fall into the borders of two categories in terms of morphology are attributed to atypical MNT.It is proposed that the diagnosis of MNT should be established on the diagnostic criteria mentioned above.CONCLUSION Our diagnostic algorithm can effectively distinguish malignant tumors from benign tumors and provides a potent basis for predicting a prognosis,which offers a practical reference for oncologists and pathologists.展开更多
文摘We herein describe a rare case of multilocular thymic cysts (MTCs) with follicular hyperplasia. The patient was a 50-year-old man, who was symptom-free. A mediastinal mass was found on chest computed tomography (CT) followed after pancreatitis. Chest CT revealed a 30 × 10 mm anterior mediastinal mass with multiple cystic lesions. Magnetic resonance imaging showed an anterior mediastinal cystic mass with low-signal intensity on T1-weighted image and on high-signal intensity T2-weighted image. Thus we made a preoperative diagnosis of MTCs with thymoma within the cyst wall. The lesion was resected by thymectomy. Intraoperatively, multiple cysts and swelling of mediastinal lymph nodes were noted throughout the entire thymus. Histopathological findings revealed lymphoid follicular hyperplasia of thymic tissues but no neoplastic lesions. Based on these findings, a diagnosis of MTCs associated with thymic hyperplasia was made. This is a rare case that preoperatively was difficult to diagnose.
文摘BACKGROUND Micronodular thymic tumors with lymphoid stroma include micronodular thymoma with lymphoid stroma(MNT)and micronodular thymic carcinoma with lymphoid hyperplasia(MNC),whose micromorphological features are lymphoid stromal hyperplasia and nodular arrangement of tumor epithelial cells.This type of tumor is rare;therefore,the corresponding clinical guidelines,histopathological diagnostic criteria,prognostic factors,and therapeutic regimens have not been established.CASE SUMMARY This study covers a novel presentation of MNC in a patient and summarizes the clinicopathological characteristics of this type of tumor by using pooled-analysis methods.Morphologically,this tumor type is a series of benign to malignant pedigrees.We establish the following criteria for the classification of micronodular thymic tumors with lymphoid stroma:(1)Tumor cells with moderate-to-severe dysplasia;(2)Tumor cell mitotic figures>2/10 high-power fields;(3)Appearance of neoplastic necrosis;(4)No terminal deoxynucleotidyl transferase-positive immature T lymphocytes within the tumor;(5)Tumor cells with a Ki-67 index≥10%;and(6)Tumor cells express CD5.Cases that fall into the borders of two categories in terms of morphology are attributed to atypical MNT.It is proposed that the diagnosis of MNT should be established on the diagnostic criteria mentioned above.CONCLUSION Our diagnostic algorithm can effectively distinguish malignant tumors from benign tumors and provides a potent basis for predicting a prognosis,which offers a practical reference for oncologists and pathologists.