National Cancer Institute®
Last Modified: January 1, 2002
UI - 11471225
AU - Prieto JL; Soria MJ; Pena JA; Infantes JM; Navas CJ; Martin L
TI - [Achalasia secondary to radiotherapy in a patient with thymoma and myasthenia gravis]
SO - Rev Esp Enferm Dig 2001 Feb;93(2):125-6
UI - 11412515
AU - Leon Atance P; Gonzalez Aragoneses F; Moreno Mata N; Garcia Fontan E;
TI - Leon Medina D; Naranjo Gomez J; Munoz Blanco J; Orusco Palomino E; Folque Gomez E [Thymectomy in myasthenia gravis]
SO - Arch Bronconeumol 2001 May;37(5):235-9
AD - Cirugia Toracica. Hospital General Universitario Gregorio Maranon. Madrid.
OBJECTIVE: To analyze outcome after thymectomy in patients with myasthenia gravis (MG). MATERIAL AND METHODS: Thirty-five patients with had associated thymomas. Preoperative Osserman classification showed 2 at level I, 20 at level IIA, 11 at level IIB and 2 at level III. Extended thymectomy through a medial sternotomy was performed in all. RESULTS: Postoperative complications developed in three patients (1 medullary aplasia, 1 postoperative reintubation, 1 myasthenic crisis). Mean follow-up was 89 months, with 22.8% achieving complete remission and 97.1% reporting improvements. The results were similar in the 10 patients with thymomas (20% full remission and 90% showing improvement). By DeFilippi classification, 22.8% were in class 1, 22.8% in class 2, 51.4% in class 3 and 2.8% in class 4. By Osserman classification, 9 were in the same category before and after surgery, 12 had improved one level, 10 had improved 2 levels, 3 had improved 3 levels and 1 patient had improved 4 levels. CONCLUSION: Thymectomy is an appropriate therapeutic procedure in the multidisciplinary treatment of patients with MG and it is the approach of choice for patients with associated thymomas. The intra- and post-operative complication rate is low and the rate of clinical improvement is high.
UI - 11482190
AU - Peliukhovskii SV
TI - [Experience of surgical treatment of thymoma]
SO - Klin Khir 2001 Apr;(4):35-6
For period from 1992 to 2000 years 72 patients with thymoma were operated. In 29 (40.2%) patients lymphocytic thymoma was revealed, in 10 (13.8%)--"benign". Postoperative mortality was 4.1%. In term from 1 to 1.5 years 5 (6.9%) patients died.
UI - 11456312
AU - Buckley C; Douek D; Newsom-Davis J; Vincent A; Willcox N
TI - Mature, long-lived CD4+ and CD8+ T cells are generated by the thymoma in myasthenia gravis.
SO - Ann Neurol 2001 Jul;50(1):64-72
AD - Neurosciences Group, Weatherall Institute of Molecular Medicine, John Radcliffe Hospital, Oxford, United Kingdom.
Antibodies to muscle acetylcholine receptors, to other muscle antigens, and to some cytokines are found in the majority of patients with thymic tumors (thymomas) and myasthenia gravis (MG). The role of the tumor in initiating autoimmunity, however, is unclear; in particular, it is not known whether the thymoma exports mature and long-lived T cells, which could provide help for antibody production in the periphery. Here, we quantified recently exported thymic T cells using the approach of measuring episomal DNA fragments [T-cell receptor excision circles (TRECs)], generated by T-cell receptor gene rearrangement. Compared to values in healthy individuals (n = 10) or in patients with late-onset MG (n = 8), TREC levels were significantly raised in both the CD4+ and CD8+ peripheral blood compartments of patients with thymoma and MG (n = 14, p = 0.002 and p = 0.0004 compared to healthy controls) but only in the CD8+ compartment of the three patients with thymoma without MG (p = 0.4 and p = 0.01 for CD4+ and CD8+). TREC levels decreased following thymectomy to values similar to controls but were substantially raised in patients who had developed tumor recurrence (n = 6, p = 0.04 and p = 0.02 for CD4+ and CD8+); this was associated with increased antibodies to interferon-alpha and interleukin-12 in the one case studied serially. Collectively, these results support the hypothesis that the neoplastic thymoma tissue itself can generate and export mature, long-lived T cells and that these T cells reflect the thymic pathology and are likely to be related to the associated autoimmune diseases. The results also provide a new approach for early diagnosis of thymoma recurrence.
UI - 11467386
AU - Hashimoto T; Takahashi K; Goto M; Endo H; Kono T; Nishiyama H; Iimura F;
TI - Kuwashima S; Sawada H; Saiki N; Yamato M; Fujioka M Detection of malignant thymoma in primary tumor and metastatic lesions using 99mTc-tetrofosmin scintigraphy.
SO - Radiat Med 2001 May-Jun;19(3):169-72
AD - Department of Radiology, Dokkyo University School of Medicine, Tochigi, Japan.
99mTc-tetrofosmin was developed as a myocardial perfusion imaging agent and can also be used to depict tumors. We have experienced five cases of malignant thymoma delineated on 99mTc-tetrofosmin SPECT. In one case significant activity was clearly detected in the primary tumor and metastatic lesions. In quantitative analysis, similar 99mTc-tetrofosmin and 201Tl-chloride uptake ratios were obtained (1.95+/-0.57 versus 2.27+/-0.85, respectively; n.s.). The ability of 99mTc-tetrofosmin to detect malignant thymoma was comparable to that of 201Tl-chloride. Therefore, 99mTc-tetrofosmin might be a useful tracer for the detection of malignant thymoma, although more studies will be required to evaluate its diagnostic accuracy.
UI - 11468328
AU - Fujii N; Furuta A; Yamaguchi H; Nakanishi K; Iwaki T
TI - Limbic encephalitis associated with recurrent thymoma: a postmortem study.
SO - Neurology 2001 Jul 24;57(2):344-7
AD - Department of Neurology, Iizuka Hospital, Iizuka, Japan. firstname.lastname@example.org
The authors report an autopsied patient with limbic encephalitis and recurrent thymoma. The immunohistochemical study showed selective depositions of immunoglobulin G on the neurons in the limbic system and the tumor cells of the recurrent thymoma. The immunoblotting study detected two types of antibodies that react with the human brain, rat brain, and rat thymus.
UI - 11574213
AU - Salakou S; Tsamandas AC; Bonikos DS; Papapetropoulos T; Dougenis D
TI - The potential role of bcl-2, bax, and Ki67 expression in thymus of patients with myasthenia gravis, and their correlation with clinicopathologic parameters.
SO - Eur J Cardiothorac Surg 2001 Oct;20(4):712-21
AD - Department of Neurology, University of Patras, School of Medicine, Patras, Greece.
OBJECTIVE: The aim of this study was to evaluate bcl-2, bax (apoptotic-oncoproteins), and Ki67 (cell proliferation-marker) expression in thymus of patients with myasthenia gravis (MG) and to determine the potential correlation with clinicopathologic parameters. METHODS: The study was done on 38 patients (16 males, 22 females; mean age 38+/-10 years) with MG who underwent modified maximal thymectomy (MMT). Clinical staging (Osserman classification) included stage I in three, IIA in 19, IIB in 13 and III in three. Microscopic examination of thymus showed thymic hyperplasia in 19, atrophy in eight, thymoma in nine and thymic carcinoma in two. On paraffin sections, the streptavidin-biotin technique, using antibodies to bcl-2, bax, and Ki67, was employed, and in situ hybridization with digoxigenin-labeled probes to bcl-2 and bax was performed. In addition, the apoptotic body index (ABI) was assessed via the TUNEL method. Staining results were correlated with clinicopathologic parameters. RESULTS: Bcl-2 expression was higher in hyperplasia and thymoma cases, compared to thymic carcinomas (P<0.001). Higher expression in carcinomas, compared to hyperplasia and thymomas, was observed for bax (P<0.001), Ki67 (P<0.001) and ABI (P<0.001). Statistical analysis demonstrated: (A) positive correlation of bax+ cells with MG stage (P<0.001), ABI and %Ki67+ cells with MG stage (P<0.001, respectively), %Ki67+ and %bax+ cells with ABI (P<0.05); and (B) reverse correlation between %bcl-2+ cells and MG stage (P<0.05). CONCLUSIONS: In patients with MG who underwent MMT, bcl-2, bax, and Ki67 expression correlates positively or reversibly with the microscopic findings of thymus. Increased apoptosis and proliferation accompany advanced disease stage and possible worse prognosis.
UI - 11593315
AU - Hanna N; Gharpure VS; Abonour R; Cornetta K; Loehrer PJ Sr
TI - High-dose carboplatin with etoposide in patients with recurrent thymoma: the Indiana University experience.
SO - Bone Marrow Transplant 2001 Sep;28(5):435-8
AD - Indiana University, Indianapolis, IN 46202, USA.
Thymoma is a chemotherapy-sensitive tumor with a 30-50% 5-year survival in previously untreated patients. Unfortunately, durable CRs with salvage chemotherapy are rarely observed. We initiated a phase II trial of high-dose carboplatin and etoposide in patients with relapsed thymoma or thymic carcinoma. All patients had progressive disease (PD) after initial or salvage chemotherapy, but were not cisplatin-refractory. PBSCs were mobilized using 10 microg/kg/day G-CSF. Patients received carboplatin 700 mg/m(2) and etoposide 750 mg/m(2) i.v. on days -5, -4, -3. Five patients were enrolled and evaluated after tandem transplants 4 weeks apart. All patients had pleural-based and lung parenchymal metastasis, one or two prior surgeries and two or more courses of prior cisplatin-based chemotherapy regimens. Chemotherapy was well tolerated, although grade IV hematological toxicity occurred in all patients. Progression-free survival following HDC ranged from 3.5 to 16.5 months. One patient maintained a CR for 12.8 months, then died from an unrelated cause. With a minimum of 2 years follow-up for all patients, three of five patients remain alive at 26+, 36+, and 49+ months. High-dose carboplatin and etoposide in relapsed thymoma is feasible with acceptable toxicity; however, these limited data do not appear superior to standard-dose salvage therapy.
UI - 11584960
AU - Samaiya A; Chumber S; Kashyap R; Subramaniam R; Vashisht S;
TI - Vijayaraghavan M; Srivastava A Pure red cell aplasia with thymoma.
SO - J Assoc Physicians India 2001 Jun;49():679-80
UI - 11581613
AU - Yoshino I; Hashizume M; Shimada M; Tomikawa M; Tomiyasu M; Suemitsu R;
TI - Sugimachi K Thoracoscopic thymomectomy with the da Vinci computer-enhanced surgical system.
SO - J Thorac Cardiovasc Surg 2001 Oct;122(4):783-5
AD - Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. email@example.com
UI - 11673738
AU - Herve S; Savoye G; Savoye-Collet C; Behbahani A; Auliac JB; Bota S;
TI - Francois A; Lerebours E [Intrahepatic extramedullary hematopoiesis as a manifestation of a malignant thymoma: an unusual cause of nodular hepatomegaly]
SO - Gastroenterol Clin Biol 2001 Jun-Jul;25(6-7):711-3
UI - 11669591
AU - Lucchi M; Mussi A; Ambrogi M; Gunfiotti A; Fontanini G; Basolo F;
TI - Angeletti CA Thymic carcinoma: a report of 13 cases.
SO - Eur J Surg Oncol 2001 Nov;27(7):636-40
AD - Cardiac and Thoracic Department, Division of Thoracic Surgery, University of Pisa, Via Paradisa 2, Pisa 56124, Italy. firstname.lastname@example.org
OBJECTIVE: Thymic carcinoma is a rare thymic neoplasm. It is more invasive and has a poorer prognosis than thymoma. We report our experience in the treatment of 13 thymic carcinomas. METHODS: Thirteen patients with histologically confirmed thymic carcinoma were treated therapy. Seven patients underwent neoadjuvant chemotherapy, followed by surgery and post-operative radiotherapy. RESULTS: The diagnosis of thymic carcinoma was achieved in six cases by a mediastinotomy, in three cases by a ultrasound-guided or a CT-guided fine needle aspiration and in three cases the pre-operative diagnosis was thymoma. In one case we did not have the histological diagnosis. All seven patients treated with neoadjuvant chemotherapy responded. The surgical resection was complete in seven cases. Eight patients are still alive 8-142 months from the diagnosis, and six are disease-free. CONCLUSIONS: Our experience supports the role of surgery and post-operative radiotherapy in thymic carcinomas. Pre-operative treatment of such neoplasms by multi-drug chemotherapy may improve the resectability and the survival rate. Copyright 2001 Harcourt Publishers Limited.
UI - 11675689
AU - Noh TW; Kim SH; Lim BJ; Yang WI; Chung KY
TI - Thymoma with pseudosarcomatous stroma.
SO - Yonsei Med J 2001 Oct;42(5):571-5
AD - Department of Pathology, Yonsei University College of Medicine, C.P.O. Box 8044, Seoul 120-752, Korea.
Thymoma with psuedosarcomatous stroma is a recently described, rare variant of thymomas that are characterized by having a biphasic histologic pattern which consists of both an epithelial and a spindle cell stromal component. So far only 11 cases having similar histologic findings have been reported worldwide. At this time we report a case of this rare variant of thymoma which occurred in a 53-year-old Korean man. This previously healthy patient presented with coughing and an anterior mediastinal mass was then detected radiographically. Mediastinal exploration revealed a 9 x 8 x 8 cm-sized well- encapsulated, ovoid, cystic mass. Histological examination showed a biphasic neoplasm composed of anastomosing nests of epithelial cells and somewhat cellular stromal spindle cells that had advanced degenerative changes. Immunohistochemical staining using the antibodies for cytokeratins, EMA, e-cadherin, and p75NGFR showed a strong expression of these markers in the epithelial component but no expression in the spindle stromal cells. The epithelial tumor cells showed no reactivity to CD5 and L26 and a high proportion of the infiltrated lymphocytes were the cortical type that expressed CD99 and terminal deoxynucleotidyl transferase. Ultrastructural examinations revealed tonofilaments in the spindle cells. Follow up has been done for 5 years after the surgical excision and the patient has been free of disease during that period. Similar to previous reports, this patient had a benign clinical course that was unassociated with myasthenia gravis which appears to be a characteristic of this histologic variant of thymoma. However, our case also showed advanced degenerative features and we could demonstrate ultrastructural evidence of epithelial differentiation in the stromal spindle cells that were not mentioned in the previously reported cases. Based on the results of our studies, we suggest this entity is a distinct type of organotypic thymoma that shows cortical differentiation and abundant cellular stroma.
UI - 11693806
AU - De Toma G; Plocco M; Nicolanti V; Brozzetti S; Letizia C; Cavallaro A
TI - Type B1 thymoma in multiple endocrine neoplasia type 1 (MEN-1) syndrome.
SO - Tumori 2001 Jul-Aug;87(4):266-8
AD - Department of Surgery Pietro Valdoni, University of Rome La Sapienza, Italy. email@example.com
AIMS AND BACKGROUND: Multiple endocrine neoplasia (MEN) syndromes include a group of disorders characterized by the neoplastic transformation of two or more endocrine tissues. In type 1 syndrome (MEN-1), pituitary, parathyroid and pancreatic islet tumors are most frequently represented. Thymic neoplasms are also rarely associated, and thymectomy during subtotal or total parathyroidectomy should always be considered. STUDY DESIGN: The authors describe a rare case of a 22-year-old male who presented a type B1 thymoma without myasthenia gravis associated to hyperparathyroidism, corticoadrenal adenoma and three neuroendocrine pancreatic lesions (somatostatinoma, glucagonoma and insulinoma).
UI - 11689291
AU - Sasaki H; Yukiue H; Kobayashi Y; Nakashima Y; Kaji M; Fukai I; Kiriyama
TI - M; Yamakawa Y; Fujii Y Expression of the MTA1 mRNA in thymoma patients.
SO - Cancer Lett 2001 Dec 28;174(2):159-63
AD - Department of Surgery II, Nagoya City University Medical School, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya 467-8601, Japan. firstname.lastname@example.org
The MTA1 gene is a recently identified metastasis-associated gene which has been implicated in the signal transduction or regulation of gene expression. We examined the mRNA expression levels of the MTA1, the human homologue of the rat mta1 gene in thymoma. Expression of MTA1 mRNA was evaluated by reverse transcription polymerase chain reaction (RT-PCR) in 30 thymoma samples using LightCycler. The data was analyzed in reference to clinicopathological data. There was no relationship between MTA1 gene expression and age and gender. MTA1/GAPDH mRNA level in stage IV thymoma (6.431+/-3.404) was significantly higher than the level in stage I thymoma (2.592+/-1.902, P=0.0081). There was a tendency towards higher MTA1/GAPDH mRNA level in stage IV thymoma when compared to stage II thymoma (3.746+/-3.292, P=0.072). Thus our results show that the expression of the MTA1 gene is closely related to invasiveness in thymoma. The gene MTA1 could potentially provide information on the mechanism of tumor invasion and metastasis.
UI - 11696445
AU - Zhou R; Zettl A; Strobel P; Wagner K; Muller-Hermelink HK; Zhang S; Marx
TI - A; Starostik P Thymic epithelial tumors can develop along two different pathogenetic pathways.
SO - Am J Pathol 2001 Nov;159(5):1853-60
AD - Institute of Pathology and Forensic Medicine, Zhejiang University Medical School, Zhejiang, China.
To investigate genetic abnormalities associated with the development of thymic epithelial tumors, we performed microsatellite analysis of 26 thymomas belonging to three different World Health Organization types (A, B3, and C) using 48 repeats. The most frequent aberration seen was loss of heterozygosity (LOH) in the region 6q23.3-25.3 detected in 11 tumors (45.8% of informative cases). Further consistent LOHs were detected in regions 3p22-24.2, 3p14.2 (FHIT gene locus), 5q21 (APC), 6p21, 6q21-22.1, 7p21-22, 8q11.21-23, 13q14 (RB), and 17p13.1 (p53). Microsatellite instability was extremely rare, occurring in one type B3 thymoma only, although, at 12.5% of the analyzed loci. Comparing the allelotypes of the analyzed thymomas, we were able to identify two pathogenetic pathways these tumors develop along, characterized by the 6q23.3-25.3 and 5q21 LOHs, respectively. The APC aberration on 5q21 showed significant associations with LOH in the 3p22-24.2, 13q14, and 17p13.1 regions. Interestingly, type A thymomas presented with consistent LOH in the region 6q23.3-25.5 only, they did not reveal any aberrations in the APC, RB, and p53 gene loci or regions 3p22-24.2 and 8q11.21-23. The absence of these aberrations might be the reason for the well-known benign behavior of type A thymomas as compared to types B3 and C tumors.
UI - 11706095
AU - Buckley C; Newsom-Davis J; Willcox N; Vincent A
TI - Do titin and cytokine antibodies in MG patients predict thymoma or thymoma recurrence?
SO - Neurology 2001 Nov 13;57(9):1579-82
AD - Neurosciences Group, Weatherall Institute of Molecular Medicine, John Radcliffe Hospital, Oxford, UK.
BACKGROUND: Patients with MG often have other autoantibodies in addition to those against the acetylcholine receptor (AChR). It has been suggested that antibodies to the muscle protein titin may be diagnostic of a thymoma, but they have also been found in patients with late-onset MG. Antibodies to certain cytokines have also been detected in patients with MG and thymoma, and it is not clear whether these antibodies could be more useful clinically. The authors measured antibodies against titin and the cytokines interferon alpha (IFNalpha) and interleukin 12 (IL12) in patients with MG and thymoma or thymoma recurrence, and in patients with MG but without thymoma presenting before (early-onset MG) or after (late-onset MG) 40 years of age. METHOD: Levels of titin, IFNalpha, and IL12 antibodies were determined by radioimmunoassay in 191 patients with MG and 82 controls. RESULTS: As previously reported, titin antibodies were uncommon in patients with early-onset MG. However, in patients with late-onset MG, titin antibodies had similar prevalence and levels to those in patients with MG and thymoma, although the antibodies were uncommon in patients between 40 and 60 years of age presenting without a tumor. By contrast, cytokine antibodies were more common in patients with thymoma than in patients without thymoma, and cytokine antibodies typically increased substantially if the thymoma recurred. CONCLUSIONS: Measurement of titin antibodies has limited use in predicting the presence of a tumor, unless the patient is less than 60 years of age, but measurement of IFNalpha and IL12 antibodies may be helpful in identifying patients with a thymoma recurrence, particularly when mediastinal imaging is equivocal.
UI - 11725628
AU - Lee HC; Cheng YF; Chuang FR; Chen JB; Hsu KT
TI - Minimal change nephrotic syndrome associated with malignant thymoma: case report and literature review.
SO - Chang Gung Med J 2001 Sep;24(9):576-81
AD - Division of Nephrology, Department of Internal Medicine, Chang Gung Memorial Hospital, 123, Ta-Pei Road, Niaosung, Kaohsiung, Taiwan, R.O.C. email@example.com
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.
UI - 11745803
AU - Haniuda M; Kondo R; Numanami H; Makiuchi A; Machida E; Amano J
TI - Recurrence of thymoma: clinicopathological features, re-operation, and outcome.
SO - J Surg Oncol 2001 Nov;78(3):183-8
AD - Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan. firstname.lastname@example.org
BACKGROUND: Even after complete resection, recurrence of thymoma is not infrequently observed, and treatment of recurrent thymoma remains controversial. STUDY DESIGN: One hundred and twenty-six patients underwent surgically complete resection for thymoma, and 24 of them had a recurrence. Surgical treatment of recurrent thymoma was attempted in 15 patients for a total of 18 times. In the present study, the relevance of clinicopathological features and the re-operation on the survival rate after the recurrence were determined. RESULTS: The most frequent recurrent type was pleural dissemination (92%), with local recurrence observed in 5%. Overall 5- and 10-year survivals after recurrence were 37 and 16%, respectively. Disease-free interval after initial operation and complication of myasthenia gravis had no significant effect on postrecurrent survival. The use of postoperative mediastinal irradiation had no effect on reducing the recurrence rate or improving survival after recurrence. Two of 15 patients who underwent re-operation died of major complications after It. pleuropneumonectomy for severe pleural dissemination. In the present study, the re-operation was not significantly effective for prolongation of postrecurrence survival. CONCLUSION: Our study showed that re-operation should not be attempted for all patients with recurrent thymoma. Because effect of subtotal resection for severe pleural recurrence is disappointing, total resection for minimal pleural dissemination or small local recurrence will be undertaken to improve postrecurrent survival. Careful follow-up for > 10 years will increase the chance of the total resection of the recurrent thymoma. Copyright 2001 Wiley-Liss, Inc.
UI - 11734317
AU - Goh SG; Lau LC; Sivaswaren C; Chuah KL; Tan PH; Lai D
TI - Pseudodicentric (16;12)(q11;p11.2) in a type AB (mixed) thymoma.
SO - Cancer Genet Cytogenet 2001 Nov;131(1):42-7
AD - Department of Pathology, Singapore General Hospital, Outram Road, 169608, Singapore, Singapore.
Genetic alterations of thymomas are rarely described in the literature. In this study, a previously unreported instance of aberrant karyotypic change consisting of 45,XX,pseu dic(16;12) (q11;p11.2) [cp23]/87-90,idemx2[cp4] in a Masaoka Stage II mixed thymoma or type AB thymoma affecting a 56-year-old Chinese woman is detailed. Abnormalities involving 12p containing important tumor suppressor-like genes have been documented especially in hematological malignancies. Recently, recurrent losses involving 16q, a locus known to harbor several tumor suppressor genes, have been described in type C thymomas (squamous cell carcinoma), suggesting a possible relationship between type AB thymoma and type C thymoma. Whether these genes are involved in the pathogenesis of type AB thymoma remain to be clarified and it is currently unclear if cytogenetic studies may eventually play a role in the classification of thymic tumors.
UI - 11688282
AU - Peliukhovskii SV; Gonshcherovskii L; Kaspshik M
TI - [Comparative characteristics of surgical treatment of thymoma with the clinical signs of myasthenia and without them]
SO - Klin Khir 2001 Jul;(7):38-40
Analysis of results of surgical treatment of 72 patients with thymoma, including 49 in combination with clinical signs of myasthenia and 23 without them, is presented. In group of patients with symptoms of myasthenia the women aged from 30 to 39 yrs prevailed and among those who had not--the men, aged from 40 to 49 yrs. Histologic investigation in 29 (59.1%) of patients with symptoms of myasthenia showed lymphocytic thymoma, in 10 (43.4%) of patients without signs of myasthenia--benign thymoma was revealed.
UI - 11766610
AU - Chen X; Lu C; Qiao J
TI - [The significance of Titin antibody in diagnosing myasthenia gravis with thymoma]
SO - Zhonghua Yi Xue Za Zhi 2001 Sep 25;81(18):1118-20
AD - Department of Neurology, Huashan Hospital, Medical Center of Fudan University, Shanghai 200040, China.
OBJECTIVE: To investigate the clinical significance of Titin antibody (Titin-ab) in diagnosing myasthenia gravis with thymoma (MGT). METHODS: Titin-ab and acetylcholine receptor antibody (AChR-ab) in the sera of 73 MGT patients with different thymic pathological patterns and 58 MG patients without thymoma (NTMG) were detected by ELISA. RESULTS: The positive rate of Titin-ab in MGT group was 76.7%, significantly higher than those of NTMG group, other neurologic diseases group and healthy control group (P < 0.01). The sensitivity of Titin-ab in diagnosis of MGT was significantly lower than that of CT scan or MR of thymus (P < 0.05), but the specificity of Titin-ab in diagnosis of MGT was significantly higher than that of CT scan or MR of thymus (P < 0.05). The positive rate of Titin-ab was mainly related to the thymic pathology and was the highest in the thymic epithelial thymoma (TET) subgroup (95.1%). There was no significant correlation between the positive rate of Titin-ab and the Masaoka's stage of thymoma (P > 0.05). The titer of Titin-ab was highly correlated to the titer of AChR-ab in MGT group (r = 0.496, P < 0.01), but not in MGH group (r = 0.385, P > 0.05). CONCLUSION: Detection of Titin-ab is a rather sensitive, specific, handy method in diagnosis of MGT (especially TET). It may play an important role in the pathogenesis of MGT.
UI - 11745297
AU - Pan CC; Chen PC; Wang LS; Chi KH; Chiang H
TI - Thymoma is associated with an increased risk of second malignancy.
SO - Cancer 2001 Nov 1;92(9):2406-11
AD - Department of Pathology, Veterans General Hospital-Taipei, No. 201, Sec. 2, Shih-Pai Road, Taipei, 11217 Taiwan. email@example.com
BACKGROUND: An association between thymoma and second malignancy has been suggested but has not been validated. Whether the relation is due to treatment or to other thymoma-associated conditions is unclear. METHODS: The authors studied 192 consecutive patients with thymoma and compared the incidence of second malignancies with those of 206 patients who underwent thymectomy for nonthymomatous conditions and 1426 patients with nasopharyngeal carcinoma (NPC). Detailed clinicopathologic features of thymoma patients with second malignancies were described. RESULTS: Additional malignancies were detected in 15 of 192 patients (8%) during their clinical courses. The risk for those patients was significantly greater compared with the risk for patients with nonthymomatous conditions (adjusted odds ratio [OR], 3.81; 95% confidential intervals [95%CI], 1.05-13.81; P = 0.042) and patients with NPC (adjusted OR, 4.89; 95%CI, 2.26-10.53; P < 0.0001) after adjustment for age, gender, length of follow-up, myasthenia gravis, and radiation therapy. The occurrence of second malignancies did not correlate with histologic type or stage of thymoma, radiation therapy, or myasthenia gravis. CONCLUSIONS: Thymoma is associated with an increased risk of second malignancy. The association cannot be attributed to the effect of thymectomy or radiation therapy. Patients with thymoma, even if it is benign, should be followed regularly to facilitate the early detection of other malignancies. Copyright 2001 American Cancer Society.
UI - 11508787
AU - Ferone D; Kwekkeboom DJ; Pivonello R; Bogers ADColao A; Lamberts SW; van
TI - Hagen PM; Hofland LJ In vivo and in vitro expression of somatostatin receptors in two human thymomas with similar clinical presentation and different histological features.
SO - J Endocrinol Invest 2001 Jul-Aug;24(7):522-8
AD - Department of Internal Medicine, Erasmus Medical Center Rotterdam, The Netherlands. firstname.lastname@example.org
[(111)In-DTPA0]octreotide scintigraphy allows the in vivo visualization of several types of SS receptor (SSR)-expressing tumors. Among these, thymomas have been recently detected. Here we report on 2 patients admitted for myasthenia gravis and radiological evidence of thymic mass. Although these patients had similar clinical presentation, in vivo SSR scintigraphy displayed a difference in the degree of the [(111)In-DTPA0]octreotide uptake. Considering that both thymic masses had comparable volume, [(111)In-DTPA0]octreotide level was significantly higher in one of the 2 tumors (tumor/background ratio of 5.7 vs 2.6). The SSR subtype expression pattern was studied in vitro on the surgically resected specimens by ligand binding techniques, quantitative reverse transcriptase polymerase chain reaction (RT-PCR) and immunohistochemistry. According to the recent World Health Organization classification, the 2 tumors were classified A and B2 thymomas respectively. In membrane homogenates, we found a higher number of high affinity [125I-Tyr11]-SS-14 binding sites in the B2 thymomas (23.5+/-2.5 vs 12.0+/-0.4 fmol/mg membrane protein; p<0.05). RT-PCR analysis showed sst1, sst2A and sst3 mRNA in the 2 thymoma tissues, whereas SS mRNA was detectable only in the A thymoma. Quantitative evaluation of RT-PCR data showed a comparable expression of the relative amount of sst2A mRNA in both tumors, whereas a significant higher expression of sst3 mRNA in the B2 thymoma. Sst2A immunoreactivity was localized mainly on the endothelium of intratumoral vessels, whereas sst3 was present on either tumoral epithelial cells or normal reactive thymocytes. The expression of sst2A receptors in these tumors is in line with the in vivo visualization by [(111)In-DTPA0]octreotide, which is considered a sst2-preferring ligand. However, since radioligand uptake was significantly higher in the B2 thymoma, which expressed the largest sst3 mRNA levels, it might be possible that this subtype is involved in determining the tumor visualization during SSR scintigraphy. Apart from the affinity of the radioligand for the receptor, also the efficacy of the internalization of the radioligand-receptor complex might play a role in radioactivity accumulation during in vivo SSR scintigraphy. In fact, although octreotide binds with lower affinity to sst3 receptors, this subtype displayed the highest amount of agonist-dependent receptor internalization compared to the other SSR subtypes. Moreover, sst3 was localized on both tumor cells and reactive thymocytes, and these latter cells are characterized by a very active turnover of membrane molecules. Finally, although more cases need to be evaluated, the lack of detection of SS mRNA in the tumor presenting a more aggressive phenotype (B2 thymoma) might have physiopathological or prognostic significance.
UI - 11711802
AU - Funai K; Yokose T; Yoshida J; Nishimura M; Nagai K; Nishiwaki Y; Ochiai
TI - A Thymoma with osseous metaplasia.
SO - J Comput Assist Tomogr 2001 Nov-Dec;25(6):897-9
AD - Pathology Division, National Cancer Center Research Institute East, Chiba, Japan.
A 69-year-old woman with a 15-year history of abnormal chest shadow was referred to our hospital. An enhanced chest CT scan of the anterior mediastinum revealed a mass containing a high-density area. The preoperative radiologic diagnosis was thymoma. Operation was performed within the tumor. Intratumoral ossification has never been reported in thymoma. Therefore, we report the first case of thymoma associated with multiple foci of osseous metaplasia.
UI - 11726901
AU - Carr CS; O'Keefe PA
TI - An ectopic thymoma with spontaneous infarction.
SO - J Thorac Cardiovasc Surg 2001 Dec;122(6):1234-5
AD - Department Thoracic Surgery, Guy's Hospital, London, United Kingdom. email@example.com
UI - 7985981
AU - Deminatti MM; Ribet M; Gosselin B; Bauters F; Mencier E; Savary JB; Lai
TI - JL; Vasseur F; Morel P; Bisiau-Leconte S [Familial thymoma and translocation t (14;20) (q24;p13)]
SO - Ann Genet 1994;37(2):72-4
AD - Service de Genetique Humaine et Pathologie Foetale, Faculte de Medecine, Lille, France.
A familial lympho-epithelial thymoma with constitutional chromosomal translocation t (14;20) (q24;p13) is presented: the thymoma and its particular translocation are present in the mother and the two sons of her offspring. The small number of cases do not allow establishing any relation between thymoma and this particular translocation. Concerning genetic counseling, an annual thoracic radiography is necessary for all the other family members, carriers or not of the translocation.
UI - 8827877
AU - Doi T; Sakamaki S; Koike K; Matsunaga T; Kobayashi D; Muramatsu H; Sato
TI - T; Watanabe N; Kougo Y; Niitsu Y [CD7, HLA-DR, CD38 positive acute undifferentiated leukemia with subcutaneous tumor and thymoma]
SO - Rinsho Ketsueki 1996 Aug;37(8):676-81
AD - Forth Department of Internal Medicine, Sapporo Medical University.
A case of acute undifferentiated leukemia (AUL), accompanied by subcutaneous tumor and thymoma is reported. The analysis of immunophenotype showed that the leukemic blasts were positive for CD7, HLA-DR, CD38 and CD34 in 17.5% but negative results were obtained for other lymphoid and myeloid antigens. The leukemic blasts had a rearranged immunoglobulin heavy chain (IgH) gene and T cell receptor delta (TCR-delta) chain gene chromosomal abnormality, 47, XY, +8, t(13; 17) (q12; q21), -17, +M was observed. In general, the CR rate is low and prognosis is poor in patients with AUL. In our case, CR was not achieved by the therapy with JALSG-ALL87 protocol, but was achieved by subsequent treatment with high dose ara-C therapy and combination chemotherapy including intermediate-dose ara-C, mitoxantrone, etoposide and prednisolone.
UI - 11079034
AU - Mirza I; Kazimi SN; Ligi R; Burns J; Braza F
TI - Cytogenetic profile of a thymoma. A case report and review of the literature.
SO - Arch Pathol Lab Med 2000 Nov;124(11):1714-6
AD - Department of Pathology and Laboratory Medicine, Danbury Hospital, Danbury, CT 06810, USA.
Cytogenetic analysis of mixed lymphocyte and epithelial thymoma in a nonmyasthenic female patient revealed deletion of part of the short arm of chromosome 6. To our knowledge, this cytogenetic abnormality in a benign thymoma has not been previously described in the literature, which is reviewed.
UI - 11776857
AU - Lin D; Lu N; Feng X
TI - [Clinico-pathologic characteristics of malignant thymoma]
SO - Zhonghua Zhong Liu Za Zhi 1999 Mar;21(2):136-8
AD - Department of Pathology, Cancer Institute (Hospital), Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100021.
OBJECTIVE: To assess the histopathology, clinical staging and treatment of malignant thymoma in relation to prognosis. METHODS: Sixty four cases with malignant epithelial thymic tumors treated in the period of 1958-1995 were retrospectively studied. Archived specimens were categorized according to Levine and Rosai into type I malignant thymoma(MT) and type II thymic carcinoma (TC). MT was histologically classified according to Muller-Hermelink(M-H). Clinical staging was ascertained according to Masaoka's criteria. RESULTS: There were 41 cases of MT and 23 cases of TC. No medullary or mixed thymoma was observed in this series of MT. The 5-year survival rate of patients with MT of predominantly cortical, cortical, and well-differentiated thymic carcinoma (MDTC) subtypes was 75.3%, 44.7% and 43.3%, respectively. That of patients with TC of squamous-cell carcinoma and lympho-epithelioid subtypes was 27.5% and 60.0%, respectively. The 10-year survival rate of these 5 subtypes was 25.3%, 10.0%, 0, 0, 20.0%, respectively(P < 0.05). The 5-year and 10-year survival rates decreased with increase in staging. In 22 patients in stage III and IV who received thoracotomy with biopsy only, their survival rate was significantly lower than that in patients with their tumor resected. CONCLUSION: Histomorphology of the tumor, heterogeneity in cell types, clinical staging and the extent of tumor resection are factors affecting survival.
UI - 11776813
AU - Li J; Wang L; Zhang R
TI - [Clinico-pathological characteristics and prognosis of thymoma: an analysis of 159 cases]
SO - Zhonghua Zhong Liu Za Zhi 1999 Jul;21(4):272-4
AD - Department of Thoracic Surgery, Cancer Institute (Hospital), Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100021.
OBJECTIVE: To investigate the clinicopathologic features of thymoma and assess prognostic factors. METHODS: Data of 159 patients operated for thymoma were collected. A retrospective analysis was performed, through comparison of survival rate computed by the actuarial method and rate of recurrence and metastasis. RESULTS: (1) The 3-, 5-, and 10-year survival rate was 78.9%, 63.7% and 46.3%, respectively. All patients treated by subtotal thymoma resection with postoperative radiotherapy survived more than 3 years. (2) Patient's age, location and image density of tumor play important role in differential diagnosis. (3) Tumors with epithelial predominance were more frequently seen in late stage than those of other histologic types(P < 0.01). (4) The prognosis of patients whose tumors had incomplete or no capsule was poor as compared to that of stage I tumor (P < 0.05). (5) According to multivariate analysis, the most important prognostic variables included completeness of resection (OR = 2.10) and clinicopathologic stage (OR = 1.73). Myasthenic crisis was the most important factor influencing operative death. Sex, symptoms and histologic classification did not influence prognosis. (6) Recurrence and metastasis occurred in all stages, but more frequent in the later stages of the disease. CONCLUSION: Complete resection helps decrease recurrence of thymoma. Prognosis of patients receiving palliative resection of thymoma may be improved by postoperative radiotherapy.
UI - 11531146
AU - Kenny-Moynihan MB; DeRose PB; Gal AA; Chakraborty H; Cohen C
TI - Flow and image cytometry in thymic neoplasia: correlation with clinical outcome.
SO - Anal Quant Cytol Histol 2001 Aug;23(4):313-20
AD - Department of Pathology and Laboratory Medicine, Rollins School of Public Health, Robert W. Woodruff Health Sciences Center, Emory University, Atlanta, Georgia 30322, USA.
OBJECTIVE: To compare nuclear DNA by flow (FCM) and image cytometry (ICM) in thymic neoplasms and to relate results to clinical outcome. STUDY DESIGN: DNA ploidy of 44 thymomas and 6 thymic carcinomas was studied by FCM and ICM of single nuclear suspensions from paraffin blocks. RESULTS: By FCM, 33 thymomas (75%) and one thymic carcinoma (17%) were diploid; 6 thymomas (14%) and 4 thymic carcinomas (67%) were aneuploid. By ICM, 36 thymomas (82%) were diploid; 7 thymomas (16%) and 6 thymic carcinomas (100%) were aneuploid. Mean follow-up in 44 cases was 46.2 months (range, 1-162). Ten patients with persistent/recurrent disease included four with thymic carcinoma, who died of the disease (two aneuploid by both techniques, two aneuploid by ICM with unsatisfactory/diploid FCM). Four had invasive thymoma and recurrence after 13-150 months (two diploid and two aneuploid by both methods), one had diploidy and noninvasive thymoma that recurred at 92 months, and one had an epithelial thymoma that recurred at 144 months (aneuploid by FCM, diploid by ICM). CONCLUSION: The results obtained in this preliminary, retrospective study show a high concordance between FCM and ICM; aneuploidy correlated with poor outcome by both methodologies. While these findings are encouraging, larger numbers of cases will be needed to define the role of FCM and ICM in predicting outcome in thymic tumors.
UI - 11718752
AU - Hagiwara H; Enomoto-Nakatani S; Sakai K; Ugawa Y; Kusunoki S; Kanazawa I
TI - Stiff-person syndrome associated with invasive thymoma: a case report.
SO - J Neurol Sci 2001 Dec 15;193(1):59-62
AD - Department of Neurology, Division of Neuroscience, Graduate School of Medicine, University of Tokyo, Hongo 7-3-1, Tokyo, 113-8655, Bunkyo, Japan.
We report a case of a 40-year-old female with continuous muscle stiffness and painful muscle spasms. The symptoms worsened over a two-week period after onset. Electrophysiological examinations revealed continuous muscle discharge, which was markedly reduced by intravenous administration of diazepam. High levels of anti-glutamic acid decarboxylase (GAD) antibodies were detected in both serum and cerebrospinal fluid, suggesting that the patient suffered from stiff-person syndrome. Steroid pulse therapy and immunoadsorption therapy alleviated the clinical symptoms and decreased the anti-GAD antibody titer. A chest CT revealed the presence of an invasive thymoma. Neither anti-acetylcholine receptor (AChR) antibodies nor symptoms of myasthenia gravis (MG) were observed. The patient underwent a thymectomy and postoperative radiotherapy. These treatments further alleviated the clinical symptoms. The present case is the first that associates stiff-person syndrome with invasive thymoma, and not accompanied by MG. The autoimmune mechanism, in this case, may be triggered by the invasive thymoma.
UI - 11761906
AU - Adachi K; Tanaka J; Sato T; Makino S; Hosaka N; Takao M; Yada I;
TI - Namikawa S [A case of thymoma with pure red cell aplasia]
SO - Kyobu Geka 2001 Dec;54(13):1153-5
AD - Department of Thoracic and Cardiovascular Surgery, Toyooka Hospital, Toyooka, Japan.
A 71-year-old man was admitted to the hospital because of general fatigue. There were few reticulocytes in the peripheral blood and no erythroblasts in the bone marrow. Chest CT revealed an anterior mediastinal tumor. Under a diagnosis of thymoma with PRCA, extended thymothymectomy was performed. Histological diagnosis was mixed type thymoma with no invasive growth beyond the capsule. Administration of predonisolone following surgery was not effective for PRCA. Otherwise, peripheral blood counts were significantly improved following occasional onset of acute bronchitis.
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