National Cancer Institute®
Last Modified: February 1, 2002
UI - 11778563
AU - Tan L; Qiu D; Wang Q
TI - [Preoperative chemotherapy and operation for invasive Masaoke stage III and IV a thymoma]
SO - Zhonghua Zhong Liu Za Zhi 2000 Jul;22(4):327-9
AD - Department of Thoracic Surgery, Zhong Shan Hospital, Shanghai Medical University, Shanghai 200032, China.
OBJECTIVE: To assess the effect of preoperative chemotherapy on invasive thymoma. METHODS: Fourteen patients with invasive thymoma (12 cases in Masaoka stage III and 2 cases in stage IV a) were treated with 3-4 cycles of CAVP (cyclophosphamide 600 mg/m2 D1, adriamycin 30 mg/m2 or epi-adriamycin 40 mg/m2 D1, vincristine 0.6 mg/m2 D1 or vindestine 3 mg/m2 D1, D8, cisplatin 30 mg/m2 D1, 2, 3). Following chemotherapy, patients were operated within 1-3 months. In 10 patients, sternotomy was performed and in 4 patients, anterolateral thoracotomy was performed. Radiotherapy was given with a total dose of 50-60 Gy in all patients except in those who were pathologically in complete remission. The patients were followed up for 6 months to 3 years. RESULTS: After chemotherapy, complete response was observed in 5 patients (35.7%) and partial response in 9 patients (64.3%). Nine patients received radical tumor resection and 5 patients received partial resection. Histologic/examination of the surgical specimens showed fibrosis of the remnant thymus in 5 patients. All but two patients survived in the follow-up period. Patient died from distant metastases at 18 and 24 months after treatment, respectively. CONCLUSION: Preoperative chemotherapy helps increase the resectability of stage III and IV a invasive thymoma. A longer follow-up period and more patients are needed to ascertain the impact of this treatment strategy on long-term survival.
UI - 11815982
AU - Watanabe M; Yu SK; Sawafuji M; Kawamura M; Horinouchi H; Mukai M;
TI - Kobayashi K Enhanced expression of telomerase activity in thymoma and thymic carcinoma tissues: a clinicopathologic study.
SO - Cancer 2002 Jan 1;94(1):240-4
AD - Department of Surgery, School of Medicine, Keio University, Tokyo, Japan. firstname.lastname@example.org
BACKGROUND: Telomerase is a nucleoprotein complex that caps the physical termini of all eukaryotic chromosomes. Because most malignant cells and reproductive cells have telomerase activity, which elongates telomeric DNA, telomerase may play important roles in unlimited cell division acquisition of the malignant phenotype. The current study examined the relation of telomerase activity in thymoma and thymic carcinoma with the clinicopathologic features of these lesions. METHODS: Tissue specimens were surgically resected from patients with thymoma and thymic carcinoma. Telomerase activity was evaluated according to a modified telomeric repeat amplification protocol assay. Paraffin sections of tumor were immunostained by MIC2 antibody, a marker of immature T cells. RESULTS: Telomerase activity was detected in all thymic epithelial tumors. The activity (mean +/- SD; unit per microg protein) in thymoma (n = 17) was significantly higher than that in thymic carcinoma (n = 7) (431.8 +/- 400.1 vs. 68.8 +/- 39.8; P < 0.01). Telomerase activities in thymoma and thymic carcinoma were significantly higher than that in primary lung adenocarcinoma (33.5 +/- 39.2, n = 47), studied as a control (P < 0.01). In patients with thymoma, telomerase activity did not correlate with tumor stage according to Masaoka classification (P = 0.776). In patients with thymic carcinoma, however, telomerase activity positively correlated with tumor stage (P = 0.02). In thymoma, telomerase activity positively correlated with the ratio of induced lymphocytes according to Rosai's classification (P = 0.045). MIC2-positive lymphocytes were identified in all cases of thymoma (n = 12). In contrast, lymphocytes infiltrating thymic carcinoma did not react with MIC2. CONCLUSIONS: In thymoma, telomerase activity reflects the presence of immature T-cell lymphocytes in tumor tissue rather than tumor stage or malignant phenotype. In thymic carcinoma, telomerase activity derived directly from cancer cells may relate to tumor stage. Copyright 2002 American Cancer Society.
UI - 11735267
AU - Okumura M; Fujii Y; Miyoshi S; Shiono H; Inoue M; Kadota Y; Fukuhara K;
TI - Matsuda H Three-color flow cytometric study on lymphocytes derived from thymic diseases.
SO - J Surg Res 2001 Dec;101(2):130-7
AD - Department of Surgery (E-1), Graduate School of Medicine, Osaka University, Suita-City, Japan. email@example.com
BACKGROUND: Anterior mediastinal masses derive from a variety of diseases. Thymomas have been shown to commonly hold CD4(+)CD8(+) double-positive (DP) lymphocytes, and identification of this subset by two-color flow cytometric study was suggested to help diagnosis of thymoma. Several other thymic diseases, however, possibly hold CD4(+)CD8(+) DP lymphocytes. In this study, we utilized the three-color flow cytometric method for further examination of the phenotypes of lymphocytes in the thymic diseases. MATERIALS AND METHODS: One hundred eight specimens (77 primary and 10 metastatic thymomas, 10 thymic carcinomas, 2 thymic carcinoids, 4 malignant lymphomas, 2 seminomas, an inflammatory pseudotumor, and 2 nonneoplastic thymic hyperplasias) were subjected to the study. The expressions of CD3, CD4, and CD8 on tumor-associated lymphocytes were evaluated by three-color flow cytometric study. RESULTS: The proportion of the CD4(+)CD8(+) DP subset was more than 30% in all 78 lymphocyte-rich thymomas, in 2 malignant lymphomas, and in both thymic hyperplasias. CD3 expression of the CD4(+)CD8(+) DP subset ranged from a negative to a high level in thymomas and thymic hyperplasias, while it was restricted to a particular level in CD4(+)CD8(+) DP-type malignant lymphomas. The proportion of CD3(+) cells in the CD4(+)CD8(-) single-positive subset was consistently less than 90% in the lymphocyte-rich thymomas, while it was more than 90% in the thymic hyperplasias. CONCLUSION: Although identification of the CD4(+)CD8(+) DP subset in the tumor-associated lymphocytes does not necessarily indicate thymoma, a further characterization of thymic neoplasms possessing the CD4(+)CD8(+) DP subset was enabled by three-color flow cytometric study, suggesting the utility of this method as an ancillary tool for differential diagnosis of these diseases.
UI - 11808089
AU - Sakuraba M; Onuki T; Nitta S
TI - Measurement of antiacetylcholine receptor antibody in patients with thymoma without myasthenia gravis complications.
SO - Jpn J Thorac Cardiovasc Surg 2001 Dec;49(12):690-2
AD - Department Surgery I, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan.
OBJECTIVE: Some patients with thymoma reported to show higher antiacetylcholine receptor antibody titers without the preoperative occurrence of myasthenia gravis and some have suffered postoperative complications of myasthenia gravis despite being negative for antiacetylcholine receptor antibody preoperatively. We evaluated changes in antiacetylcholine receptor antibody titers and the occurrence of myasthenia gravis in thymoma patients. METHODS: Subjects were 31 of 44 patients with thymoma undergoing thymothymectomy at Tokyo Women's Medical University Hospital between 1987 to 1999 in whom antiacetylcholine receptor antibody titers were measured preoperatively. We studied postoperative changes in antiacetylcholine receptor antibody titers and the presence or absence of myasthenia gravis. RESULTS: Eight patients were positive for antiacetylcholine receptor antibody preoperatively, suggesting the presence of subclinical myasthenia gravis. Neither postoperative changes in antiacetylcholine receptor antibody titers nor the occurrence of myasthenia gravis was observed in these 8 patients. Recurrent thymoma and rapid elevation of antiacetylcholine receptor antibody titers were observed postoperatively in 1 patient negative for antiacetylcholine receptor antibody preoperatively, resulting in manifestation of myasthenia gravis symptoms. CONCLUSION: We found no correlation between preoperative titers and myasthenia gravis symptoms. Rapid titer elevation indicates the occurrence of myasthenia gravis symptoms or the recurrence of thymoma.
UI - 11569925
AU - Shiraishi J; Utsuyama M; Akashi T; Nemoto T; Ohashi K; Akamatsu H;
TI - Sunamori M; Kitagawa M; Hirokawa K Immunohistological analysis of thymoma by molecules differentially expressed in the thymic cortex and medulla, and its application in the differential diagnosis of thymoma from esophageal and lung cancer.
SO - Pathol Res Pract 2001;197(9):611-9
AD - Department of Pathology and Immunology, Tokyo Medical and Dental University Graduate School, Japan.
The purpose of this study was to verify the WHO classification of thymic tumors using immunohistological methods, and to discover whether these methods can be applied to differentiate thymoma from squamous cell carcinoma (SCC) of the esophagus and the lung. Twenty-nine thymoma cases were classified according to WHO and were then immunohistologically examined for the positivity of these molecules. All thymoma cases investigated in this study were positive for IL-1R, and most of them were also positive for bek. In contrast, UH-1 was highly positive in B1 and B2 type thymomas, but negative or weakly positive in A, AB and B3 type thymomas. Twelve esophageal cancers and 21 lung cancers were also examined for the positivity of the same molecules. All esophageal cancers were negative for UH-1. Three of 12 cases were weakly positive for IL-1R, and four of these 12 cases were also weakly positive for bek. Twelve of 21 lung cancer cases were adenocarcinomas, all of them negative for IL-1R, bek and UH-1. Nine of 21 lung cancer cases were SCCs, all of them negative for UH-1. Eight of nine SCC cases were strongly positive for IL-1R, while seven of these were weakly positive for bek. We conclude that the WHO classification of thymic tumors is still valid as demonstrated by immunohistological analysis and that the positivity of UH-1, IL- 1R and bek might be helpful in differentiating thymoma from SCC of the esophagus and the lung.
UI - 11789012
AU - Martinek V; Matousovic K; Dvorak D; Bartunkova J; Stejskal J; Chadimova
TI - M [The kaleidoscope of autoimmune disorders: thymoma and systemic lupus erythematosus]
SO - Vnitr Lek 2001 Oct;47(10):715-9
UI - 11837917
AU - Mehran R; Ghosh R; Maziak D; O'Rourke K; Shamji F
TI - Surgical treatment of thymoma.
SO - Can J Surg 2002 Feb;45(1):25-30
AD - Division of Thoracic Surgery, University of Ottawa, Ont.
OBJECTIVE: To describe experience with the surgical treatment of thymoma. DESIGN: A retrospective study. Setting: A teaching hospital at the University of Ottawa. PATIENTS: Over 25 years, 42 consecutive patients (22 men, 20 women) who had a thymoma requiring operation. INTERVENTIONS: Thymectomy. OUTCOME MEASURES: Age, sex, association with myasthenia gravis, presence of a paraneoplastic syndrome, extent of surgical resection, tumour size, histologic features of the tumour, clinical staging of the thymoma and short- and long-term outcome after surgery. RESULTS: The mean (and standard deviation) age of the patients was 52.8 (12.5) years. Thirteen patients had myasthenia gravis. With respect to tumour staging, 24 patients had stage I, 7 had stage II and 11 had stage III disease. Three patients were lost to follow-up. Radiotherapy was used as an adjunct to surgical treatment in 83% of patients with stages II and III disease. Fifty-one percent of patients available for follow-up survived 175.1 months, and the cumulative 5- and 10-year overall survival rates were 87.3% and 81.4% respectively. Only 1 patient died of metastatic thymoma. Complete or partial remission of myasthenia gravis was seen in 10 (77%) affected patients. Mixed cellular histologic features and a tumour size of less than 115 cm3 were more commonly seen with stage I disease. CONCLUSIONS: Thymomas are characterized by slow growth and prolonged survival even in patients with invasive disease as long as the tumour is resected completely and treatment is accompanied by radiotherapy.
UI - 11783072
AU - Lin D; Lu N; Zhang R
TI - [An analysis of clinicopathologic features affecting prognosis of thymoma]
SO - Zhonghua Zhong Liu Za Zhi 2001 Jan;23(1):57-9
AD - Cancer Institute (Hospital), Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100021, China.
OBJECTIVE: To discuss the relationship between the clinicopathologic characteristics and prognosis of thymoma. METHODS: One hundred and thirty cases of thymoma were analyzed in terms of myasthenia gravis(MG), tumor size, necrosis, mitosis, capsule, histologic type according to the Lattes-Bernatz(L-B) classification and Muller-Hermelink(M-H) classification, staging according to Masaoka. RESULTS: Association with MG, size of tumor, necrosis, mitosis and L-B classification were of no prognostic significance. The survival rate was higher in patients with a well encapsulated tumor. According to the M-H subtypes, the prognosis was better in patients in medullary type than in patients with cortical type thymoma. In patients with well-differentiated thymic carcinoma(WDTC), their 5-year survival rate was 43.4%, and none survived at 10 years. The survival of patients decreased with the increase in clinical stage of the disease. Cell atypia and invasion of neighboring organs were of prognostic impact on survival. CONCLUSION: Histologic typing according to M-H classification and clinical staging according to Masaoka, cell atypia and invasion to neighboring organs are of prognostic value in patients with thymoma.
UI - 11766079
AU - Sasaki H; Yukiue H; Kobayashi Y; Nakashima Y; Moriyama S; Kaji M;
TI - Kiriyama M; Fukai I; Yamakawa Y; Fujii Y Elevated serum vascular endothelial growth factor and basic fibroblast growth factor levels in patients with thymic epithelial neoplasms.
SO - Surg Today 2001;31(11):1038-40
AD - Department of Surgery II, Nagoya City University Medical School, Nagoya, Japan.
Neovascularization, an essential event for the growth of solid tumors, is regulated by a number of angiogenic factors, among which vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF), are considered to exert potent angiogenic activity. In this study, we investigated whether serum VEGF and bFGF levels could be predictors of the development and extension of thymic epithelial neoplasms. The subjects of this study were 37 patients with thymoma, 6 with thymic carcinoma, and 23 healthy volunteers. Serum samples were collected before clinical treatment. Serum VEGF levels were significantly (P < 0.05) elevated in the patients with thymic carcinoma (1,080 +/- 1,185pg/ml) compared with those in the healthy volunteers (407 +/- 589 microg/ml). Serum bFGF levels were also significantly (P < 0.05) elevated in the patients with thymic carcinoma (2740 +/- 631 pg/ml) compared with those in the healthy volunteers (1728 +/- 1,192 pg/ml). However, the serum VEGF and bFGF levels did not significantly differ between the patients with thymoma and the healthy volunteers. Serum VEGF and bFGF levels did not significantly differ according to the stage and pathological subtype of thymoma. Moreover, there was no correlation between the serum levels of VEGF and those of bFGF. Thus, while serum VEGF and bFGF levels may serve as markers for thymic epithelial tumors, it is unlikely that circulating VEGF and bFGF could be used as markers for assessing the progression of thymoma tumors.
UI - 11220734
AU - Yu Z; Kryzer TJ; Griesmann GE; Kim K; Benarroch EE; Lennon VA
TI - CRMP-5 neuronal autoantibody: marker of lung cancer and thymoma-related autoimmunity.
SO - Ann Neurol 2001 Feb;49(2):146-54
AD - Department of Immunology, Mayo Clinic, Rochester, MN 55905, USA.
We have defined a new paraneoplastic immunoglobulin G (IgG) autoantibody specific for CRMP-5, a previously unknown 62-kd neuronal cytoplasmic protein of the collapsin response-mediator family. CRMP-5 is in adult central and peripheral neurons, including synapses, and in small-cell lung carcinomas. Since 1993, our Clinical Neuroimmunology Laboratory has detected CRMP-5-IgG in 121 patients among approximately 68,000 whose sera were submitted for standardized immunofluorescence screening because a subacute neurological presentation was suspected to be paraneoplastic. This makes CRMP-5 autoantibody as frequent as PCA-1 (anti-Yo) autoantibody, second only to ANNA-1 (anti-Hu). Clinical information, obtained for 116 patients, revealed multifocal neurological signs. Most remarkable were the high frequencies of chorea (11%) and cranial neuropathy (17%, including 10% loss of olfaction/taste, 7% optic neuropathy). Other common signs were peripheral neuropathy (47%), autonomic neuropathy (31%), cerebellar ataxia (26%), subacute dementia (25%), and neuromuscular junction disorders (12%). Spinal fluid was inflammatory in 86%, and CRMP-5-IgG in 37% equaled or significantly exceeded serum titers. Lung carcinoma (mostly limited small-cell) was found in 77% of patients; thymoma was in 6%. Half of those remaining had miscellaneous neoplasms; all but two were smokers. Serum IgG in all cases bound to recombinant CRMP-5 (predominantly N-terminal epitopes), but not to human CRMP-2 or CRMP-3.
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