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Thymic epithelial neoplasms with rhabdomyomatous component: a clinicopathological and immunohistochemical study of 7 cases. Hum Pathol 2019; 83:100-105. [DOI: 10.1016/j.humpath.2018.08.027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Revised: 08/23/2018] [Accepted: 08/29/2018] [Indexed: 11/20/2022]
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2
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den Bakker MA, Marx A, Mukai K, Ströbel P. Mesenchymal tumours of the mediastinum--part II. Virchows Arch 2015; 467:501-17. [PMID: 26358060 PMCID: PMC4656710 DOI: 10.1007/s00428-015-1832-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Revised: 08/06/2015] [Accepted: 08/11/2015] [Indexed: 02/06/2023]
Abstract
This is the second part of a two-part review on soft tissue tumours which may be encountered in the mediastinum. This review is based on the 2013 WHO classification of soft tissue tumours and the 2015 WHO classification of tumours of the lung, pleura, thymus and heart and provides an updated overview of mesenchymal tumours that have been reported in the mediastinum.
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Affiliation(s)
- Michael A den Bakker
- Department of Pathology, Maasstad Ziekenhuis, PO Box 9100, 3007, AC, Rotterdam, The Netherlands.
- Department of Pathology, Erasmus MC, Rotterdam, The Netherlands.
| | - Alexander Marx
- Institute of Pathology, University Medical Center Mannheim, University of Heidelberg, Heidelberg, Germany
| | - Kiyoshi Mukai
- Department of Diagnostic Pathology, Saiseikai Central Hospital, Tokyo, Japan
| | - Philipp Ströbel
- Department of Pathology, Universitätsmedizin Göttingen, Göttingen, Germany
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3
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Mesenchymal tumours of the mediastinum--part I. Virchows Arch 2015; 467:487-500. [PMID: 26358059 PMCID: PMC4656709 DOI: 10.1007/s00428-015-1830-8] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Revised: 08/06/2015] [Accepted: 08/11/2015] [Indexed: 12/11/2022]
Abstract
The mediastinum is an anatomically defined space in which organs and major blood vessels reside with surrounding soft tissue elements. The thymus is an important organ in the mediastinum, and many of the masses encountered in the mediastinum are related to this organ. Most neoplasms diagnosed in the mediastinum are epithelial tumours (thymomas and thymic carcinomas), lymphomas or germ cell tumours. In contrast, soft tissue tumours of the mediastinum are rare. In 1963, Pachter and Lattes systematically reviewed soft tissue pathology of the mediastinum, covering the hitherto described [2, 226, 227] In this review, based on the 2013 WHO classification of soft tissue tumours and the 2015 WHO classification of tumours of the lung, pleura, thymus and heart, we provide an updated overview of mesenchymal tumours that may be encountered in the mediastinum.
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Dutta R, Kumar A, Kannan U, Bhalla AP, Kaushal S, Julka PK. Surgically treated aggressive mediastinal sarcoma: a tumor of possible thymic origin. Gen Thorac Cardiovasc Surg 2011; 59:65-7. [PMID: 21225406 DOI: 10.1007/s11748-010-0602-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2009] [Accepted: 02/18/2010] [Indexed: 10/18/2022]
Abstract
True sarcoma of thymus has no epithelial component. This tumor behaves aggressively with invasion of adjacent structures. Only a few anecdotal case reports of this tumor are found in the English-language literature, and they describe a poor outcome. This case report describes a rapidly growing thymic sarcoma diagnosed at an advanced stage with a compressive effect on the heart. The tumor was resected en bloc with adjacent invaded structures.
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Affiliation(s)
- Roman Dutta
- Department of Surgical Disciplines, All India Institute of Medical Sciences, New Delhi 110029, India
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5
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Starost MF, Tsang K, Zerfas PM, Stratakis CA. A rhabdomyoma within a multilocular thymic cyst in a p53-null mouse. Vet Pathol 2010; 47:132-6. [PMID: 20080493 DOI: 10.1177/0300985809353175] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A 9-month-old p53-null female mouse was found dead in its cage. At necropsy, a large thymic mass encompassed the heart. Microscopically, the mass was composed of numerous varying-sized cysts lined with simple squamous epithelial cells to columnar ciliated cells. Also present within this mass was a large aggregate of loosely arranged fusiform-shaped cells. These cells also were found in smaller numbers in the connective tissue surrounding the cysts. The larger aggregate of fusiform cells was positive for desmin and S-100 and negative for smooth muscle actin. Electron microscopy revealed well-formed Z lines and I bands of skeletal muscle phenotype. A diagnosis of rhabdomyoma within a congenital multilocular thymic cyst was made. The thymus contains a small population of myoid cells, which should be taken in consideration when evaluating thymic tumors.
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Affiliation(s)
- M F Starost
- Division of Veterinary Resources, National Institutes of Health, 9000 Rockville Pike, Bethesda, MD 20892, USA.
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6
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Abstract
Cutaneous metastases have been reported in 5%-10% of patients with internal malignancy. The most common clinical features are the sudden appearance of discrete, firm, and nontender nodules in a particular area of the body. The most frequent metastatic site of extraskeletal osteosarcoma (ESOS) is the lungs. Cutaneous metastasis of ESOS is rare. To our knowledge, only one case of ESOS has been reported with skin metastasis, histopathologically classified as the osteoblastic subtype. Here, we describe a case of chondroblastic ESOS arising in the mediastinum with metastasis to the skin. Our patient presented with a scalp nodule after diagnosis of primary ESOS at the mediastinum.
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den Bakker MA, Oosterhuis JW. Tumours and tumour-like conditions of the thymus other than thymoma; a practical approach. Histopathology 2009; 54:69-89. [DOI: 10.1111/j.1365-2559.2008.03177.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Inai K, Takagi K, Takimoto N, Okada H, Imamura Y, Ueda T, Naiki H, Noriki S. Multiple inflammatory cytokine-productive ThyL-6 cell line established from a patient with thymic carcinoma. Cancer Sci 2008; 99:1778-84. [PMID: 18691242 PMCID: PMC11159824 DOI: 10.1111/j.1349-7006.2008.00897.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Thymic epithelial cells can produce many kinds of cytokines, and interleukin (IL)-6-producing thymic carcinoma cases have been reported. However, a cytokine-producing human thymic tumor cell line has not previously been established. In this paper, we report a novel, multiple inflammatory cytokine-productive cell line that was established from a patient with thymic carcinoma. This cell line, designated ThyL-6, positively expressed epithelial membrane antigen, cytokeratins, vimentin intermediate filament and CD5, although hematological markers were not present in the cells. Cytokine antibody array analysis showed that the cells secreted several cytokines including IL-1alpha, IL-6, IL-8, RANTES, soluble TNFalpha-receptor 1, VEGF and CTLA into the culture medium. The addition of ThyL-6-cultured supernatant supported the growth of human myeloma ILKM-3 cells, which require the presence of IL-6 in the culture medium for the maintenance of cell growth, suggesting that the secreted IL-6 from ThyL-6 cells was biologically active. Chromosome analysis demonstrated that ThyL-6 cells had complex karyotype anomalies, including der(16)t(1;16); the latter has been recognized in thymic squamous cell carcinoma and thymic sarcomatoid carcinoma cases, as well as in several other kinds of malignancies. Heterotransplantation of the cells into nude mice showed tumorigenesis with neutrophil infiltration and liquefactive necrosis. These findings suggest that ThyL-6 cells will provide us with a new experimental tool for investigating not only the pathogenesis, biological behavior, chromo-somal analysis and therapeutic reagents of human thymic carcinoma, but also for studying cytokine-chemokine network systems.
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Affiliation(s)
- Kunihiro Inai
- Division of Molecular Pathology, Department of Pathological Sciences, Faculty of Medical Sciences, Univeristy of Fukui, Fukui 910-1193, Japan
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Moran CA, Suster S. Thymic Carcinoma: Current Concepts and Histologic Features. Hematol Oncol Clin North Am 2008; 22:393-407. [PMID: 18514123 DOI: 10.1016/j.hoc.2008.03.002] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Cesar A Moran
- Department of Anatomic Pathology, The University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA
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Kashiwabara K, Ikota H, Tanaka S, Ohta C, Yajima T, Endoh H, Yamaki E, Kuwano H, Nakajima T. Thymoma with ganglioneuroblastomatous component: case report. Virchows Arch 2007; 452:319-24. [DOI: 10.1007/s00428-007-0544-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2007] [Revised: 10/30/2007] [Accepted: 10/31/2007] [Indexed: 10/22/2022]
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Laeng RH, Eimoto T, Kuo TT, Zettl A, Marx A, Moschopulos M, Tateyama H, Shimokawa K. Corpuscular thymoma: Entity or variant of organotypical thymomas WHO B2/B3? Pathol Res Pract 2006; 202:697-704. [PMID: 16887284 DOI: 10.1016/j.prp.2006.06.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2006] [Accepted: 06/06/2006] [Indexed: 11/24/2022]
Abstract
Hassall's corpuscles are regular structures in the medulla of the normal thymus and in non-neoplastic thymic conditions, e.g. in multilocular thymic cysts. In thymomas, however, they are inconsistently found, and are believed to indicate medullary differentiation of WHO type B1-3 thymomas. We present five organotypical thymomas resembling WHO type B2 and B3 thymomas, but with an abundance of Hassall's corpuscles. We wonder whether this exceedingly rare observation might herald a distinct entity. Four tumors were asymptomatic, incidental findings and of low Masaoka stage (I or II) [20] . One patient suffered from myasthenia gravis which disappeared upon surgical removal of the thymus, while all other patients had no concomitant autoimmune disease. Two patients had a relapse-free follow-up of 12 and 2 years, respectively, upon curative surgery, and another tumor was an autopsy finding; follow-up data of two more recent cases was not yet available. The neoplastic epithelium other than Hassall's corpuscles was arranged either in a cortical type B2 pattern or in type B3 solid cords. In all examples, there was cyst formation, inflammatory reaction and repair, indicative of a long-standing condition. Immature T cells were present in all instances. "Corpuscular thymomas" morphologically resemble WHO type B2 and B3 thymomas, but appear biologically indolent and are rarely associated with myasthenia gravis. Whether they qualify for a separate entity has to be proven by larger series, including genetic studies.
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Affiliation(s)
- R Hubert Laeng
- Department of Pathology, Kantonsspital, CH-5001 Aarau, Switzerland.
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Abstract
Thymic carcinomas are rare tumors thought to derive from thymic epithelium. Because of the complex embryological origin of the thymus, whose development includes contributions from the third and, to a lesser extent, the fourth pharyngeal pouches, thymic carcinomas are endowed with great morphologic heterogeneity. A large number of histologic types have been described that resemble tumors arising in other organs. Unfortunately, no definitive pathognomonic histological features or immunohistochemical markers are associated with these tumors, making them a real challenge for diagnosis. Because of their close similarity with tumors arising at other organs, the diagnosis of thymic carcinoma must be regarded, for the most part, as a diagnosis of exclusion. This review will focus on current criteria for diagnosis of these tumors, with a review of the various histopathologic appearances that they can adopt.
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Affiliation(s)
- Saul Suster
- Department of Pathology, The Ohio State University and James Cancer Center, Columbus, Ohio 43210, USA.
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Chang A, Schuetze SM, Conrad EU, Swisshelm KL, Norwood TH, Rubin BP. So-called "inflammatory leiomyosarcoma'': a series of 3 cases providing additional insights into a rare entity. Int J Surg Pathol 2005; 13:185-95. [PMID: 15864383 DOI: 10.1177/106689690501300210] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Inflammatory leiomyosarcoma, a rare entity first described in 1995, has been characterized by smooth muscle differentiation, a near-haploid karyotype, and a surprisingly good prognosis. The morphology is similar to that of conventional leiomyosarcoma admixed with a chronic inflammatory infiltrate. Thus far, only 15 cases have been reported in the English language literature. We report the clinical and pathological features of 3 additional cases of inflammatory leiomyosarcoma. Two women (ages 64 and 25, respectively) and 1 man (age 32) presented with a thigh, ovary, and lung mass, respectively. Inflammatory symptoms, such as anorexia, fever, night sweats, abdominal pain, and diarrhea, coincided with the thigh and ovarian primaries. Immunohistochemical studies revealed diffuse positivity for desmin and poor expression for other smooth muscle and skeletal muscle markers (muscle-specific actin [0/3], alpha-smooth muscle actin 1/3 [focal], calponin [1/3], caldesmon [0/3], and myogenin [0/3]). CD68 was diffusely positive in both the histiocytes and spindle cell component in all cases. Ultrastructural evaluation of 1 case (lung primary) lacked definitive smooth muscle differentiation. Cytogenetic analysis in 1 of 2 cases that were karyotyped, identified a near-haploid karyotype, which has been reported in other cases of inflammatory leiomyosarcoma. The other case showed 2 clonal populations of cells with interstitial deletions of the short arm of chromosome 8 and the long arm of chromosome 9, respectively. The case without cytogenetic data was intimately associated with an ovarian mature teratoma. These data also suggest that inflammatory leiomyosarcoma may lack smooth muscle differentiation, characterized by diffuse immunoreactivity for desmin but lack of immunoreactivity for alpha-smooth muscle actin, calponin, and caldesmon. In addition, 2 of the 3 cases developed distant metastases to the lungs, which suggests that these lesions may have a worse prognosis than previously believed.
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Affiliation(s)
- Anthony Chang
- Department of Pathology, University of Washington Medical Center, Seattle, WA 98195, USA
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Rzhaninova AA, Gornostaeva SN, Goldshtein DV. Isolation and phenotypical characterization of mesenchymal stem cells from human fetal thymus. Bull Exp Biol Med 2005; 139:134-40. [PMID: 16142296 DOI: 10.1007/s10517-005-0231-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Stem cells from human fetal thymus ectomesenchyma capable of forming colonies during in vitro culturing were isolated and characterized. Selection of culturing conditions showed that the growth and phenotypical characteristics of these cultures depended on seeding density and presence of basic fibroblast growth factor in the medium. After nonspecific inhibition of proliferation clonogenic cultures of thymic mesenchymal stem cells differentiated into myoblasts, formed characteristic myotubes, and expressed specific myogenesis markers. Colonies of thymic mesenchymal stem cells differentiated into chondrogenic, osteogenic, and adipogenic lines under conditions described for bone marrow mesenchymal stem cells. Cytofluorometric analysis of surface epitopes of thymic mesenchymal stem cells showed that the majority of cells expressed mesenchymal markers Thy-1, CD44, and CD105. Testing for CD34, CD38, CD45, and HLA-DR were negative in all cases. The main cell population (70-95%) did not express MHCl antigens during long-term culturing.
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Affiliation(s)
- A A Rzhaninova
- Institute of Stem Cell and Cell Technologies, Moscow, Russia.
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Chalabreysse L, Etienne-Mastroianni B, Adeleine P, Cordier JF, Greenland T, Thivolet-Bejui F. Thymic carcinoma: a clinicopathological and immunohistological study of 19 cases. Histopathology 2004; 44:367-74. [PMID: 15049903 DOI: 10.1111/j.1365-2559.2004.01796.x] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
AIMS To study 19 cases of primary thymic carcinoma in order to define the clinicopathological features and the precise histochemical profile of this rare and heterogeneous group of tumours of the anterior mediastinum. METHODS AND RESULTS The study group consisted of 13 males and six females, with a mean age of 58.5 years (range 29-75 years). Superior vena cava syndrome and chest pain were the main presenting symptoms. Three patients were asymptomatic. No patient had myasthenia gravis. Six different histological types were identified: neuroendocrine tumours (six patients), epidermoid carcinoma (five patients), sarcomatoid carcinoma (three patients), lymphoepithelioma-like carcinoma (two patients), mucoepidermoid carcinoma, clear cell carcinoma, and undifferentiated carcinoma (one patient each). The clear cell carcinoma was associated with a thymic cyst. No association with thymoma was observed. Surgical resection, performed in 10 cases, was complete in two. Sixteen patients received thoracic radiation, and 11 received systemic chemotherapy. Follow-up information was available in 16 cases; 12 patients presented with local or metastatic relapse, and 10 patients died of their tumour. The overall 5-year survival was 14.5%. CONCLUSION Primary thymic carcinoma is a very heterogeneous group of tumours of the anterior mediastinum with an aggressive clinical behaviour, and a poor overall prognosis.
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Abstract
Myoid cells have been described in the thymus in association with a variety of benign and malignant conditions. The presence of a benign rhabdomyomatous component in a malignant primary thymic epithelial neoplasm, however, is extremely rare. A case of poorly differentiated carcinoma of the thymus arising in the posterior mediastinum containing a prominent rhabdomyomatous component is described. The patient, a 70-year-old woman, was seen for a large posterior mediastinal mass. An open chest biopsy revealed an extensively necrotic tumor composed of islands of atypical cells with vesicular nuclei and prominent nucleoli with numerous mitotic figures admixed with abortive glandular structures. Interspersed with the malignant epithelial components were islands of large cells containing brightly eosinophilic cytoplasm and small, round, excentrically placed nuclei. Immunohistochemical studies showed strong positivity of the epithelial cells for cytokeratin and strong positivity of the myoid cells for pan-actin, desmin, and myogenin. The possible relationship of the rhabdomyomatous component of this tumor with the myoid cells of the thymus is discussed.
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