Primary Intrapulmonary Thymomas: Case Report and Review of the Literature

AB thymoma revealed by a huge intraparenchymal lung mass: a case report

Thymoma is an epithelial neoplasm of the thymus, which commonly lies in the anterior mediastinum. Unusually it can be found in other locations as well. Ectopic thymoma rarely presents as an intrathoracic tumor. We report a case of ectopic thymoma presenting as a giant right intrathoracic tumor, the patient was 51-year-old, and who was presented with heaviness in chest and breathlessness. Detailed investigation including chest computed tomography scan revealed a well-defined large solid tumor in the right thoracic cavity, in this case, immunohistochemical analysis demonstrated a thymome AB. The tumor was metastatic to the lung. Patient received a neoadjuvant chemotherapy, with favorable evolution.

Ectopic thymoma: Retrospective analysis of eight cases with clinical features and computed tomography findings

OBJECTIVE

To analyze the computed tomography (CT) and clinical features of ectopic thymoma, and to be familiar with the CT diagnosis of this disease.

MATERIALS AND METHODS

CT data, clinical data, and pathological data of eight cases of ectopic thymoma, confirmed by pathology from September 2013 to June 2019, were retrospectively analyzed.

RESULTS

Eight cases of thymoma were diagnosed, which included three in mediastinum (one of B1 type, two of C type), two in pericardium (both of B3 type), one in lung (B1 type), one in pleura (AB type), and one in right atrium (B2 type). Among the eight cases, four were men and four were women, aged 36-70 years. The clinical manifestations were chest tightness, shortness of breath and cough, and one case of myasthenia gravis. Six of the 8 patients were misdiagnosed as lymphoma, solitary fibrous tumor, malignant teratoma by CT. CT showed the following: the long diameter of tumor was 4.2 cm-19.5 cm, the shape was elliptical or round, and one case of ectopic thymoma grew in the atrium. The density was homogeneous in two cases and heterogeneous in six cases. The boundary was clear in three cases and unclear in five cases. Among the eight cases, three showed pleural effusion, two showed pericardial effusion and three showed calcification.

CONCLUSIONS

Ectopic thymoma is rare and often misdiagnosed due to abnormal position. However, CT findings of ectopic thymoma are similar to those of the anterior superior mediastinal thymoma.

Bilateral multiple intrapulmonary nodules: a puzzled and rare disease

Primary intrapulmonary spindle cell thymomas (PISCT) are rare lesions that may be mistaken for a variety of benign and malignant epithelial or mesenchymal tumors. It is thought as one subtype of primary intrapulmonary thymomas (PIT). To the best of our knowledge, no bilateral multiple primary intrapulmonary spindle thymomas and treatment had been reported in literature. We fortunately diagnosed and managed this unique case, which might provide some experience for physicians who were interested in this disease.

Differential diagnosis of primary intrapulmonary thymoma: a report of two cases

Primary intrapulmonary thymomas (PITs), which are intrapulmonary tumors without an associated mediastinal component, are very rare. The diagnosis of a PIT can be difficult. Here, we report two cases of resected PITs that were difficult to differentiate from other lung tumors. The patients, of a 62-year-old man and a 64-year-old woman, had no significant symptoms and were both referred to our hospital due to the presence of an abnormal shadow on chest computed tomography (CT). The patients underwent ¹⁸F-fluorodeoxyglucose positron emission tomography-CT (FDG-PET/CT) and subsequently tumor excision. A PIT was confirmed histopathologically in the surgical specimens from both patients. In one case, the tumor consisted of a type A thymoma without abnormal FDG uptake. In the other case, the tumor consisted of a type B2 thymoma presenting with weak FDG uptake. This report thus documents two cases of PITs with different histopathologic and FDG-PET/CT findings. Thoracoscopic surgery is essential in the differential diagnosis between PITs and other lung tumors.

Primary intrapulmonary thymoma

Primary intrapulmonary thymoma (PIT), which is an intrapulmonary tumor without an associated mediastinal component, is rare. We herein report a resected case of PIT in a 55-year-old female who presented with a 2.5 × 2.4 cm mass in the left upper lobe. We also summarize the clinicopathological features and discuss the diagnosis, pathogenesis, and treatment of PIT.