[Pathology] Atlas of Thymic Epithelial Neoplasms (part 3)

[Pathology] Atlas of Thymic Epithelial Neoplasms (part 3), Thymic Epithelial Neoplasms, Atlas of Mediastinal Pathology


Part 2: [Pathology] Atlas of Thymic Epithelial Neoplasms (part 2)

Fig. 2.20 Spindle-cell thymoma can often undergo cystic degenerative
changes. In this particular example, the tumor is characterized by multiple
 small cystic spaces, resulting in a reticular pattern of growth

Fig. 2.21 Spindle-cell thymoma with reticular and microcystic growth
patterns. Notice that the cells in the walls of the cysts are small and
spindled and there are scattered small lymphocytes admixed with the
cells and in the cystic lumina  


Fig. 2.22 Spindle-cell thymoma with microcystic growth pattern.
Higher magnifi cation shows that the microcystic spaces correspond to
abortive perivascular spaces. Notice the central vessel in the larger cyst
on the left

Fig. 2.23 Another variation on the topic of microcystic thymoma
shows a dense spindle-cell proliferation dotted by numerous small
empty spaces suggestive of adipocytes on scanning magnification.
Notice the scattering of small lymphocytes admixed with the spindle
cells in the background

Fig. 2.24 Higher magnification from spindle-cell thymoma with
microcysts shows small empty lumina scattered among the spindle cells
that contain a rare small lymphocyte. The cells lack the features of adipocytes but may also not be recognized as perivascular spaces because
of the absence of a centrally located vessel

Fig. 2.25 Another aspect of spindle-cell thymoma with a microcystic
growth pattern shows evenly spaced small cystic cavities surrounded by
bland-appearing monotonous spindle-cell proliferation  


Fig. 2.26 Higher magnification from microcystic spindle-cell thymoma
 shows that the small cystic spaces contain small lymphocytes  

Fig. 2.27 A spindle-cell thymoma with a macrocystic growth pattern
shows numerous small dilated perivascular spaces that have focally
coalesced to form larger, macrocystic spaces. The process can advance
to form a large multicystic mass that can be grossly confused for a multilocular thymic cyst  


Fig. 2.28 A spindle-cell thymoma with a hemangiopericytoma-like
growth pattern is characterized by multiple branching vascular spaces
with open lumina surrounded by a dense spindle-cell population. On
cursory examination, tumors with these features can be mistaken for
solitary fibrous tumors or monophasic synovial sarcomas  


Fig. 2.29 A different appearance of spindle-cell thymoma with a

hemangiopericytoma-like growth pattern shows dilated, anastomosing,
and branching vascular spaces lined by round to oval cells simulating
hemangiopericytoma  



Suggested Reading

Chalabreysse L, Roy P, Cordier J-F, Loire R, Gamondes JP, ThivoletBejui F. Correlation of the WHO schema for the classification of thymic epithelial neoplasms with prognosis: a retrospective study of 90 tumors. Am J Surg Pathol. 2002;26:1605–11.

Choi WWL, Lui YH, Lau WH, Crowley P, Khan A, Chan JK. Adenocarcinoma of the thymus: report of two cases, including a previously undescribed mucinous subtype. Am J Surg Pathol. 2003;27:124–30.

Hasserjian RP, Klimstra DS, Rosai J. Carcinoma of the thymus with clear cell features: report of eight cases and a review of the literature. Am J Surg Pathol. 1995;19:835–41.

Kalhor N, Suster S, Moran CA. Spindle cell thymoma with prominent papillary and pseudopapillary features: A clinicopathologic study of 10 cases. Am J Surg Pathol. 2011;35:372–7.

Koga K, Matsuno Y, Noguchi M, Mukai K, Asamura H, Goya T, Shimosato Y. A review of 79 thymomas: modification of staging system and reappraisal of conventional division into invasive and non-invasive thymoma. Pathol Int. 1994;44:359–67.

Matsuno Y, Morozumi N, Hirosashi S, Shimosato Y, Rosai J. Papillary carcinoma of the thymus. Report of four cases of a new microscopic type of thymic carcinoma. Am J Surg Pathol. 1998;22:873–80.

Moran CA, Suster S. Mucoepidermoid carcinomas of the thymus. Clinicopathologic study of 6 cases. Am J Surg Pathol. 1995;19:826–34.

Moran CA, Suster S. Thymoma with prominent cystic and hemorrhagic changes and areas of necrosis and infarction. A clinicopathologic study of 25 cases. Am J Surg Pathol. 2001;25:1086–90.

Moran CA, Suster S. Ancient (sclerosing) thymomas. A clinicopathologic study of 10 cases. Am J Clin Pathol. 2004;121:867–71.

Moran CA, Suster S. Thymic carcinoma: current concepts and histologic features. Hematol Oncol Clin North Am. 2008;22:393–407.

Moran CA, Kalhor N, Suster S. Invasive spindle cell thymomas (WHO type A): a clinicopathologic correlation of 41 cases. Am J Clin Pathol. 2010;134:793–8.

Pan CC, Chen WY, Chiang H. Spindle cell and mixed spindle/lymphocytic thymomas: an integrated clinicopathologic and immunohistochemical study of 81 cases. Am J Surg Pathol. 2001;25:111–20.

Rieker RJ, Hoegel J, Morresi-Hauf A, Hofmann WJ, Blaeker H, Penzel R, Otto HF. Histologic classification of thymic epithelial tumors: comparison of established classifications schemes. Int J Cancer. 2002;98:900–6.

Shimosato Y, Kameya T, Nagai K, Suemasu K. Squamous cell carcinoma of the thymus: an analysis of 8 cases. Am J Surg Pathol. 1997;1:109–21.

Snover DC, Levine GD, Rosai J. Thymic carcinoma: five distinctive histological variants. Am J Surg Pathol. 1982;6:451–70.

Suster S, Rosai J. Thymic carcinoma: a clinicopathologic study of 60 cases. Cancer. 1991;67:1025–32.

Suster S, Rosai J. Cystic thymomas: clinicopathologic study of 10 cases. Cancer. 1992;69:92–7.

Suster S, Moran CA. Primary thymic epithelial neoplasms with combined features of thymoma and  thymic carcinoma. A clinicopathologic study of 22 cases. Am J Surg Pathol. 1996;20:1469–80. 

Suster S, Moran CA, Chan JKC. Thymoma with pseudosarcomatous stroma. Report of an unusual histologic variant of thymic epithelial neoplasms that may simulate carcinosarcoma. Am J Surg Pathol. 1997;21:1316–23.

Suster S, Moran CA. Thymic carcinoma: spectrum of differentiation and histologic types. Pathology. 1998;30:111–22. 

Suster S, Moran CA. Thymoma, atypical thymoma and thymic carcinoma. A novel conceptual approach to the classifi cation of neoplasms of thymic epithelium. Am J Clin Pathol. 1999a;111:826–33.

Suster S, Moran CA. Spindle cell carcinoma of the thymus. Clinicopathologic and immunohistochemical study of 15 cases of a novel form of thymic carcinoma. Am J Surg Pathol. 1999b;23:691–700.

Suster S, Moran CA. Micronodular thymoma with lymphoid B-cell hyperplasia. Clinicopathologic and immunohistochemical study of 18 cases of a distinctive morphologic variant of thymic epithelial
neoplasm. Am J Surg Pathol. 1999c;23:955–62.

Suster S, Moran CA. Primary thymic epithelial neoplasms: spectrum of differentiation and histologic features. Semin Diagn Pathol. 1999d;16:2–17.

Suster S. Thymic carcinoma: update of current diagnostic criteria and histologic types. Semin Diagn Pathol. 2005;22:198–212. 

Suster S, Moran CA. Thymoma classification: current status and future trends. Am J Clin Pathol. 2006;125:542–54.

Suster S, Moran CA. Classification of thymoma: the WHO and beyond. Hematol Oncol Clin North Am. 2008;22:381–92. 

Suster S, Moran CA. The mediastinum. In: Weidner N, Cote R, Suster S, Weiss LM, editors. Modern surgical pathology. 2nd ed. Philadelphia: W.B. Saunders; 2009. p. 454–516.

Travis WD, Brambilla E, Burke AP, Marx A, Nicholson AG. Pathology and genetics. Tumors of the lung, pleura, thymus, and heart. In: World Health Organization classification of tumors. Lyon: IARC
Press; 2015.

Wu T-C, Kuo T-T. Study of Epstein-Barr virus RNA (EBER-1) expression by in-situ hybridization in thymic epithelial tumors of Chinese patients in Taiwan. Hum Pathol. 1993;24:235–8.

This is only a part of the book : Atlas of Mediastinal Pathology  of authors: Saul Suster. If you want to view the full content of the book and support author. Please buy it here: https://www.amazon.com/Atlas-Mediastinal-Pathology-Anatomic/dp/149392673X

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CLINICAL ATLAS,118,DERMATOLOGY ATLAS,10,EMERGENCY ATLAS,44,HAEMATOLOGY ATLAS,23,HUMAN ANATOMY,1,MICROBIOLOGY ATLAS,66,PARASITOLOGY ATLAS,4,PATHOLOGY ATLAS,22,PEDIATRIC ATLAS,42,STDs,19,SUBCLINICAL ATLAS,116,
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