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Thymoma with Pseudosarcomatous Stroma

Authors
 Tae Woong Noh  ;  Se Hoon Kim  ;  Beom Jin Lim  ;  Woo Ick Yang  ;  Kyung Young Chung 
Citation
 YONSEI MEDICAL JOURNAL, Vol.42(5) : 571-575, 2001 
Journal Title
YONSEI MEDICAL JOURNAL
ISSN
 0513-5796 
Issue Date
2001
MeSH
Humans ; Immunohistochemistry ; Male ; Microscopy, Electron ; Middle Aged ; Sarcoma/pathology* ; Stromal Cells/pathology* ; Thymoma/pathology* ; Thymoma/surgery ; Thymus Neoplasms/pathology* ; Thymus Neoplasms/surgery
Keywords
Thymoma ; pseudosarcomatous stroma ; immunohistochemistry ; electron microscopy
Abstract
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 world wide. 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 × 8 × 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.
Files in This Item:
T200101699.pdf Download
DOI
10.3349/ymj.2001.42.5.571
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
Yonsei Authors
Kim, Se Hoon(김세훈) ORCID logo https://orcid.org/0000-0001-7516-7372
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/142156
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