Pathologic Finding of Tymic Carcinoma Accompanied by Myasthenia Gravis
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Background and Purpose Te World Health Organization (WHO) has classifed thymic carcinoma and other thymomas (types A, AB, and B) as diferent neoplasms. Myasthenia gravis (MG) is an early sign of thymoma and theoretically does not accompany thymic carcinoma; however, cases of thymic carcinoma with MG have been reported. Whether thymic carcinoma can accompany MG has yet to be established. Methods Te medical records of patients who underwent thymectomy for MG between 1990 and 2011 in a single hospital were reviewed. All cases with the diagnostic code of “thymic carcinoma” or “thymoma type C” (old terminology) were selected. A pathologist re-reviewed the pathologic specimens using the new WHO criteria. Te rate of thymic carcinoma among these MG patients was then calculated. Results A total of 81 patients with MG had thymic tumors, 10 of whom had thymic carcinomas or thymoma type C. Seven cases of well-diferentiated thymic carcinomas (type B3) were excluded, leaving three (3.7%) cases of thymic carcinoma with MG. All three of these cases were type B3 thymoma with a focal squamous cell carcinoma component that was very small and well demarcated. In addition, two out of the three tumors were found to be at an early clinical stage. All of the cases survived without recurrence over follow-up periods of at least 5 years. Conclusions Tymic carcinoma transformation from thymoma can occur during the early stages of thymoma. Te association of this condition with MG is not as rare as was previously thought. Tymic carcinomas accompanying MG had a predominant B3 thymoma component with a focal thymic carcinoma area (squamous cell carcinoma).
Abstract
Background and Purpose Te World Health Organization (WHO) has classifed thymic carcinoma and other thymomas (types A, AB, and B) as diferent neoplasms. Myasthenia gravis (MG) is an early sign of thymoma and theoretically does not accompany thymic carcinoma; however, cases of thymic carcinoma with MG have been reported. Whether thymic carcinoma can accompany MG has yet to be established. Methods Te medical records of patients who underwent thymectomy for MG between 1990 and 2011 in a single hospital were reviewed. All cases with the diagnostic code of “thymic carcinoma” or “thymoma type C” (old terminology) were selected. A pathologist re-reviewed the pathologic specimens using the new WHO criteria. Te rate of thymic carcinoma among these MG patients was then calculated. Results A total of 81 patients with MG had thymic tumors, 10 of whom had thymic carcinomas or thymoma type C. Seven cases of well-diferentiated thymic carcinomas (type B3) were excluded, leaving three (3.7%) cases of thymic carcinoma with MG. All three of these cases were type B3 thymoma with a focal squamous cell carcinoma component that was very small and well demarcated. In addition, two out of the three tumors were found to be at an early clinical stage. All of the cases survived without recurrence over follow-up periods of at least 5 years. Conclusions Tymic carcinoma transformation from thymoma can occur during the early stages of thymoma. Te association of this condition with MG is not as rare as was previously thought. Tymic carcinomas accompanying MG had a predominant B3 thymoma component with a focal thymic carcinoma area (squamous cell carcinoma).
참고문헌 (20)
- Marulli G, "Surgical and neurologic outcomes after robotic thymectomy in 100 consecutive patients with myasthenia gravis", J Thorac Cardiovasc Surg, 145, pp.730~735 (2013)
- Goldstein SD, "Assessment of robotic thymectomy using the Myasthenia Gravis Foundation of America Guidelines", Ann Thorac Surg, 89, pp.1080~1085 (2010)
- Seong YW, "Early clinical outcomes of robot-assisted surgery for anterior mediastinal mass: its superiority over a conventional sternotomy approach evaluated by propensity score matching", Eur J Cardiothorac Surg, 45, pp.e68~e73 (2014)
- Ettinger DS, "Thymomas and thymic carcinomas: Clinical Practice Guidelines in Oncology", J Natl Compr Canc Netw, 11, pp.562~576 (2013)
- Müller-Hermelink HK, "Pathology and genetics:tumours of the lung, pleura, thymus, and heart", pp.148~151 (2004), IARC Press
- Marx A, "Thymoma and paraneoplastic myasthenia gravis", Autoimmunity, 43, pp.413~427 (2010)
- Yu L, "Different characteristics of thymomas with and without myasthenia gravis", Ann Surg Oncol, 19, pp.94~98 (2012)
- Marx A, "Pathology and genetics: tumours of the lung, pleura, thymus, and heart", pp.152~153 (2004), IARC Press
- Ruffini E, "Thymoma: inter-relationships among World Health Organization histology, Masaoka staging and myasthenia gravis and their independent prognostic significance: a single-centre experience", Eur J Cardiothorac Surg, 40, pp.146~153 (2011)
- Nakagawa K, "Thymoma: a clinicopathologic study based on the new World Health Organization classification", J Thorac Cardiovasc Surg, 126, pp.1134~1140 (2003)
- Kuo TT, "Thymic carcinoma arising in thymoma is associated with alterations in immunohistochemical profile", Am J Surg Pathol, 22, pp.1474~1481 (1998)
- Suster S, "Primary thymic epithelial neoplasms showing combined features of thymoma and thymic carcinoma. A clinicopathologic study of 22 cases", Am J Surg Pathol, 20, pp.1469~1480 (1996)
- Moran CA, "Thymomas I: a clinicopathologic correlation of 250 cases with emphasis on the World Health Organization schema", Am J Clin Pathol, 137, pp.444~450 (2012)
- Kirchner T, "Well-differentiated thymic carcinoma. An organotypical low-grade carcinoma with relationship to cortical thymoma", Am J Surg Pathol, 16, pp.1153~1169 (1992)
- Ströbel P, "Thymoma and thymic carcinoma: an update of the WHO Classification 2004", Surg Today, 35, pp.805~811 (2005)
- Zettl A, "Recurrent genetic aberrations in thymoma and thymic carcinoma", Am J Pathol, 157, pp.257~266 (2000)
- Ströbel P, "Thymoma and thymic carcinoma:molecular pathology and targeted therapy", J Thorac Oncol, 5(10), pp.S286~S290 (2010)
- Badve S, "Molecular analysis of thymoma", PLoS One, 7, pp.e42669~ (2012)
- Syrios J, "Advances in thymic carcinoma diagnosis and treatment: a review of literature", Med Oncol, 31, pp.44~ (2014)
- Ye B, "Surgical techniques for early-stage thymoma: video-assisted thoracoscopic thymectomy versus transsternal thymectomy", J Thorac Cardiovasc Surg, 147, pp.1599~1603 (2014)