Thymic carcinoma classification: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Thymic carcinoma}} | {{Thymic carcinoma}} | ||
{{CMG}}; {{AE}} {{ | {{CMG}}; {{AE}} {{Marjan}} | ||
==Overview== | ==Overview== | ||
Thymic carcinomas may be classified according to a histological grading system into either low grade subtypes or high grade subtypes.<ref name="Suster-1991">{{Cite journal | last1 = Suster | first1 = S. | last2 = Rosai | first2 = J. | title = Thymic carcinoma. A clinicopathologic study of 60 cases. | journal = Cancer | volume = 67 | issue = 4 | pages = 1025-32 | month = Feb | year = 1991 | doi = | PMID = 1991250 }}</ref>. Primary thymic carcinomas are rare malignant neoplasms of the mediastinum, and combined thymic carcinomas are even less common. Although tumor stage is the single most important prognostic factor in thymoma, a combination of stage and histologic subtype should be considered in predicting survival. | Thymic carcinomas may be classified according to a histological grading system into either low grade subtypes or high grade subtypes.<ref name="Suster-1991">{{Cite journal | last1 = Suster | first1 = S. | last2 = Rosai | first2 = J. | title = Thymic carcinoma. A clinicopathologic study of 60 cases. | journal = Cancer | volume = 67 | issue = 4 | pages = 1025-32 | month = Feb | year = 1991 | doi = | PMID = 1991250 }}</ref>. Primary thymic carcinomas are rare malignant neoplasms of the mediastinum, and combined thymic carcinomas are even less common. Although tumor stage is the single most important prognostic factor in thymoma, a combination of stage and histologic subtype should be considered in predicting survival. | ||
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:** This subtype of thymic carcinoma is the most common and exhibits atypia with a clear-cut aspect of [[keratinization]] with [[Keratin 1|keratin]] pearls as seen in squamous cell carcinomas. | :** This subtype of thymic carcinoma is the most common and exhibits atypia with a clear-cut aspect of [[keratinization]] with [[Keratin 1|keratin]] pearls as seen in squamous cell carcinomas. | ||
:** Squamous cell carcinoma lack of capsule and presents with [[necrosis]] and [[hemorrhage]]. | |||
:* '''Basaloid carcinoma:''' | |||
:** This subtype consists of solid lobules of tumor cells with marginal palisading, without keratinization and a [[basophilic]] pattern due to an elevated [[nuclear]]:[[cytoplasmic]] ratio. | :** This subtype consists of solid lobules of tumor cells with marginal palisading, without keratinization and a [[basophilic]] pattern due to an elevated [[nuclear]]:[[cytoplasmic]] ratio. | ||
:* '''Mucoepidermoid carcinoma:''' | :* '''Mucoepidermoid carcinoma:''' | ||
:** The characteristic features for this rare subtype is the presence of [[squamous cell|squamous c]]<nowiki/>[[squamous cell|ell]]<nowiki/>s and [[mucus]] producing cell<nowiki/>s, with moderate nuclear atypia. | :** The characteristic features for this rare subtype is the presence of [[squamous cell|squamous c]]<nowiki/>[[squamous cell|ell]]<nowiki/>s and [[mucus]] producing cell<nowiki/>s, with moderate nuclear atypia. | ||
:** It has a mucinous macroscopic appearance. | :** It has a mucinous macroscopic appearance. | ||
:* '''Lymphoepithelioma-like carcinoma:''' | :* '''Lymphoepithelioma-like carcinoma:''' | ||
Latest revision as of 18:40, 10 September 2019
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Thymic carcinoma classification On the Web |
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Risk calculators and risk factors for Thymic carcinoma classification |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Marjan Khan M.B.B.S.[2]
Overview
Thymic carcinomas may be classified according to a histological grading system into either low grade subtypes or high grade subtypes.[1]. Primary thymic carcinomas are rare malignant neoplasms of the mediastinum, and combined thymic carcinomas are even less common. Although tumor stage is the single most important prognostic factor in thymoma, a combination of stage and histologic subtype should be considered in predicting survival.
Classification
- Thymic carcinomas may be classified according to a histological grading system into either low grade subtypes or high grade subtypes, which include:[1]
- Squamous cell carcinoma:
- This subtype of thymic carcinoma is the most common and exhibits atypia with a clear-cut aspect of keratinization with keratin pearls as seen in squamous cell carcinomas.
- Squamous cell carcinoma lack of capsule and presents with necrosis and hemorrhage.
- Basaloid carcinoma:
- This subtype consists of solid lobules of tumor cells with marginal palisading, without keratinization and a basophilic pattern due to an elevated nuclear:cytoplasmic ratio.
- Mucoepidermoid carcinoma:
- The characteristic features for this rare subtype is the presence of squamous cells and mucus producing cells, with moderate nuclear atypia.
- It has a mucinous macroscopic appearance.
- Lymphoepithelioma-like carcinoma:
- The morphology of this subtype resembles the nasopharingeal lymphoepitelioma, with syncytial growth of undifferentiated malignant cells.
- Lymphoepithelioma-like carcinoma:
- Sarcomatoid carcinoma (carcinosarcoma):
- It is also known as spindle cell thymic carcinoma, is an infiltrative neoplasm with large areas of coagulative necrosis and without a capsule.
- It is an uncommon tumor that affects patients between 40-80 years old.
- Sarcomatoid carcinoma (carcinosarcoma):
- Clear cell carcinoma:
- Consist of cells with minimal nuclear atypia with a characteristic lucent cytoplasm and a lobulated architecture without sinusoidal vasculature (in contrast with the renal clear cell carcinoma)
- Clear cell carcinoma:
- Papillary adenocarcinoma:
- It has a tubulopapillary pattern growth with cuboidal cells and psammoma bodies may be present.
- Type A thymoma may be the origin of this subtype of carcinoma due an expression of malignant transformation.
- Papillary adenocarcinoma:
- Carcinoma with t(15;19) translocation:
- It is an aggressive tumor with a translocation t(15;19)(q13:p13.1 ) that has the characteristic presence of undifferentiated cells with high mitotic activity and squamous morphology.
- Carcinoma with t(15;19) translocation:
- Neuroendocrine Carcinomas:
- The neuroendocrine thymic carcinomas are classified in 4 categories: typical, atypical, small cell, and large cell carcinomas.
- The typical and atypical are categorized as well differentiated neuroendocrine carcinomas, and the small cell and large cell carcinomas are categorized as poorly differentiated.
- The neuroendocrine thymic carcinomas are classified in 4 categories: typical, atypical, small cell, and large cell carcinomas.
- Neuroendocrine Carcinomas:
- The table below lists the histological classification of neuroendocrine carcinomas:[2]
| Well Differentiated | Poorly Differentiated | ||
|---|---|---|---|
| Typical Carcinoid | Atypical Carcinoid | Small Cell | Large Cell |
| No necrosis; <2 mitoses per 2 mm2 (10 HPF) |
Necrosis present and/or 2-10 mitoses per 2 mm2 (10 HPF) |
Small cell cytology | Non-small cell NEC with >10 mitoses per 2 mm2 (10 HPF) |
| Morphological Variants Spindle cell type Pigmented type With amyloid (extrathyroidal medullary carcinoma) Oncocytic/oxyphilic type Mucinous Angiomatoid type Combinations of the above variants |
Variants SCNEC combined with Non-NECs |
— | |
HPF: High power field, SCNEC: Small cell neuroendocrine carcinoma, NEC: Neuroendocrine carcinoma
References
- ↑ 1.0 1.1 Suster, S.; Rosai, J. (1991). "Thymic carcinoma. A clinicopathologic study of 60 cases". Cancer. 67 (4): 1025–32. PMID 1991250. Unknown parameter
|month=ignored (help) - ↑ Travis WD, Organization WH, Cancer IA et al. Pathology and Genetics of Tumours of the Lung, Pleura, Thymus and Heart. Diamond Pocket Books (P) Ltd.; 2004.