Thymoma differential diagnosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Amr Marawan, M.D. [2] Ahmad Al Maradni, M.D. [3]
Overview
Thymoma must be differentiated from other diseases such as thymic carcinoma, thymic cyst, thymic hyperplasia and germ cell tumors.
Differential Diagnosis
Thymoma must be differentiated from other diseases such as:
- Thymic masses
- Thymic cyst: It is an incidental mass that may be congenital or acquired. It might contain parathyroid or salivary tissue, as they have a common embryological origin.
- Thymic hyperplasia: Resected only if associated paraneoplastic syndrome.
- Thymolipoma: Increased thymic size with mixed adipose tissue.
- Thymic carcinoma: Rare thymic tumor, poor survival rate, high rate of recurrence. Sometimes called type C thymoma.
- Thymic carcinoid: Also called thymic neuroendocrine tumor, uncommon and presents as a mass in the anterior mediastinum.
- Ectopic parathyroid tissue
- Germ cell tumors
- The most common site of extragonadal germ cell tumors is the mediastinum.
- Germ cell tumors include:
- Teratomas: Represents two thirds of mediastinal germ cell tumors. Usually benign, but when malignant, it's very aggressive and has a very poor prognosis.
- Dermoid cysts: Very rare tumor, only 118 cases have been reported.[1]
- Malignant germ cell tumor: 90% of malignant mediastinal germ cell tumors occur in males. A full physical examination and scrotal ultrasound is required.
- Seminomas: Slightly more common, grows slowly but might reach large sizes.
- Non-seminomatous germ cell tumor: Consists of yolk sac tumors, embryonal cell carcinoma, and/or choriocarcinoma. Commonly occurs between 20 and 40 years of age.
- Lymphoma (anterior mediatinal lymphoma, also known as terrible lymphoma, may be middle or posterior mediastinal)
- Nodular sclerosing Hodgkin’s lymphoma and primary mediastinal B-cell lymphoma are the two common types that present in the mediastinum.
- Usually has systemic symptoms such as fever, weight loss, and night sweats and may also have other symptoms as chest pain, wheezing, dyspnea or superior vena cava syndrome.
- Thyroid (intrathyroid goiter)
- Grave's disease and Hashimoto's thyroiditis are usually associated with goiter.
- Presents with shortness of breath or dysphagia.
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