Thymoma diagnostic study of choice
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Shyam Patel [2] Associate Editor(s)-in-Chief: Khuram Nouman, M.D. [2]
Overview
Thymoma can be largely diagnosed by using radiological techniques.
Diagnostic Study of Choice
Study of Choice
- Posterior-anterior (PA) and lateral x-ray of the chest are helpful in diagnosing most of the thymomas.
- Among the patients who present with clinical signs of myasthenia gravis (MG), CT scan is the test of choice for the diagnosis of thymoma.
- CT scan with IV contrast and MRI are helpful in determining the vascularity of the thymoma and helps in safe surgical removal of large tumors.
- PET scan is very valuable in diagnosing the cases of invasive malignant thymoma.[1]
- Thallium 201 single photon emission computed tomography is useful to distinguish normal thymic tissue from hyperplastic tissue or thymoma
- Ultrasonically guided core needle biopsy is used to obtain larger tissue specimens for histological examination.
- Annessi and colleagues were able to diagnose thymoma in all patients who had undergone anterior mediastinal core needle biopsy by ultrasonic guidance with a sensitivity and specificity of 100%.
Staging
- The thymic epithelial tumor staging system was initially proposed by Bergh and his colleagues in 1978, modified by Wilkins and Castleman in 1979, and further developed by Masaoka et al. in 1981.[2][3][4][5]
- Modified Masaoka staging grouped with TNM classification is the most widely adopted system for thymic epithelial tumors currently in use.
Modified Masaoka Clinical Staging of Thymoma
| Stage | Description |
|---|---|
| I |
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| II |
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| III |
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| IV |
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TNM Classification of Thymic Epithelial Tumors
| T/N/M Stage | Description | |
|---|---|---|
| T | T1 |
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| T2 |
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| T3 |
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| T4 |
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| N | N0 | |
| N1 | ||
| N2 |
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| N3 | ||
| M | M0 | |
| M1 | ||
| Masaoka Stage | T | N | M |
|---|---|---|---|
| Stage I | T1 | N0 | M0 |
| Stage II | T2 | N0 | M0 |
| Stage III | T3 | N0 | M0 |
| Stage IVa | T4 | N0 | M0 |
| Stage IVb | Any T | N1, N2, or N3 | M0 |
| Any T | Any N | M1 |
Previously Reported Staging System
| Stage | Description |
|---|---|
| I |
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| II |
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| III |
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| IVa |
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| IVb |
| Author | Stage | Description |
|---|---|---|
| Bergh et al. | I | |
| II |
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| III |
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| Wilkins et al. | I | |
| II |
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| III |
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References
- ↑ Scagliori E, Evangelista L, Panunzio A, Calabrese F, Nannini N, Polverosi R; et al. (2015). "Conflicting or complementary role of computed tomography (CT) and positron emission tomography (PET)/CT in the assessment of thymic cancer and thymoma: our experience and literature review". Thorac Cancer. 6 (4): 433–42. doi:10.1111/1759-7714.12197. PMC 4511321. PMID 26273398.
- ↑ 2.0 2.1 Wilkins, EW.; Castleman, B. (1979). "Thymoma: a continuing survey at the Massachusetts General Hospital". Ann Thorac Surg. 28 (3): 252–6. PMID 485626. Unknown parameter
|month=ignored (help) - ↑ 3.0 3.1 Bergh, NP.; Gatzinsky, P.; Larsson, S.; Lundin, P.; Ridell, B. (1978). "Tumors of the thymus and thymic region: I. Clinicopathological studies on thymomas". Ann Thorac Surg. 25 (2): 91–8. PMID 626543. Unknown parameter
|month=ignored (help) - ↑ 4.0 4.1 Masaoka, A.; Monden, Y.; Nakahara, K.; Tanioka, T. (1981). "Follow-up study of thymomas with special reference to their clinical stages". Cancer. 48 (11): 2485–92. PMID 7296496. Unknown parameter
|month=ignored (help) - ↑ Kondo, K. (2005). "Invited commentary". Ann Thorac Surg. 80 (6): 2000–1. doi:10.1016/j.athoracsur.2005.08.053. PMID 16305832. Unknown parameter
|month=ignored (help) - ↑ Masaoka, A.; Yamakawa, Y.; Niwa, H.; Fukai, I.; Saito, Y.; Tokudome, S.; Nakahara, K.; Fujii, Y. (1994). "Thymectomy and malignancy". Eur J Cardiothorac Surg. 8 (5): 251–3. PMID 8043287.
- ↑ Sinha Hikim AP, Hoffer AP (1987). "Quantitative analysis of germ cells and Leydig cells in rat made infertile with gossypol". Contraception. 35 (4): 395–408. PMID 3621939.
- ↑ Tsuchiya R, Koga K, Matsuno Y, Mukai K, Shimosato Y (1994). "Thymic carcinoma: proposal for pathological TNM and staging". Pathol Int. 44 (7): 505–12. PMID 7921194.