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]

Differential Diagnosis

Differential diagnosis of thymomas types A, AB, B and thymic carcinomas.[1]

Thymoma must be differentiated from other diseases such as:

  • Thymic masses
  • Thymic Cyst: It is incidental mass that may be congenital or acquired. It might contain parathyroid or salivary tissue, as they has 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 tumors, uncommon and present 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.

  • Teratomas: Represents two thirds of mediastinal germ cell tumor. Usually benign, but when malignant, it's very aggressive and very poor prognosis.
  • Dermoid cysts: Very rare tumor, only 118 cases have been reported.[2]
  • Malignant germ cell tumor: 90% of malignant mediastinal germ cell tumor occur in males. Full physical examination and scrotal ultrasound is required.
  • Seminomas: Slightly more common, grow slowly but might reach large sizes.
  • Non-seminomatous germ cell tumor: Consists of yolk sac tumor, embryonal cell carcinoma, and/or choriocarcinoma. Commonly between 20-40 years of age.


  • Lymphoma (terrible, could be middle or posterior mediastinal too)

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 as fever weight loss and night sweats and may also have other symptoms as chest pain, wheezing, dyspnea or superior vena cava syndrome.

Presents with shortness of breath or dysphagia.

References

  1. "http://www.iarc.fr/en/publications/pdfs-online/pat-gen/bb10/BB10.pdf" (PDF). External link in |title= (help)
  2. Ripa, LW. (1992). "Rinses for the control of dental caries". Int Dent J. 42 (4 Suppl 1): 263–9. PMID 1399044. Unknown parameter |month= ignored (help)

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