Thymoma
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| Thymoma | |
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| Thymoma: A bottle-shaped tumor is encapsulated and shows a bulging, rather homogeneous, faintly lobulated ivory-colored cut surface. Image courtesy of Professor Peter Anderson DVM PhD and published with permission © PEIR, University of Alabama at Birmingham, Department of Pathology | |
| ICD-10 | C37.9, D60 |
| ICD-9 | 164.0, 212.6 |
| ICD-O: | 8580 |
| DiseasesDB | 13067 |
| MedlinePlus | 001086 |
| MeSH | D013945 |
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Thymoma Microchapters |
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Diagnosis |
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Case Studies |
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Thymoma On the Web |
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American Roentgen Ray Society Images of Thymoma |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Michael Maddaleni, B.S.
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Overview
Historical Perspective
Pathophysiology
Epidemiology & Demographics
Risk Factors
Screening
Causes
Differentiating Thymoma
Complications & Prognosis
Diagnosis
History and Symptoms | Physical Examination | Staging | Laboratory tests | Electrocardiogram | X Rays | CT | MRI Echocardiography or Ultrasound | Other images | Alternative diagnostics
Treatment
Medical therapy | Surgical options | Primary prevention | Secondary prevention | Financial costs | Future therapies
Diagnosis
When a thymic mass is identified, the made is achieved with histology (obtaining a tissue sample of the mass). When a thymoma is suspected, a CT/CAT scan is generally performed to estimate the size of the tumor, and can be biopsied with a CT-guided needle. There is a small risk of pneumomediastinum, mediastinitis and the risk of damaging the heart or large blood vessels. The final diagnosis is made by removing the thymus. Pathological investigation of the specimen will reveal if the tumor was benign or malignant, although the initial biopsy is usually indicative.[1]
The tumor is generally located inside the thymus, and can be calcified. Increased vascular enhancement can be indicative of malignancy, as can be pleural deposits.[1]
If the suspicion is high, some blood tests are often performed to look for associated problems or possible spread. These include: full blood count, protein electrophoresis, antibodies to the acetylcholine receptor (indicative of myasthenia), electrolytes, liver enzymes and renal function.[1]
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CT shows Thymoma (Image courtesy of RadsWiki and copylefted)
Pathophysiology
Thymoma originates from the epithelial cell population in the thymus. Many subtypes are recognized, some of which have a better- or worse-than-general prognosis.[1]
Treatment
Surgery is the mainstay of treatment. If the tumor was benign and was removed completely, no further therapy is necessary. Removal of the thymus in adults does not appear to induce a severe immune deficiency. In children, however, added care and scrupulous vaccination are necessary to protect from infections. Malignant tumors may need additional treatment with radiotherapy, or sometimes with chemotherapy (cyclophosphamide, doxorubicin and cisplatin).[1]
Prognosis
Thymomas associated with autoimmune disorders usually are benign. Malignant thymomas can metastasize, generally to pleura, kidney, bone, liver or brain.[1]
Epidemiology
Men and women are equally affected. The typical age at diagnosis is 30-40, although cases have been described in every age group.[1]