Szołkowska Małgorzata, Langfort Renata, Roszkowski-Sliz Kazimierz
Zakład Patomorfologii, IGiChP.
Pneumonol Alergol Pol. 2005;73(2):153-9.
Thymomas are rare mediastinal tumors that have heterogeneous microscopic morphology and uncertain outcome.
The aim of the study was to evaluate the practical usefulness of WHO classification by correlation of histological subtype of thymoma with staging, symptoms and epidemiology.
87 cases of thymomas was reclassified according to the WHO Histologic classification and Masaoka staging system. Clinical symptoms, age and sex of the patient were taken into consideration in each case.
The histological subtypes was diagnosed in order of frequency: AB (n = 21; 24%), B2 (n = 19; 22%), B1 (n = 14; 16%), A (n = 6; 7%), C (n = 4; 5%), B3 (n = 3; 3%). Combined types was observed in 17 (20%) cases. Tendency to invasion increased as follows: A < AB < B1 < B2 < B3 < C. The median value of patients' age was: type A--67,5 years, type AB--62 yrs., type B1--48 yrs., type B2--52 yrs., type B3--32 yrs. and type C (thymic carcinoma)--49,5 yrs. No correlation was found between histological type and sex of patient. The most often clinical symptom--myasthenia, accompanied predominantly B2 thymomas.
The WHO classification is useful in routine pathologic examination of thymomas, because it enables to distinguish histological subtypes with different clinical representation.
胸腺瘤是罕见的纵隔肿瘤，具有异质性的微观形态且预后不确定。
本研究的目的是通过胸腺瘤组织学亚型与分期、症状及流行病学的相关性来评估世界卫生组织（WHO）分类的实际实用性。
根据WHO组织学分类和Masaoka分期系统对87例胸腺瘤进行重新分类。每例均考虑患者的临床症状、年龄和性别。
组织学亚型按频率依次诊断为：AB型（n = 21；24%）、B2型（n = 19；22%）、B1型（n = 14；16%）、A型（n = 6；7%）、C型（n = 4；5%）、B3型（n = 3；3%）。17例（20%）观察到合并类型。侵袭倾向按以下顺序增加：A＜AB＜B1＜B2＜B3＜C。患者年龄的中位数为：A型——67.5岁，AB型——62岁，B1型——48岁，B2型——52岁，B3型——32岁，C型（胸腺癌）——49.5岁。未发现组织学类型与患者性别之间存在相关性。最常见的临床症状——重症肌无力，主要伴随B2型胸腺瘤。
WHO分类在胸腺瘤的常规病理检查中有用，因为它能够区分具有不同临床表现的组织学亚型。
