Kim Na Rae, Lee Jae Ik, Ha Seung Yeon
Department of Pathology, Gachon University Gil Medical Center, Incheon, Korea.
Korean J Pathol. 2013 Aug;47(4):392-4. doi: 10.4132/KoreanJPathol.2013.47.4.392. Epub 2013 Aug 26.
Herein, we report a case of micronodular thymoma with lymphoid stroma in a previously healthy 73-year-old male. Thymectomy was performed. The solid and macrocystic masses were encapsulated with focal invasion. The solid portion consisted of nodules of bland-looking spindle or round epithelial cells in lymphoid stroma containing prominent germinal centers. The epithelial cells had moderate amount of cytoplasm and occasional mucin production. The cystic portion was lined with cuboidal epithelium. According to World Health Organization (WHO) classification, the mass was diagnosed as a micronodular thymoma with lymphoid stroma accompanied by a pre-existing multilocular thymic cyst. Micronodular thymoma with lymphoid stroma, a possible variant of type A thymoma, is an extremely rare tumor. This so-called "unusual" variant may imply the schematic weakness of the current WHO classification that cannot cover all morphologic types. Further study is recommended for clarification of this variant and its incorporation into the current classification.
在此,我们报告一例73岁既往健康男性的微结节型胸腺瘤伴淋巴样间质。患者接受了胸腺切除术。实性和大囊实性肿块有包膜,伴局灶性浸润。实性部分由外观温和的梭形或圆形上皮细胞结节构成,位于含有显著生发中心的淋巴样间质中。上皮细胞有中等量的细胞质,偶尔产生黏液。囊性部分内衬立方形上皮。根据世界卫生组织(WHO)分类,该肿块被诊断为微结节型胸腺瘤伴淋巴样间质,同时存在一个多房性胸腺囊肿。微结节型胸腺瘤伴淋巴样间质,可能是A型胸腺瘤的一种变体,是一种极其罕见的肿瘤。这种所谓的“不寻常”变体可能意味着当前WHO分类存在框架性缺陷,无法涵盖所有形态学类型。建议进一步研究以阐明该变体并将其纳入当前分类。