Department of Pathology, The First Affiliated Hospital, Sun Yat-sen University, 58, Zhongshan Road II, Guangzhou 510080, China.
Diagn Pathol. 2014 Jan 20;9:8. doi: 10.1186/1746-1596-9-8.
In rare condition, combined thymic epithelial tumors showing either type A or type B thymomas areas combined with thymic carcinoma components may occur in thymus. Mucoepidermoid carcinoma (MEC) of the thymus is rare in thymic carcinoma, and so far there is no report to describe a combined epithelial tumor of thymus with MEC component. We report an unusual case of combined thymic MEC/type B2 thymoma in a middle-aged male occurring in a mass of anterior mediastinum.
A 51-year-old Chinese male patient presented with a 6-month history of right ptosis and progressive muscle weakness. Computed tomography (CT) examination revealed a solitary, well-circumscribed mass was in the anterior mediastinum with mild heterogeneous enhancement. Histologically, the mass contained two separated components and displayed typically histological features of low-grade MEC and type B2 thymoma, respectively. There was no gradual transition of these two components observed in mass, and no enlarged lymph node was found in the surrounding tissues. A diagnosis of combined thymic MEC/type B2 thymoma was made. The patient received thymectomy to resect the mass totally. After surgery, chemotherapy with regiments of cisplatin and mitomycin, and radiotherapy of the main tumor bed were performed on the patient. There was no evidence of tumor recurrence during the period of 12 months follow-up.
To our best knowledge, this is the first report of combined thymic epithelial tumor with MEC component. Although this tumor is rare, the diagnosis of a thymic MEC should be taken into consideration when a combined epithelial tumor is occasionally encountered in thymus.
The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/9721397571157894.
在罕见情况下,胸腺中可能发生同时显示 A 型或 B 型胸腺瘤区域和胸腺癌成分的联合胸腺上皮肿瘤。胸腺黏液表皮样癌(MEC)在胸腺癌中很少见,迄今为止尚无描述具有 MEC 成分的联合胸腺上皮肿瘤的报道。我们报告了一例罕见的中年男性前纵隔肿块中发生的伴有 MEC 成分的联合胸腺 MEC/ B2 胸腺瘤病例。
一名 51 岁的中国男性患者因右侧上睑下垂和进行性肌无力病史 6 个月就诊。计算机断层扫描(CT)检查显示前纵隔内有一个孤立的、边界清楚的肿块,轻度不均匀增强。组织学上,该肿块包含两个分离的成分,分别显示出典型的低级别 MEC 和 B2 胸腺瘤的组织学特征。在肿块中没有观察到这两个成分的逐渐过渡,周围组织中也没有发现肿大的淋巴结。诊断为伴有 MEC 的联合胸腺 B2 胸腺瘤。患者接受了胸腺切除术以完全切除肿块。手术后,患者接受了顺铂和丝裂霉素的化疗以及主肿瘤床的放疗。在 12 个月的随访期间,没有发现肿瘤复发的证据。
据我们所知,这是首例伴有 MEC 成分的联合胸腺上皮肿瘤的报告。尽管这种肿瘤很少见,但在偶尔遇到胸腺上皮肿瘤时,应考虑诊断为胸腺 MEC。