Hashimoto Masaki, Shimizu Shigeki, Takuwa Teruhisa, Tsukamoto Yoshitane, Tsujimura Tohru, Hasegawa Seiki
Department of Thoracic Surgery, division of Surgery, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan.
Department of Pathology, Kinki University of Medicine, Osakasayama, Japan.
Surg Case Rep. 2016 Dec;2(1):116. doi: 10.1186/s40792-016-0245-3. Epub 2016 Oct 21.
An atypical type A thymoma variant was newly added to the WHO classification of type A thymoma family in 2015.
A 72-year-old female was present a large round mass in the anterior mediastinum. The radiological examination led to a preoperative diagnosis of non-invasive thymoma. Tumor resection was undertaken via median sternotomy. Complete removal of the mediastinal tumor was achieved. Pathological examination revealed that the tumor cells were spindle- and oval-shaped with atypia. Immunohistochemical work-up revealed that the tumor was type A thymoma. On the basis of these findings, the tumor was finally diagnosed to be an atypical type A thymoma variant.
Preoperative diagnosis as atypical type A thymoma variant based on radiological examination is difficult. In case of atypical type A thymoma variant, a careful postoperative systemic follow-up should be done.
2015年，一种非典型A型胸腺瘤变体被新加入世界卫生组织A型胸腺瘤家族分类中。
一名72岁女性，前纵隔出现一个大的圆形肿块。影像学检查术前诊断为非侵袭性胸腺瘤。通过正中胸骨切开术进行肿瘤切除。成功完整切除纵隔肿瘤。病理检查显示肿瘤细胞呈梭形和椭圆形，具有异型性。免疫组织化学检查显示该肿瘤为A型胸腺瘤。基于这些发现，该肿瘤最终被诊断为非典型A型胸腺瘤变体。
基于影像学检查术前诊断为非典型A型胸腺瘤变体很困难。对于非典型A型胸腺瘤变体病例，术后应进行仔细的全身随访。
