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一种由鳞状细胞癌和AB型胸腺瘤组成的罕见复合型胸腺癌：一例罕见病例报告

An unusual combined thymic carcinoma composed of squamous cell carcinoma and type AB thymoma: a rare case report.

作者信息

Jiang Yufeng, Liu Yang, Shi Xiuying, Mao Xiaoyun, Zhao Yang, Fan Chuifeng

机构信息

Department of Pathology, First Affiliated Hospital and College of Basic Medical Sciences of China Medical University, 110001, Shenyang, China.

97K Seven-year Program of Medicine, China Medical University, 110001, Shenyang, China.

出版信息

Diagn Pathol. 2017 Jan 17;12(1):9. doi: 10.1186/s13000-016-0590-3.

DOI:10.1186/s13000-016-0590-3
PMID:28095872
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5240224/
Abstract

BACKGROUND

Combined thymic carcinoma is a malignant neoplasm of the thymus recently added to the 4th edition of the World Health Organization (WHO) classification of tumors of the lung, pleura, thymus and heart. It involves at least one type of thymic carcinoma and another thymic epithelial tumor. The previously used term "combined thymic epithelial tumor" has been abandoned.

CASE PRESENTATION

Here, we present an unusual case of combined thymic carcinoma of the thymus in a 44-year-old male who had suffered from fever, chest pain, chest tightness and shortness of breath. Magnetic resonance imaging (MRI) detected a mass approximately 6.4 cm × 4.2 cm in the anterior mediastinum, and a nonencapsulated tumor approximately 5.0 cm × 3.5 cm × 2.5 cm with an irregular shape was resected. The morphological features and the immunostaining pattern of the tumor revealed it to be an unusual combined thymic carcinoma consisting of type AB thymoma and squamous cell carcinoma. There were cysts of various sizes, some of which had crack-like structures, in the type AB thymoma area. A gradual transition could be seen between these structures and the squamous cell carcinoma, indicating that the carcinoma portion may have originated from the composition of the thymoma.

CONCLUSIONS

Combined thymic carcinoma composed of type AB thymoma and squamous cell carcinoma is rare, and the carcinoma portion may have originated from epithelial structures in the type AB thymoma.

摘要

背景

复合性胸腺癌是胸腺的一种恶性肿瘤，最近被纳入世界卫生组织（WHO）肺、胸膜、胸腺和心脏肿瘤分类第4版。它涉及至少一种胸腺癌和另一种胸腺上皮肿瘤。之前使用的术语“复合性胸腺上皮肿瘤”已被弃用。

病例报告

在此，我们报告一例44岁男性的不寻常的胸腺复合性胸腺癌病例，该患者有发热、胸痛、胸闷和气短症状。磁共振成像（MRI）检测到前纵隔有一个约6.4 cm×4.2 cm的肿块，切除了一个大小约为5.0 cm×3.5 cm×2.5 cm、形状不规则的无包膜肿瘤。肿瘤的形态学特征和免疫染色模式显示其为一种不寻常的复合性胸腺癌，由AB型胸腺瘤和鳞状细胞癌组成。在AB型胸腺瘤区域有大小不一的囊肿，其中一些有裂隙样结构。这些结构与鳞状细胞癌之间可见逐渐过渡，表明癌部分可能起源于胸腺瘤的成分。

结论

由AB型胸腺瘤和鳞状细胞癌组成的复合性胸腺癌罕见，癌部分可能起源于AB型胸腺瘤中的上皮结构。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f615/5240224/25c0795d4ad8/13000_2016_590_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f615/5240224/898602bb094e/13000_2016_590_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f615/5240224/a1f11b597288/13000_2016_590_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f615/5240224/9a9f047e6117/13000_2016_590_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f615/5240224/093e64b52155/13000_2016_590_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f615/5240224/75636a7862de/13000_2016_590_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f615/5240224/25c0795d4ad8/13000_2016_590_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f615/5240224/898602bb094e/13000_2016_590_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f615/5240224/a1f11b597288/13000_2016_590_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f615/5240224/9a9f047e6117/13000_2016_590_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f615/5240224/093e64b52155/13000_2016_590_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f615/5240224/75636a7862de/13000_2016_590_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f615/5240224/25c0795d4ad8/13000_2016_590_Fig6_HTML.jpg

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Successful diagnosis of a combined thymic epithelial tumor by endobronchial ultrasound-guided transbronchial needle aspiration.
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Comprehensive genomic analysis reveals clinically relevant molecular distinctions between thymic carcinomas and thymomas.全面的基因组分析揭示了胸腺癌和胸腺瘤之间具有临床意义的分子差异。
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