Kaminuma Yasunori, Tanahashi Masayuki, Yukiue Haruhiro, Suzuki Eriko, Yoshii Naoko, Fujino Toshio, Ogawa Hiroshi, Niwa Hiroshi
Division of Thoracic Surgery, Respiratory Disease Center, Seirei Mikatahara General Hospital, 3453, Mikatahara-cho, Kita-ku Hamamatsu, Shizuoka, Japan.
Department of Pathology, Seirei Mikatahara General Hospital, 3453, Mikatahara-cho, Kita-ku Hamamatsu, Shizuoka, Japan.
J Med Case Rep. 2019 Mar 16;13(1):69. doi: 10.1186/s13256-019-2006-y.
Micronodular thymoma with lymphoid stroma is a rare subtype of thymoma. Here we report a case of micronodular thymoma with lymphoid stroma that was completely resected after incomplete resection 10 years earlier.
A 70-year-old Japanese woman who had undergone resection for a thymic cyst 10 years earlier was found to have a solid nodule with a multilocular lesion at the site of the previous operation. We suspected that the tumor was a malignant tumor and performed trans-sternal radical thymectomy and diagnosed the lesion as micronodular thymoma with lymphoid stroma pathologically. When we reassessed the thymic cyst that had been resected 10 years earlier, a few lesions of micronodular thymoma with lymphoid stroma were found in the cyst wall. Based on these findings, we concluded that only the cystic component of micronodular thymoma with lymphoid stroma had been removed, and that the residual lesion grew locally over the next 10 years before being completely resected by reoperation.
We experienced an unusual case of micronodular thymoma with lymphoid stroma, which is a rare subtype of thymoma. Greater care should be taken to exclude a thymoma with a cystic lesion, even if a thymic cyst is strongly suspected on computed tomography and magnetic resonance imaging.
微结节型伴淋巴样间质胸腺瘤是胸腺瘤的一种罕见亚型。在此，我们报告一例微结节型伴淋巴样间质胸腺瘤病例，该病例在10年前不完全切除后进行了完整切除。
一名70岁日本女性，10年前因胸腺囊肿接受了切除术，此次在先前手术部位发现一个实性结节伴多房性病变。我们怀疑该肿瘤为恶性肿瘤，遂行胸骨正中根治性胸腺切除术，术后病理诊断为微结节型伴淋巴样间质胸腺瘤。当我们重新评估10年前切除的胸腺囊肿时，在囊肿壁上发现了一些微结节型伴淋巴样间质胸腺瘤病灶。基于这些发现，我们得出结论，10年前仅切除了微结节型伴淋巴样间质胸腺瘤的囊性成分，残余病灶在接下来的10年里局部生长，随后通过再次手术得以完整切除。
我们遇到了一例不寻常的微结节型伴淋巴样间质胸腺瘤病例，这是胸腺瘤的一种罕见亚型。即使在计算机断层扫描和磁共振成像上强烈怀疑为胸腺囊肿，也应更加谨慎地排除伴有囊性病变的胸腺瘤。
