Departments of Pathology, Mount Sinai Hospital and Icahn School of Medicine, New York City, New York.
Department of Pathology, Medical College of Wisconsin, Milwaukee, Wisconsin.
J Am Soc Cytopathol. 2020 Sep-Oct;9(5):346-358. doi: 10.1016/j.jasc.2020.04.006. Epub 2020 May 4.
Thymic epithelial neoplasms are rare tumors derived from thymic epithelium that most often present as large anterior mediastinal masses. The vast majority of thymic epithelial neoplasms fall under the diagnostic category of thymoma, with a smaller percentage qualifying for a diagnosis of thymic carcinoma. The ability to render a definitive diagnosis on these tumors is generally hampered by their deep location and close proximity to vital structures, which makes biopsy sampling for histopathologic evaluation difficult. In recent years, the trend in medicine has been to opt for the least invasive procedure to obtain tissue samples that, by definition, implies also obtaining smaller and smaller biopsies, resulting in lesser amounts of tissue available for examination. In the mediastinum, the most common modalities for procuring biopsy samples from mass lesions include fine-needle aspiration, percutaneous core needle biopsy and video-assisted thoracoscopic biopsy. In this review, we will deal only with the role and limitations of percutaneous core biopsies in the interpretation of thymic epithelial neoplasms.
胸腺上皮肿瘤是来源于胸腺上皮的罕见肿瘤，多表现为前纵隔大肿块。绝大多数胸腺上皮肿瘤属于胸腺瘤的诊断范畴，只有较小比例的肿瘤符合胸腺癌的诊断。由于这些肿瘤位置深，与重要结构毗邻，使得活检取样进行组织病理学评估变得困难，因此通常难以对这些肿瘤做出明确诊断。近年来，医学的发展趋势是选择创伤最小的方法获取组织样本，根据定义，这也意味着获取的活检样本越来越小，用于检查的组织量也越来越少。在纵隔，从肿块病变中获取活检样本的最常见方法包括细针抽吸、经皮核心针活检和电视辅助胸腔镜活检。在本综述中，我们仅讨论经皮核心活检在解读胸腺上皮肿瘤中的作用和局限性。
