Lowenthal R M, Gumpel J M, Kreel L, McLaughlin J E, Skeggs D B
Thorax. 1974 Sep;29(5):553-8. doi: 10.1136/thx.29.5.553.
, , 553-558. Following recent reports of an unusual mediastinal tumour described as `mediastinal endocrine neoplasm of probable thymic origin, related to carcinoid tumour' (Rosai and Higa, 1972), a further case, in a 72-year-old man, has been studied. Polyarthropathy was the presenting feature, and the patient also had clubbing of the fingers and clinical evidence of a probable proximal myopathy and a peripheral neuropathy. These non-metastatic systemic manifestations have not previously been described with this type of tumour. By retrograde thymic venography the tumour was conclusively shown to be arising in the thymus, as had been suspected but not proven in previously described cases. Histologically the typical picture, including areas of cells with true rosette formation and cells with argyrophil granules, was seen. In contrast to the more usual thymic tumours, this type of neoplasm responds poorly to radiotherapy, but surgical treatment may give good results. Therefore, in a situation where the possibility of carcinoid tumour of the thymus exists, it is imperative that tissue be obtained for histological diagnosis before any therapeutic decision is made.
继最近有报道称一种不寻常的纵隔肿瘤被描述为“可能起源于胸腺的纵隔内分泌肿瘤,与类癌肿瘤相关”(罗萨伊和希加,1972年)之后,对一名72岁男性的另一例病例进行了研究。多关节病是主要表现,该患者还伴有手指杵状指以及可能存在近端肌病和周围神经病变的临床证据。此前尚未有关于此类肿瘤出现这些非转移性全身表现的描述。通过逆行胸腺静脉造影,最终证实肿瘤起源于胸腺,这在之前描述的病例中虽有怀疑但未得到证实。组织学检查可见典型图像,包括有真正玫瑰花结形成的细胞区域和有嗜银颗粒的细胞。与更常见的胸腺肿瘤不同,这种肿瘤对放疗反应不佳,但手术治疗可能会取得良好效果。因此,在存在胸腺类癌肿瘤可能性的情况下,在做出任何治疗决定之前,必须获取组织进行组织学诊断。