Diagnosis of Cervical Thymoma by Fine Needle Aspiration Biopsy with Flow Cytometry

Ponder, T. Brent; Collins, Brian T.; Bee, Christopher S.; Silverberg, Alan B.; Grosso, Leonard E.; Dunphy, Cherie H.

doi:10.1159/000327119

Cited by 25 publications

(31 citation statements)

References 4 publications

(9 reference statements)

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“…The subtypes B1, B2 and B3 refer to the relative proportions of neoplastic epithelial cells and lymphocytes: type B1 has scanty neoplastic cells surrounded by numerous lymphocytes; type B3 is predominantly epithelial with a low number of lymphocytes, and type B2 is intermediate between B1 and B3. A description of the cytology features of ectopic thymoma by FNA has only been rarely documented [1,2,3,4,5,6,7,8,9,10,11,12,13]. To our knowledge, this is only the fourteenth case documenting the findings of cervical thymoma by FNA and the first case of subtype B3 in this location.…”

Section: Discussionmentioning

confidence: 88%

“…Thymic ectopia results from a failure of this migration, leaving remnants within the neck and thyroid gland [2]. Thymomas arising in such an ectopic location are rare and have been reported in the submandibular area, the hilar regions of lung, pleura and inferior mediastinum close to the diaphragm, but most frequently they are found in the left cervical region [1,2,3,4,5,7,8,9,11,12,13]. Such thymomas are usually situated deep in the sternocleidomastoid muscle, often in the vicinity of or sometimes within the thyroid gland [2].…”

Section: Discussionmentioning

confidence: 99%

“…The tumour commonly presents as a palpable neck mass that can be easily approached by fine needle aspiration (FNA). There are 13 cases of ectopic cervical thymomas described by aspiration smear [1,2,3,4,5,6,7,8,9,10,11,12,13]. Because of the unusual location and rare incidence, the cytologic features of ectopic cervical thymomas are often misinterpreted as thyroiditis, thyroid malignancy, metastatic tumour to lymph nodes and even soft tissue tumours [1,2,3,4,5,7,8,9,10,11,12,13,14].…”

Section: Introductionmentioning

confidence: 99%

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Ectopic Thymoma Can Mimic Benign and Malignant Thyroid Lesions on Fine Needle Aspiration Cytology: A Case Report and Literature Review

Taweevisit

Sampatanukul²,

Thorner³

2013

Acta Cytologica

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Background: Ectopic cervical thymomas are rare and there are few descriptions of the cytologic findings based on fine needle aspiration. Their appearances can be misinterpreted as either benign or malignant lesions of the thyroid. The authors report such a case occurring in a patient with Sotos syndrome, a genetic disorder characterized by somatic overgrowth and cognitive impairment. Case Report: The patient developed a neck mass that was examined first by fine needle aspiration and then by pathologic examination of the resected specimen. On fine needle aspiration, a diagnosis of papillary carcinoma of the thyroid was favoured, based on the presence of large cohesive sheets of anastomosing papillary tissue fragments with fibrovascular cores. Pathologic examination of the resection specimen showed a thymoma, subtype B3. The cytologic findings correlated with the presence of nuclear palisading of tumour cells around perivascular spaces. Conclusion: To the best of our knowledge, this histologic subtype of thymoma has never been reported in ectopic cervical thymic tissue, nor these particular cytologic findings that can lead to an erroneous diagnosis of thyroid carcinoma. Moreover, this is the first description of thymoma in association with Sotos syndrome.

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Section: Discussionmentioning

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Ectopic Thymoma Can Mimic Benign and Malignant Thyroid Lesions on Fine Needle Aspiration Cytology: A Case Report and Literature Review

Taweevisit

Sampatanukul²,

Thorner³

2013

Acta Cytologica

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“…This paper was published prior to the 1999 WHO Classification of thymic epithelial tumors. Since then, fewer than twenty cases of ECT have been published [2,[4][5][6][7][8][9][19][20][21][22][23][24][25]. Table 1 provides a list of the various reported subtypes as defined by the 1999/2004 WHO classification system where known.…”

Section: Discussionmentioning

confidence: 99%

Ectopic Cervical Thymoma: A Report of Two Cases of a Rare Entity Frequently Misdiagnosed on Fine Needle Aspiration Cytology and Frozen Section

Yan

Lim

Petersson

2010

Head and Neck Pathol

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Ectopic cervical thymoma (ECT) is a rare tumor that is frequently misdiagnosed on fine needle aspiration cytology and frozen section. Using conventional light microscopy and immunohistochemistry, we characterized the only two cases of ECT found in our institutional files over a period of 20 years. Both tumors were classified as type AB-thymoma. Neoplastic cells expressed cytokeratins but not CD5. Non-neoplastic T-lymphocytes were positive for CD3 and CD5. Lymphocytes expressed CD1a in only one case. One tumor breached the capsule and had positive surgical margins. For this patient, adjuvant radiotherapy was given. The other patient has had an uneventful follow-up for 20 years with no other therapy than surgery. Both cases of ECT showed identical histomorphological and immunohistochemical features of type AB-thymomas originating in the thymus. Short follow-up precludes conclusion on the implication of positive margins in conjunction with adjuvant radiotherapy for one of the patients presented herein.

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“…Taweevisit et al (4) compiled the details of all 14 cases in a literature review. The initial cytological diagnoses included Hashimoto thyroiditis, lymphocytic thyroiditis, papillary and medullary carcinomas, malignant lymphoma of the thyroid and various types of soft-tissue tumor (3)(4)(5)7,(11)(12)(13)(14)(15)(16)(17)(18)(19)(20). According to the 2004 WHO classification system, the thymoma subtypes were predominantly type AB and type B1, as well as two type A thymomas, one type B2 thymoma and one type B3 thymoma (5,6).…”

Section: Discussionmentioning

confidence: 99%

Aspiration cytology of an ectopic cervical thymoma misinterpreted as a lymphoproliferative lesion of the thyroid: A case report

Lee

Wang

2015

Oncology Letters

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Abstract. Ectopic cervical thymoma is a rare tumor that originates from ectopic thymic tissue trapped during the migration of the embryonic thymus. To the best of our knowledge, only 14 cases of ectopic cervical thymoma, which include descriptions of the cytological features based on fine-needle aspiration (FNA), have been reported thus far. The current study describes the case of a 52-year-old male presenting with an enlarging anterior neck mass that been apparent for a number of years and was now accompanied by shortness of breath. FNA cytology revealed large numbers of small lymphocytes admixed with rare groups of large, polygonal cells that were interpreted to be reactive lymphocytes or possible follicular dendritic cells. However, no definite follicular or Hürthle cells were identified. Therefore, the overall cytological features were misinterpreted as a lymphoproliferative lesion. However, subsequent histological analysis of the resected left total lobectomy specimen determined a diagnosis of thymoma, type B1. Thus, awareness of this entity combined with a careful search for thymic epithelial cells may aid in determining a correct diagnosis when FNA is performed for the evaluation of a neck mass.

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Diagnosis of Cervical Thymoma by Fine Needle Aspiration Biopsy with Flow Cytometry

Cited by 25 publications

References 4 publications

Ectopic Thymoma Can Mimic Benign and Malignant Thyroid Lesions on Fine Needle Aspiration Cytology: A Case Report and Literature Review

Ectopic Thymoma Can Mimic Benign and Malignant Thyroid Lesions on Fine Needle Aspiration Cytology: A Case Report and Literature Review

Ectopic Cervical Thymoma: A Report of Two Cases of a Rare Entity Frequently Misdiagnosed on Fine Needle Aspiration Cytology and Frozen Section

Aspiration cytology of an ectopic cervical thymoma misinterpreted as a lymphoproliferative lesion of the thyroid: A case report

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