Management of an isolated thymic mass after primary therapy for lymphoma

Anchisi, Sandro; Abele, Reto; Guetty-Alberto, M; Alberto, P.

doi:10.1023/a:1008220211849

Cited by 5 publications

(7 citation statements)

References 16 publications

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“…After CR of testicular carcinoma, thymic hyperplasia has also been reported [6]. It is postulated that thymus regeneration following involution during chemotherapy represents a rebound phenomenon [2,4]. In this study, we report 5 cases with malignant lymphoma presenting with a mediastinal mass on the CT scan after chemotherapy, initially thought to be due to relapse of lymphoma.…”

Section: Introductionmentioning

confidence: 69%

“…The differential diagnosis of mediastinal masses after successful treatment of lymphoma consists of residual fibrosis and necrosis of the primary tumor, recurrence of disease, thymic cyst, thymic hyperplasia, pulmonary fibrosis or granulocytic sarcoma [2,4]. In the literature, CT, magnetic resonance imaging, 67 Gallium scintigraphy and 18 F-FDG PET-CT have been reported to be useful methods for the differential diagnosis of these mediastinal masses but there are limitations to each of these imaging techniques [2,5]. Thymic malignancy can be differentiated from thymoma on the basis of biologic behavior such as local invasiveness and distant metastasis (3).…”

Section: Discussionmentioning

confidence: 99%

“…Langer et al [14] found 21 cases following treatment for HL with a median age of 23 years (range; 8-40). Anchisi et al [2] reported 3 cases of thymic hyperplasia 2-8 months after chemotherapy for HL (1 case) and NHL (2 cases). Their ages were 26, 30 and 32 years, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…On CT, appearance of normal thymus in the anterior mediastinal space is described as a triangular or bilobed structure, with soft tissue density, and whose size varies according to age [2,3]. Thymic enlargement is usually suspected if the thickness of at least one lobe is greater than two standard deviations above the age-related control [2].…”

Section: Discussionmentioning

confidence: 99%

“…Thymic hyperplasia after chemotherapy is a common phenomenon in children and can be observed in young adults [1][2][3]. However, this entity has rarely been described in older patients [1].…”

Section: Introductionmentioning

confidence: 99%

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The role of PET-CT in the differential diagnosis of thymic mass after treatment of patients with lymphoma

et al. 2010

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Thymic hyperplasia is a common phenomenon in both children and young adults after chemotherapy and may explain the finding of a mediastinal mass in patients with malignant lymphoma after complete remission. In the present study, we report 5 cases with malignant lymphoma presenting with a mediastinal mass on CT scan after completion of chemotherapy diagnosed as thymic hyperplasia by PET-CT imaging. We retrospectively analyzed 5 patients who presented with anterior mediastinal masses a median of 4 months (range 3-6) after achieving complete remission following successful treatment for malignant lymphoma. Three patients were diagnosed with Hodgkin's lymphoma (HL) and the others with non-Hodgkin's lymphoma (NHL). The median age of the patients was 23 (range of 18-47). PET-CT was performed on these patients to determine the characteristics of a mass which had been detected on CT. PET-CT was performed for all patients, and the thymic masses demonstrated only mild FDG uptake considered to be consistent with thymic hyperplasia. During a median of 24 months of follow-up, all patients were recurrence-free with a median survival of 15 months (range 10-26 months). It is important to be aware of the possibility of thymic hyperplasia after chemotherapy to avoid misdiagnosis or over-staging of disease, as well as unnecessary biopsies, especially when the presenting anterior mediastinal mass was originally located near the thymus on CT scan. Mild FDG PET uptake was sufficient for the diagnosis of benign disease in the cases in this study.

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Section: Introductionmentioning

confidence: 69%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

The role of PET-CT in the differential diagnosis of thymic mass after treatment of patients with lymphoma

et al. 2010

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Hyperplastic and Inflammatory Pathology of the Thymus

Maiorana

Bonetti

2008

Thymus Gland Pathology

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PET Scan Evaluation of Thymic Mass After Autologous Peripheral Blood Stem-cell Transplantation in an Adult with Non-Hodgkin's Lymphoma

Pagliai

Rigacci

Briganti

et al. 2003

Leukemia & Lymphoma

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We report the case of a 31-year-old man with anaplastic large-cell lymphoma successfully treated with chemotherapy who showed mediastinal widening 5 months after autologous stem-cell transplantation. CT scan and PET evaluations were consistent with the diagnosis of benign thymic hyperplasia. Because of the rapid and aggressive course of this type of lymphoma, and the progressive widening of the mass at CT scan, we performed a mediastinal biopsy that confirmed these findings, showing normal thymic tissue. This is the first case of benign thymic hyperplasia defined with FDG-PET and confirmed by histologic evaluation.

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Management of an isolated thymic mass after primary therapy for lymphoma

Cited by 5 publications

References 16 publications

The role of PET-CT in the differential diagnosis of thymic mass after treatment of patients with lymphoma

The role of PET-CT in the differential diagnosis of thymic mass after treatment of patients with lymphoma

Hyperplastic and Inflammatory Pathology of the Thymus

PET Scan Evaluation of Thymic Mass After Autologous Peripheral Blood Stem-cell Transplantation in an Adult with Non-Hodgkin's Lymphoma

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