Neuroendocrine differentiation in thymic epithelial tumors with special reference to thymic carcinoma and atypical thymoma

Hishima, Tsunekazu; Fukayama, Masashi; Hayashi, Yukiko; Fujii, Takeshi; Arai, Katsumi; Shiozawa, Yumiko; Funata, Nobuaki; Koike, Masato

doi:10.1016/s0046-8177(98)90112-5

Cited by 56 publications

(36 citation statements)

References 18 publications

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“…Many reports showed that the prevalence of EBV DNAin PCNSLtissue was almost 100%and in peripheral lymphoma tissue, 40% (9,26). Furthermore, even in peripheral lymphoma tissue, a high prevalence (79% to 100%) of EBV DNAwas reported in Japan (27,28). If patients with peripheral lymphoma harbored EBVviremia and EBVwould invade into CNS,our result would be explained.…”

Section: Discussionmentioning

confidence: 62%

Detection of Toxoplasma gondii, Epstein-Barr Virus, and JC Virus DNAs in the Cerebrospinal Fluid in Acquired Immunodeficiency Syndrome Patients with Focal Central Nervous System Comlications.

et al. 1999

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Object Toxoplasmic encephalitis (TE), primary central nervous system lymphoma (PCNSL) and progressive multifocal leukoencephalopathy (PML) are major central nervous system (CNS) diseases in patients with acquired immunodeficiency syndrome (AIDS). Weassessed the diagnostic value of polymerase chain reaction (PCR) in the detection of DNAsof Toxoplasma gondii {T. gondii), Epstein-Barr virus (EBV) and JC virus (JCV) in the cerebrospinal fluid (CSF). Methods Wecompared the PCRresults with those of pathological findings at autopsy. Patients or Materials The present study included 23 autopsies representing those in whomCSF samples were obtained before death while the patient was hospitalized or at autopsy. Results The threshold levels for PCR detection were 4 tachyzoites of T. gondii, 5-15 genomes of EBVand 10 genomes of JCV. Weidentified T. gondii DNAin 4 out of5 autopsy-defined cases ofTE, EBVDNAin 5 out of5 cases with PCNSL, and JCV DNAin 2 out of2 cases with PML.The specificity ofPCR was 100% in TE, 78%in PCNSL, and 100% in PML. Conclusion Although the number of cases was relatively small in this study, PCRcorrectly identified T. gondii DNAin those cases in which PMLor PCNSL was the sole clinical diagnosis. Our results indicate that PCRexamination of CSFis a clinically useful tool for the diagnosis of focal brain lesions in patients with AIDS. (Internal Medicine 38: 556-562, 1999)

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Section: Discussionmentioning

confidence: 62%

Detection of Toxoplasma gondii, Epstein-Barr Virus, and JC Virus DNAs in the Cerebrospinal Fluid in Acquired Immunodeficiency Syndrome Patients with Focal Central Nervous System Comlications.

et al. 1999

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“…Thus, the overall response rate (complete plus partial responses) was 37% (95% confidence intervals, 14 -60 %). The median survival time was 15 months (95% Brookmeyer-Crowley confidence interval, [12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28], and the median time to progression was 14 months. Estimated curves of overall survival and time to progression are represented, respectively, in Figures 1 and 2.…”

Section: Resultsmentioning

confidence: 99%

“…This feature is characteristic of most types of malignant thymic tumors, including thymic carcinoma. 22,23 Glucocorticoid receptors were identified in both human and murine cultured thymic epithelial cells 24 and glucocorticoid hormones modulate thymic epithelial cell proliferation and production of thymic hormones. 25 Corticosteroids can induce thymoma regression.…”

Section: Discussionmentioning

confidence: 99%

Somatostatin analogs and prednisone in advanced refractory thymic tumors

Palmieri

Montella

Martignetti

et al. 2002

Cancer

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BACKGROUND Therapeutic options to cure advanced, recurrent, and metastatic thymic tumors are limited. Evidence of a high uptake of indium‐labeled octreotide (111In‐DTPA‐D‐Phe1‐octreotide) in thymic tumors and the curative application of somatostatin analogs and prednisone in one patient with thymoma and pure red cell aplasia led the authors to start a Phase II study. METHODS Sixteen patients with advanced thymic tumors, unresponsive to conventional chemotherapeutic regimens, were enrolled in the study. The schedule includes administration of somatostatin analog octreotide (1.5 mg/day subcutaneously) associated with prednisone (0.6 mg/kg/day orally for 3 months, 0.2 mg/kg/day orally during follow‐up). In 8 cases, octreotide was replaced by the long‐acting analog lanreotide (30 mg/every 14 days intramuscolarly). Treatment was prolonged until progression of disease was documented. Overall response rate, survival, progression free survival, and toxicity were evaluated. RESULTS The overall response rate among 16 evaluable patients was 37%. One patient (6%) had a complete response, 5 (31%) had a partial response, 6 obtained a stabilization of disease, and 4 progressed during the treatment. After a median follow‐up of 43 months, the median survival was 15 months, and median time to progression was 14 months. Treatment was generally well tolerated with acceptable toxicity: cholelithiasis (1 patient), Grade 2 cushingoid appearance (3 patients), Grade 1 diarrhea (5 patients), Grade 2 hyperglycemia (3 patients). CONCLUSIONS Treatment with somatostatin analogs and prednisone has shown efficacy in patients with recurrent and metastatic malignant thymic tumors refractory to standard therapeutic options. The results obtained are very satisfactory given the lack of effective alternative treatments. Such therapy is not burdened by the same toxicity of chemotherapy; thus, it can be administered to heavily pretreated patients. Somatostatin analogs and prednisone are well tolerated, and the long‐acting analog lanreotide, which requires fewer injections, improves patients' compliance. Cancer 2002;94:1414–20. © 2002 American Cancer Society. DOI 10.1002/cncr.10374

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“…Neuroendocrine differentiation in epithelial neoplasms of the thymus has been investigated immunohistochemically and ultrastructurally [4,5,7,11,12]. Thymic tumors with neuroendocrine differentiation consist of nonneuroendocrine tumors with neuroendocrine differentiation and pure neuroendocrine tumors, that is, carcinoid tumors, smallcell carcinomas, and large-cell neuroendocrine carcinomas.…”

Section: Introductionmentioning

confidence: 99%

Atypical thymoma (WHO B3) with neuroendocrine differentiation: report of a case

et al. 2006

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We report a case of type-B3 thymoma manifesting neuroendocrine differentiation. The patient was a 42-year-old woman who complained of shoulder pain but had no symptoms of myasthenia gravis or anemia. The tumor was located in the anterior mediastinum and had directly invaded the pericardium and left lung. Histological examination revealed that the tumor was lobulated by bands of fibrous tissue, perivascular spaces were scattered throughout the tumor, and there were a few intraepithelial lymphocytes. The vast majority of lymphocytes in the perivascular spaces and in the lobulated tumor were immunohistochemically positive for TdT, MIC2, and CD1a. The majority of tumor cells were polygonal and medium or large in size. The tumor cells were weakly positive for synaptophysin, chromogranin A, CD56, and NSE. Small nests of small, relatively uniform polygonal cells were observed facing the fibrous bands. These cells resembled the cells of carcinoid tumors and were strongly positive for NSE, synaptophysin, chromogranin A, and CD56. Ultrastructurally, sparse dense-core granules were observed in the cytoplasm of a few tumor cells. This is a unique case of thymoma with neuroendocrine differentiation, and to the best of our knowledge this is the first such case ever reported.

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Neuroendocrine differentiation in thymic epithelial tumors with special reference to thymic carcinoma and atypical thymoma

Cited by 56 publications

References 18 publications

Detection of Toxoplasma gondii, Epstein-Barr Virus, and JC Virus DNAs in the Cerebrospinal Fluid in Acquired Immunodeficiency Syndrome Patients with Focal Central Nervous System Comlications.

Detection of Toxoplasma gondii, Epstein-Barr Virus, and JC Virus DNAs in the Cerebrospinal Fluid in Acquired Immunodeficiency Syndrome Patients with Focal Central Nervous System Comlications.

Somatostatin analogs and prednisone in advanced refractory thymic tumors

Atypical thymoma (WHO B3) with neuroendocrine differentiation: report of a case

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