The paediatric thymus: recognising normal and ectopic thymic tissue

Wee, T.; Lee, Anna F.; Nadel, Helen; Bray, Heather J.

doi:10.1016/j.crad.2021.02.017

Cited by 17 publications

(12 citation statements)

References 51 publications

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“…Orthotopic thymus appears as bi-lobed with mild FDG avidity. 20 Using radio-immunoassay, cystic fluid aspirate may be used to estimate the concentration of thyroglobulin and parathormone to rule out thyroglossal cyst and parathyroid cyst, respectively.…”

Section: Discussionmentioning

confidence: 99%

Cervical Thymic Cyst with parathyroid tissue a diagnostic conundrum

Gupta¹,

Kaushal²,

Vedant³

et al. 2022

Autops Case Rep

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Cervical thymic cysts are relatively rare benign cystic lesions that tend to be diagnosed clinically as branchial cysts, which usually present as painless, enlarging neck masses. They can occur anywhere along the normal path of descent of thymic primordia from the angle of the mandible to the sternal notch, with mediastinal extension observed in approximately 50% of cases. They are usually seen in the first decade of life on the left side with a male predominance. Here we report a case of a 15-year-old boy who presented to the hospital with left-sided neck swelling for about 2 months. The neck's contrast-enhanced computed tomography (CECT) revealed a large, well-defined cystic swelling in the left neck region, showing peripheral enhancement, seen from the submandibular region to the superior mediastinum extending into the retrosternal region. Direct fine needle aspiration (FNA) was done, which showed a benign lesion with inflammatory and cystic characteristics, leading to the possibility of a branchial cyst. The cyst was completely excised surgically. Histopathology showed a thymic cyst with parathyroid tissue. The presence of thymic tissue with Hassall's corpuscles is essential for the diagnosis. Knowledge of the clinical presentation, cyto-histological findings, and differential diagnosis of cystic cervical lesions in the pediatric population is important to diagnose this rare entity. Hence, though uncommon, when one comes across a cystic cervical region mass in children, a diagnosis of cervical thymic cyst should be kept in mind. Nonetheless, a definitive diagnosis depends on imaging findings as well as intraoperative findings and histopathological examination.

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Section: Discussionmentioning

confidence: 99%

Cervical Thymic Cyst with parathyroid tissue a diagnostic conundrum

Gupta¹,

Kaushal²,

Vedant³

et al. 2022

Autops Case Rep

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“…The average mass of the term thymus is thought to be around 10.5 g, with linear growth throughout gestation suspected 27 . In contrast, the thymus undergoes physiological involution during childhood 28 …”

Section: Fetal Immune System: Fetal Thymusmentioning

confidence: 99%

“…27 In contrast, the thymus undergoes physiological involution during childhood. 28 Animal studies have shown that thymic involution can occur in response to chorioamnionitis, which is most likely to be attributable to lymphocyte migration to the blood or inflamed organs, rather than thymic apoptosis. 29 Studies have also demonstrate that the cortex is more profoundly affected than the medulla.…”

Section: Fetal Immune System: Fetal Thymusmentioning

confidence: 99%

Antenatal diagnosis of chorioamnionitis: A review of the potential role of fetal and placental imaging

et al. 2022

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Chorioamnionitis is present in up to 70% of spontaneous preterm births. It is defined as an acute inflammation of the chorion, with or without involvement of the amnion, and is evidence of a maternal immunological response to infection. A fetal inflammatory response can coexist and is diagnosed on placental histopathology postnatally. Fetal inflammatory response syndrome (FIRS) is associated with poorer fetal and neonatal outcomes. The only antenatal diagnostic test is amniocentesis which carries risks of miscarriage or preterm birth. Imaging of the fetal immune system, in particular the thymus and the spleen, and the placenta may give valuable information antenatally regarding the diagnosis of fetal inflammatory response.While ultrasound is largely limited to structural information, MRI can complement this with functional information that may provide insight into the metabolic activities of the fetal immune system and placenta. This review discusses fetal and placental imaging in pregnancies complicated by chorioamnionitis and their potential future use in achieving non-invasive antenatal diagnosis. Key points What's already known about the topic?� Chorioamnionitis is present in up to 70% of spontaneous preterm births and is associated with more complications than unaffected spontaneous preterm births � Diagnosis is postnatal. Antenatal diagnosis by amniocentesis carries a risk of preterm birth, and is not integrated into clinical care What does this review add?� Ultrasound assessment of the fetal immune system gives structural information and limited functional information, while MRI can complement this with greater functional tissue information � Imaging may play a role in the non-invasive antenatal diagnosis of chorioamnionitisThis is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

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“…The thymus develops in the ventral wings of the third pharyngeal arch and descends into the superior anterior mediastinum along the paired thymopharyngeal ducts typically during the seventh and eighth weeks of gestation [1]. The thymopharyngeal ducts run along the carotid sheaths from the angle of the mandible to the anterior mediastinum, deep into the thyroid gland and sternocleidomastoid muscles [2]. Following the descent, the ducts form epithelial cords that eventually involute and atrophy [3].…”

Section: Introductionmentioning

confidence: 99%

A Neck Mass of Thymic Origin in a Pediatric Patient

Zauher¹,

Jacobs²,

Isaiah³

2022

Cureus

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In this study, we present the case of a 10-year-old boy with a left-sided neck mass. Although most neck masses in children are non-cancerous, their etiology can be complex, especially in neck masses of congenital origin. The workup of a pediatric neck mass includes imaging and cytopathology. In this case, the histopathology of the excised mass revealed thymic tissue, which helped establish the diagnosis of a thymopharyngeal duct cyst. Thymophayngeal duct cysts, although rare, can be diagnosed preoperatively by characteristic tapering toward the mediastinum. Cytopathology may demonstrate Hassall corpuscles. These unique features can help disentangle the differential diagnoses, which commonly include thyroglossal duct cysts, venolymphatic malformations, and branchial cleft cysts.

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The paediatric thymus: recognising normal and ectopic thymic tissue

Cited by 17 publications

References 51 publications

Cervical Thymic Cyst with parathyroid tissue a diagnostic conundrum

Cervical Thymic Cyst with parathyroid tissue a diagnostic conundrum

Antenatal diagnosis of chorioamnionitis: A review of the potential role of fetal and placental imaging

A Neck Mass of Thymic Origin in a Pediatric Patient

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