The spectrum of micronodular thymic epithelial tumours with lymphoid B‐cell hyperplasia

Tateyama, Hisashi; Saito, Yushi; Fujii, Yoshitaka; Okumura, Meinoshin; Nakamura, Kenji; Tada, Hideaki; Yasumitsu, Tsutomu; Eimoto, Tadaaki

doi:10.1046/j.1365-2559.2001.01133.x

Cited by 51 publications

(81 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Subsequent reports have documented variations in the clinical and pathologic manifestations of this group of thymic tumors, including the presence of polygonal cell. [3][4][5][6][7][8][9] Micronodular thymic carcinoma with lymphoid hyperplasia was more recently described as the malignant counterpart of micronodular thymoma with lymphoid B-cell hyperplasia. 2 It has clinical and demographic presentations similar to those of micronodular thymoma with lymphoid B-cell hyperplasia.…”

mentioning

confidence: 99%

Micronodular thymic neoplasms: case series and literature review with emphasis on the spectrum of differentiation

et al. 2015

View full text Add to dashboard Cite

We report nine cases of micronodular thymoma with lymphoid B-cell hyperplasia and one case of micronodular thymic carcinoma with lymphoid hyperplasia from our institution. For a better understanding of these rare tumors, clinical records, and histological features of these cases were reviewed, with detailed review of additional 64 literature cases of micronodular thymic neoplasms. The joint analysis identified 64 cases of micronodular thymoma with lymphoid B-cell hyperplasia and 9 cases of micronodular thymic carcinoma with lymphoid hyperplasia. Both groups revealed slight male predilection, with male:female ratio of 1.3:1 and 5:4, and occurred at 440 years of age, with a mean of 64 (41-83) and 62 (42-78) years, respectively. Myasthenia gravis was noted in 3/64 (5%) and 1/9 (11%) patients, respectively. Other systemic, disimmune, or hematologic disorders were noted in 6/64 (9%) and 1/9 (11%) patients, respectively. Components of conventional thymoma were reported in 11/64 (17%) micronodular thymomas with lymphoid B-cell hyperplasia, with transitional morphology between the two components in most of them. Cellular morphology was predominantly spindle in micronodular thymoma with lymphoid B-cell hyperplasia when specified (30/43), and epithelioid in micronodular thymic carcinoma with lymphoid hyperplasia (6/9), and cytological atypia was more encountered in the latter. Dedifferentiation/transformation from micronodular thymoma with lymphoid B-cell hyperplasia to micronodular thymic carcinoma with lymphoid hyperplasia seems to occur in a small subset of cases. Three cases of micronodular thymomas with lymphoid B-cell hyperplasia were described with co-existent low-grade B-cell lymphomas. Follow-up data were available for 30 micronodular thymomas with lymphoid B-cell hyperplasia and 6 micronodular thymic carcinomas with lymphoid hyperplasia, with a mean of 47 (0.2-180) months and 23 (3-39) months, respectively. Patients were alive without disease, except for five micronodular thymoma with lymphoid B-cell hyperplasia patients (dead from unrelated causes), and one micronodular thymic carcinoma with lymphoid hyperplasia patient (dead of disease).

show abstract

mentioning

confidence: 99%

Micronodular thymic neoplasms: case series and literature review with emphasis on the spectrum of differentiation

et al. 2015

View full text Add to dashboard Cite

show abstract

“…4,5 Since the first description of this neoplasm by Suster, 3 only few series and case reports have been presented in the literature. [4][5][6][7][8] Micronodular thymomas with prominent lymphoid hyperplasia are usually encapsulated or minimally invasive tumors histologically characterized by a proliferation of small tumor nodules separated by an abundant lymphoid stroma with prominent germinal centers. The individual tumor nodules are composed of spindle cells containing oval nuclei that lack cytological atypia or mitotic activity.…”

Section: Discussionmentioning

confidence: 99%

“…Of note, no tumor deaths were reported for any of the patients with micronodular thymoma despite obvious cytological malignancy in a small number of cases, 3,4,[6][7][8] nor was there mortality in any of the cases described by Nonaka et al…”

Section: Discussionmentioning

confidence: 99%

“…15 It has been speculated that the striking lymphoid hyperplasia in micronodular thymoma is either a host response to tumor antigens or a tissue response to unrelated intrathymic antigens. 3,8 Similar deliberations regarding the pathogenesis of lymphoid hyperplasia also apply to micronodular thymic carcinomas. In keeping with the patient population of micronodular thymoma, none of the patients in the current series had a history of myasthenia gravis or other autoimmune disorder.…”

mentioning

confidence: 97%

“…Interestingly, all described cases of micronodular thymic epithelial neoplasms, including the three previously reported cases showing malignant cytology and the cases reported by Nonaka et al 9 have shown a favorable outcome with no reported tumor deaths. 3,6,8 Whether lymphoid hyperplasia can be considered as a host response leading to improved survival, a phenomenon described for other lymphoid rich carcinomas 16 remains to be determined. In the meantime, although follow-up period for our patients is rather short, tumor-related deaths do exist and the survival appears to be similar to those patients with the more conventional types of thymic carcinoma.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Micronodular thymic carcinoma with lymphoid hyperplasia: a clinicopathological and immunohistochemical study of five cases

Weissferdt

Moran

2012

Modern Pathology

View full text Add to dashboard Cite

Five cases of an unusual variant of thymic carcinoma are described, which represent the counterpart of the socalled micronodular thymoma with lymphoid hyperplasia. The patients were three men and two women aged 42-78 years (mean 64 years). Three patients were asymptomatic and the tumors were found incidentally on chest radiographs performed for unrelated reasons. Two patients complained of dyspnea, chest pain and shortness of breath prompting further investigations. The tumors ranged in size from 3.2 to 10.0 cm and were described as infiltrative masses often invading adjacent structures. Prominent cystic changes were not identified. Histologically, the neoplasms were composed of epithelial tumor cells arranged in a micronodular growth pattern set in a stroma showing florid lymphoid hyperplasia. Contrary to micronodular thymoma, the epithelial cell component of the present cases showed unequivocal signs of malignancy characterized by cytological atypia and increased mitotic activity. Immunohistochemical studies showed the lymphoid component to be of mixed B-and T-cell lineage. None of the patients had a history of myasthenia gravis or other autoimmune disorder. Follow-up revealed that 4 patients were alive and well 3-26 months after diagnosis while 1 patient was dead of disease 21 months after diagnosis. The tumors in this series represent a distinct subtype of thymic carcinoma histologically strongly resembling micronodular thymoma with lymphoid hyperplasia. Awareness of this type of thymic carcinoma is important in order not to dismiss this tumor for a neoplasm of lower-grade malignancy.

show abstract

Micronodular thymoma: an epithelial tumour with abnormal chemokine expression setting the stage for lymphoma development

Ströbel

Marino²,

Feuchtenberger

et al. 2005

The Journal of Pathology

View full text Add to dashboard Cite

The aetiology of primary B-cell lymphomas of the thymus is enigmatic. Although thymic follicular lymphoid hyperplasia (TFH) is commonly associated with myasthenia gravis (MG), lymphoma is not a complication of this condition. The present paper reports a high frequency of monoclonal B-cell populations (6 of 18 cases; 33%) in micronodular thymoma (MNT), a peculiar thymic epithelial neoplasm with a B-cell-rich stroma, while B cells were consistently polyclonal in TFH (25 cases) and other types of thymomas (15 cases) (p < 0.001). An intratumoural lymphoma could be identified in three of the six monoclonal MNTs. Sequencing of the monoclonal IgH chain revealed partially overlapping VDJ gene usage in MNT and thymic mucosa-associated lymphoid tissue (MALT) lymphomas. The neoplastic epithelium of MNTs, but not of TFH and other types of thymoma, expressed high levels of dendritic cell, T-cell, and B-cell chemoattractants, such as CCL18, CCR6, and CCL20. It is concluded that abnormal chemokine expression in an epithelial tumour, MNT, can promote the recruitment of MALT, the emergence of monoclonal B cells, and, eventually, the subsequent development of mediastinal lymphomas. More generally, the concept that expression of a 'high-risk' spectrum of chemokines due to local or genetic factors may interfere with B-cell homeostasis and may contribute to MALT lymphoma development in chronic inflammatory states is proposed.

show abstract

The spectrum of micronodular thymic epithelial tumours with lymphoid B‐cell hyperplasia

Cited by 51 publications

References 28 publications

Micronodular thymic neoplasms: case series and literature review with emphasis on the spectrum of differentiation

Micronodular thymic neoplasms: case series and literature review with emphasis on the spectrum of differentiation

Micronodular thymic carcinoma with lymphoid hyperplasia: a clinicopathological and immunohistochemical study of five cases

Micronodular thymoma: an epithelial tumour with abnormal chemokine expression setting the stage for lymphoma development

Contact Info

Product

Resources

About