Thymoma. A clinicopathologic review

Lewis, Jean E.; Wick, Mark R.; Scheithauer, Bernd W.; Bernatz, Philip E.; Taylor, William F.

doi:10.1002/1097-0142(19871201)60:11<2727::aid-cncr2820601125>3.0.co;2-d

Cited by 477 publications

(291 citation statements)

References 43 publications

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“…In that regard it is of interest to note that a similar biphasic survival pattern has been described in sub-populations of thymoma patients with highly invasive and/or metastatic tumors (Lewis et al, 1987). Further examination of the Tim-1 mice revealed a marked gender bias for survival, as female mice died much more rapidly than their male siblings.…”

Section: Discussionmentioning

confidence: 55%

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Heritable lympho-epithelial thymoma resulting from a transgene insertional mutation

Nakajima

Soonpaa

et al. 2000

Oncogene

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Thymoma is the most common tumor of the anteriorsuperior mediastinum. We have identi®ed a line of transgenic mice which spontaneously and heritably develop thymomas at a very high penetrance. The available data suggest that thymoma formation in these mice results as a consequence of transgene insertional mutagenesis. Immune histologic analyses indicate that the thymomas are of epithelial cell origin. Survival studies indicate that tumor progression is more aggressive in females as compared to males (73.9 vs 41.7% mortality at 20 weeks of age, respectively). Fluorescent in situ hybridizations have localized the transgene integration site to the F2-G region of mouse chromosome 2. Translocation encompassing the syntenic region in humans has been implicated in lympho-epithelial thymoma. These animals may constitute a useful resource for the identi®cation of gene(s) which participate in thymoma progression, as well as a model system for screening anti-thymoma therapeutic agents. Oncogene (2000) 19, 32 ± 38.

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Section: Discussionmentioning

confidence: 55%

“…Thymomas are comprised of neoplastic thymic epithelial cells accompanied by a variable admixture of benign lymphoblasts (Lewis et al, 1987). Although most thymomas are thought to arise spontaneously, familial forms of the disease have been reported (Matani and Dritsas, 1973;Deminatti et al, 1994).…”

Section: Introductionmentioning

confidence: 99%

Heritable lympho-epithelial thymoma resulting from a transgene insertional mutation

Nakajima

Soonpaa

et al. 2000

Oncogene

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“…Most of the previous histologic classification systems, however, either adopted these characteristics independently or adopted only some of them. 2,17,[23][24][25] Conversely, taking all of these morphologic characteristics into consideration, the WHO histologic classification system divided thymomas into five groups: type A, AB, B1, B2, and B3. 21 Our previous study showed that the WHO histologic classification system reflects the invasive nature of thymoma.…”

Section: Discussionmentioning

confidence: 99%

The World Health Organization histologic classification system reflects the oncologic behavior of thymoma

Okumura

Ohta

Tateyama

et al. 2002

Cancer

551

414

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BACKGROUNDAlthough the histologic classification of thymic epithelial tumors has been confusing and controversial, an agreement on the universal classification system for thymic epithelial tumors was achieved by the World Health Organization (WHO) in 1999. The authors previously reported that the WHO histologic classification system reflects invasiveness and immunologic function of thymic epithelial tumors. In this subsequent study, they examined the prognostic significance of this classification system.METHODSClinical features as well as postoperative survival of patients with thymoma, but not thymic carcinoma, were examined with reference to WHO histologic classification based on an experience with 273 patients over a 44‐year period.RESULTSThere were 18 type A tumors, 77 type AB tumors, 55 type B1 tumors, 97 type B2 tumors, and 26 type B3 tumors. In patients with type A, AB, B1, B2, and B3 tumors, the respective proportions of invasive tumor were 11.1%, 41.6%, 47.3%, 69.1%, and 84.6%; the respective proportions of tumors with involvement of the great vessels were 0%, 3.9%, 7.3%, 17.5%, and 19.2%; and the respective 20‐year survival rates were 100%, 87%, 91%, 59%, and 36%. According to the Masaoka staging system, the 20‐year survival rates were 89%, 91%, 49%, 0%, and 0% in patients with Stage I, II, III, IVa, and IVb disease, respectively. By multivariate analysis, the Masaoka staging system and the WHO histologic classification system were significant independent prognostic factors, whereas age, gender, association with myasthenia gravis, completeness of resection, or involvement of the great vessels were not significant independent prognostic factors.CONCLUSIONSThis study showed that histologic appearance reflects the oncologic behavior of thymoma when the WHO classification system is adopted. The WHO classification system may be helpful in clinical practice for the assessment and treatment of patients with thymoma. Cancer 2002;94:624–32. © 2002 American Cancer Society.DOI 10.1002/cncr.10225

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“…Although some promote and anticipate a benign clinical course for these tumors, 6,[12][13][14][15][16] others (ourselves included) consider all thymomas as potentially malignant neoplasms. [1][2]10,[17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34] Many prior studies have documented malignant behavior in types A and AB thymomas. In our retrospective study of 71 cases of types A and AB thymomas (37 cases with follow-up information available), 18 patients (nine each of types A and AB) developed recurrence and or metastases.…”

Section: Discussionmentioning

confidence: 99%

“…Intraoperative adhesions have also been linked with the development of recurrence. 26 It has been suggested that stage I tumors be further divided into stages Ia and Ib based on the absence or presence of peritumoral adhesions. 21,29 In some studies, recurrences were observed only among patients having intraoperative adhesions.…”

Section: Discussionmentioning

confidence: 99%

WHO types A and AB thymomas: not always benign

Jain

Mehta

Henley³

et al. 2010

Modern Pathology

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The 2004 WHO classification of thymic tumors recognizes five major subtypes of thymomas and thymic carcinoma. Subtypes A and AB thymomas are purported to be benign neoplasms, although prior studies have suggested a potential for malignant behavior. The purpose of this study was to assess the clinical behavior of A and AB thymomas identified from a large institutional pathologic database. A retrospective slide review of 500 thymic epithelial tumors identified 71 (B14%) cases of types A and AB thymomas. Clinical history and follow-up information were obtained through retrospective chart review. There were 38 and 33 cases of types A and AB thymomas, respectively. Complete follow-up data were available in 37 (52%) cases. Eighteen (49%) patients (type A, n ¼ 9 and type AB, n ¼ 9) had evidence of recurrent/metastatic disease at an average of 62 months (range from 6 to 244 months) after initial diagnosis. Survival curves for patients with types A and AB thymomas, with and without recurrences, show a statistically significant difference (P ¼ 0.001 and 0.005, respectively). Analysis of this large cohort confirms the potential for subtypes A and AB thymomas to show malignant behavior. Long-term clinical monitoring, therefore, appears to be justified in these cases. This study also shows the poor correlation between the WHO classification and tumor behavior

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Thymoma. A clinicopathologic review

Cited by 477 publications

References 43 publications

Heritable lympho-epithelial thymoma resulting from a transgene insertional mutation

Heritable lympho-epithelial thymoma resulting from a transgene insertional mutation

The World Health Organization histologic classification system reflects the oncologic behavior of thymoma

WHO types A and AB thymomas: not always benign

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