Tumors of the neck showing thymic or related branchial pouch differentiation: A unifying concept

Chan, John K.; Rosaí, Juan

doi:10.1016/0046-8177(91)90083-2

Cited by 332 publications

(358 citation statements)

References 65 publications

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“…From this, it appears that the general distribution parallels that of mediastinal thymomas, where type AB thymomas represent one of the more common subtypes [26]. One interesting observation is the marked female predominance in ECT [3], which differs from the demographics of the mediastinal thymomas where there is only a slight female predominance [26].…”

Section: Discussionmentioning

confidence: 81%

“…In a paper from 1991, Chan and Rosai compiled eleven previously published cases of ECT (of which they reviewed four cases) and added five cases of their own which to date constitute the largest number of cases with clinicopathologic data published in the English literature [3]. This paper was published prior to the 1999 WHO Classification of thymic epithelial tumors.…”

Section: Discussionmentioning

confidence: 99%

“…ET has been reported in a variety of sites such as the neck (ectopic cervical thymoma, ECT) [2][3][4][5][6][7][8][9], chest wall [10], pleura [11], lung [12] and heart [13]. Among these ectopic sites, the cervical region appears to be one of the most frequent locations, where close proximity to the thyroid frequently results in a mistaken clinical impression of a primary thyroid neoplasm.…”

Section: Introductionmentioning

confidence: 99%

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Ectopic Cervical Thymoma: A Report of Two Cases of a Rare Entity Frequently Misdiagnosed on Fine Needle Aspiration Cytology and Frozen Section

Yan

Lim

Petersson

2010

Head and Neck Pathol

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Ectopic cervical thymoma (ECT) is a rare tumor that is frequently misdiagnosed on fine needle aspiration cytology and frozen section. Using conventional light microscopy and immunohistochemistry, we characterized the only two cases of ECT found in our institutional files over a period of 20 years. Both tumors were classified as type AB-thymoma. Neoplastic cells expressed cytokeratins but not CD5. Non-neoplastic T-lymphocytes were positive for CD3 and CD5. Lymphocytes expressed CD1a in only one case. One tumor breached the capsule and had positive surgical margins. For this patient, adjuvant radiotherapy was given. The other patient has had an uneventful follow-up for 20 years with no other therapy than surgery. Both cases of ECT showed identical histomorphological and immunohistochemical features of type AB-thymomas originating in the thymus. Short follow-up precludes conclusion on the implication of positive margins in conjunction with adjuvant radiotherapy for one of the patients presented herein.

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Section: Discussionmentioning

confidence: 81%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Ectopic Cervical Thymoma: A Report of Two Cases of a Rare Entity Frequently Misdiagnosed on Fine Needle Aspiration Cytology and Frozen Section

Yan

Lim

Petersson

2010

Head and Neck Pathol

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“…Spindle epithelial tumor with thymus-like differentiation (SETTLE) is a very rare thyroid tumor formally characterized by Chan and Rosai (1) in 1991 as a tumor of the neck showing thymic or related branchial pouch differentiation. Isolated reports of this tumor entity had previously been reported under a variety of designations, such as thyroid spindle cell tumor with mucous cyst, malignant teratoma, thyroid thymoma in childhood, and "unusual thyroid tumor in a child" (2)(3)(4)(5)(6).…”

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confidence: 99%

Spindle Epithelial Tumor with Thymus-Like Differentiation (SETTLE): A Distinctive Malignant Thyroid Neoplasm with Significant Metastatic Potential

2000

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Spindle epithelial tumor with thymus-like differentiation (SETTLE) is a very rare tumor of the thyroid believed to be derived from branchial pouch or thymic remnants and showing primitive thymic differentiation. Although this tumor is prone to develop delayed blood-borne metastases, the metastatic risk is unclear because the case reports in the recent literature had very short follow-up periods. We report one case, the oldest patient reported so far, who had been followed up until death. The 59-year-old man had an enlarged thyroid for all of his adult life, and presented with recent rapid enlargement of the thyroid. Neck exploration revealed a hard tumor in the right lobe, with adhesion to sternothyroid muscle. Histologic examination showed an invasive biphasic neoplasm traversed by sclerotic septa. Tight to loose fascicles of blandlooking spindly cells were intimately intermingled with tubulopapillary structures, diagnostic of the SETTLE. This patient developed left pulmonary metastases at 2 years and subsequently developed bilateral pulmonary and widespread metastases. He died 8 years after initial presentation. This case illustrates the protracted clinical course of the tumor, and survival for many years despite the occurrence of metastases. Review of the literature shows that SETTLE occurs predominantly in young patients with a median age of 15 years and male predominance. There is a significant metastatic rate of 71% for patients with more than 5 years of follow-up in spite of the otherwise indolent nature of the tumor.

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“…2 Thyroid CASTLE may arise from an ectopic thymus or branchial pouch remnants in the thyroid gland, which retain the capability of thymic differentiation. 3 Histologically, thyroid CASTLE resembles Since thyroid CASTLE is rare and difficult to diagnose, its clinicopathologic features have not been well defined, and no universally accepted treatment recommendation is available. In this study, we retrospectively studied the clinicopathologic data of 8 cases of thyroid CASTLE diagnosed in Shengjing Hospital of China Medical University.…”

mentioning

confidence: 99%

Clinical Analysis of Thyroid Carcinoma Showing Thymus-Like Differentiation: Report of 8 Cases

Liu

Teng

Sun

et al. 2013

International Surgery

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Thyroid carcinoma showing thymus-like differentiation (CASTLE) is a kind of rare neoplasm of the thyroid gland. Because thyroid CASTLE is rare and difficult to diagnose, its clinicopathologic features have not been well defined, and no universally accepted treatment recommendation is available. We analyzed retrospectively the clinicopathologic data of 8 patients with thyroid CASTLE who underwent surgery and radiotherapy at the Shengjing Hospital of China Medical University between December 2008 and June 2012. All patients accepted radical surgery. All patients accepted postoperative radiotherapy, except one 79-year-old patient. There was no evidence of recurrence or metastasis during the follow-up period. The pattern of immunohistochemical staining was similar to that of thymic carcinoma. Six of 8 CASTLE cases expressed CD5. All 8 CASTLE patients were negatively expressed in thyroglobulin, thyroid transcription factor 1, and calcitonin. Patients with thyroid CASTLE have good outcomes after radical resection and postoperative radiotherapy. Positive CD5 immunoreactivity can contribute to diagnosis of this disease.

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Tumors of the neck showing thymic or related branchial pouch differentiation: A unifying concept

Cited by 332 publications

References 65 publications

Ectopic Cervical Thymoma: A Report of Two Cases of a Rare Entity Frequently Misdiagnosed on Fine Needle Aspiration Cytology and Frozen Section

Ectopic Cervical Thymoma: A Report of Two Cases of a Rare Entity Frequently Misdiagnosed on Fine Needle Aspiration Cytology and Frozen Section

Spindle Epithelial Tumor with Thymus-Like Differentiation (SETTLE): A Distinctive Malignant Thyroid Neoplasm with Significant Metastatic Potential

Clinical Analysis of Thyroid Carcinoma Showing Thymus-Like Differentiation: Report of 8 Cases

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