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Invasive thymoma with intraorbital metastases  [cached]
Nirmala S,Janaki M,Malavika K,Rishi Karthik
Journal of Cancer Research and Therapeutics , 2009,
Abstract: Thymomas are epithelial neoplasm of thymus and most common primary neoplasm of anterior and superior mediastinum affecting males and females equally. It occurs usually in the fifth to seventh decade. Approximately one-third of thymomas are invasive. Metastases to distant extrathoracic sites such as the liver, lung, lymph node, kidneys, ovary and brain occur infrequently. This is more common with invasive thymomas. Although brain has been shown to be a site of infrequent metastases, intraorbital metastases has not yet been reported. Here we report one such case of invasive thymoma of anterior superior mediastinum, which later metastasized to orbit as well as the brain.
Resection and reconstruction of mediastinal great vessels in invasive thymoma  [cached]
Arvind K,Roman D,Umashankkar K,Pramod K
Indian Journal of Cancer , 2010,
Abstract: Objective : To evaluate the safety, feasibility, and outcome following radical excision of thymoma with resection and reconstruction of invaded mediastinal vessels. Study Design : A retrospective study. Patients and Methods : Six patients with thymoma invading the superior vena cava (SVC) and/or the brachiocephalic veins (BCVs) were reviewed in this study. All the patients underwent radical excision of the tumor along with invaded mediastinal vessels followed by vessel reconstruction or repair. The clinical presentation, operative details, postoperative course, and follow-up were reviewed and analyzed. Results : Three patients presented with features suggestive of SVC syndrome. Contrast-enhanced computed tomography of the chest was the primary imaging modality, which detected a tumor with invasion of major mediastinal veins. WHO type B2 was the commonest histologic type, which was seen in 4 cases. Intraoperatively, SVC invasion, SVC and BCV invasion, and BCV invasions alone were seen in 1, 2, and 3 cases, respectively. The vessels were reconstructed with a prosthetic graft in 3 patients, and autologous pericardial tube graft was used in 1 patient. Two patients had primary repair of the wall of the involved vessel. Postoperative course was complicated by ventilator support requirement in 2, graft thrombosis in 2, acute renal failure in 1 and pneumonia in 1 patient. All patients are alive at the end of follow-up period ranging between 18 and 24 months. Conclusion: Thymoma excision with the reconstruction of SVC or BCV is safe and feasible in experienced hands.
Invasive medullary thymoma associated with myasthenia gravis: an unusual case
Arquivos de Neuro-Psiquiatria , 2000, DOI: 10.1590/S0004-282X2000000600020
Abstract: thymomas are tumors characterized by a remarkable morphological heterogeneity and variable clinical behavior. this tumor has unique clinical associations, most notably with hematological abnormalities and myasthenia gravis. according with the müller-hermelink criteria, there are significant differences between the histological types of thymomas and the association with myasthenia gravis. among the different histological types, medullary thymoma is the least frequent variant associated with this autoimmune disease. in this report we describe a case of medullary thymoma presenting in a 71-year- old woman with a myasthenic syndrome.
Invasive medullary thymoma associated with myasthenia gravis: an unusual case
Arquivos de Neuro-Psiquiatria , 2000,
Abstract: Thymomas are tumors characterized by a remarkable morphological heterogeneity and variable clinical behavior. This tumor has unique clinical associations, most notably with hematological abnormalities and myasthenia gravis. According with the Müller-Hermelink criteria, there are significant differences between the histological types of thymomas and the association with myasthenia gravis. Among the different histological types, medullary thymoma is the least frequent variant associated with this autoimmune disease. In this report we describe a case of medullary thymoma presenting in a 71-year- old woman with a myasthenic syndrome.
Incidental Detection of an Invasive Thymoma during Thallium-201 Imaging for Coronary Artery Disease.  [PDF]
Jo-Chi Tseng,Chung-Ching Hua,Ming-Fong Tsai,Liang-Che Chang
Chang Gung Medical Journal , 2004,
Abstract: Thallium-201 (Tl-201) is widely used for myocardial perfusion imaging, but is alsoreported to have potential tumor-seeking properties. Tl-201 uptake has been described invarious malignant diseases, including thymic tumors. Thymomas are the most frequenttumors of the anterior mediastinum, and chest pain is one of the major presentation symptoms.Sometimes, a thymoma may be overlooked on chest plain film. We report on a case ofa 63-year-old man who had a history of hypertension and suffered from intermittent chestpain for several weeks. He underwent a Tl-201 stress test to evaluate the presence of coronaryartery disease, and during the test, abnormal uptake over focal extracardiac activity inthe left upper mediastinum was incidentally revealed. Furthermore, chest computed tomographyidentified a 6-cm left anterior mediastinal mass. Mediastinal tumor resection was carriedout, and the pathological examination demonstrated an invasive epithelial-type thymoma,which had invaded the left innominate vein. Subsequently, the patient received postoperativeradiotherapy and thenceforth responded well to treatment. A Tl-201 scan has thepotential to play a part in tumor detection and clinical assessment of therapeutic effects.
Diagnosis of invasive aspergillus tracheobronchitis facilitated by endobronchial ultrasound-guided transbronchial needle aspiration: a case report
Roberto F Casal, Roberto Adachi, Carlos A Jimenez, Mona Sarkiss, Rodolfo C Morice, Georgie A Eapen
Journal of Medical Case Reports , 2009, DOI: 10.1186/1752-1947-3-9290
Abstract: A 65 year-old Hispanic man from Bolivia with a history of chronic lymphocytic leukemia developed cough and malaise eight months after having an allogenic stem cell transplant. A computed tomography of the chest revealed an area of diffuse soft tissue thickening around the left main stem bronchus, which was intensely fluorodeoxyglucose-avid on positron emission tomography scanning. An initial bronchoscopic exam revealed circumferential narrowing of the entire left main stem bronchus with necrotic and friable material on the medial wall. Neither aspirates from this necrotic area nor bronchial washing were diagnostic. A second bronchoscopy with endobronchial ultrasound evidenced a soft tissue thickening on the medial aspect of the left main stem bronchus underlying the area of necrosis visible endoluminally. Endobronchial ultrasound-guided transbronchial needle aspiration performed in this area revealed multiple fungal elements suggestive of Aspergillus species.We describe the first case of invasive aspergillus tracheobronchitis in which the diagnosis was facilitated by the use of endobronchial ultrasound guided trans-bronchial needle aspiration. To the best of our knowledge, we are also presenting the first positron emission tomography scan images of this condition in the literature. We cautiously suggest that endobronchial ultrasound imaging may be a useful tool to evaluate the degree of invasion and the involvement of vascular structures in these patients prior to bronchoscopic manipulation of the affected areas in an effort to avoid potentially fatal hemorrhage.Invasive aspergillosis is one of the most common fungal infections in immunocompromised hosts, involving the respiratory tract in 90% of cases [1]. This disease occurs almost exclusively in immunosuppressed and especially myelosuppressed patients, although there have been rare patients without any grossly apparent immune defect. The most common form of aspergillus species infection in immunocompromised patie
Primary endobronchial synovial sarcoma confirmed by SYT-SSX1 fusion gene transcript by reverse transcriptase polymerase chain reaction  [cached]
Kumar Rajiv,Menon Santosh,Desai Sangeeta,Pramesh C
Indian Journal of Pathology and Microbiology , 2009,
Abstract: Primary sarcomas of lung are rare compared to metastatic sarcomas. Herein, we report a rare case of primary pulmonary synovial sarcoma with polypoid endobronchial growth in a 35-year-old lady who presented with cough and dyspnea. A malignant pulmonary tumor was suspected and left pneumonectomy was performed. Grossly, a non-encapsulated polypoidal endobronchial tumor measuring 6 cm in greatest diameter, with a solid, tan-white cut surface was identified. Microscopically, tumor was characterized by a proliferation of oval to spindle-shaped cells arranged in sheets and fascicles. Focal hemangiopericytomatous pattern was noted. Immunohistochemically, tumor cells were positive for vimentin, BCL-2, MIC-2 and calponin and focally positive for pancytokeratin and epithelial membrane antigen. A subsequent molecular analysis performed using reverse transcriptase-polymerase chain reaction with RNA extracted from paraffin-embedded tissue, revealed SYT/SSX1 fusion gene which confirmed the diagnosis of synovial sarcoma. The utility of immunohistochemistry and molecular techniques in diagnosis of such a rare case is stressed and the relevant literature is discussed.
Thymoma calcification: Is it clinically meaningful?
Kassem Harris, Dany Elsayegh, Basem Azab, Homam Alkaied, Michel Chalhoub
World Journal of Surgical Oncology , 2011, DOI: 10.1186/1477-7819-9-95
Abstract: The thymus gland is located in the anterior mediastinal compartment of the chest. It originates from the third and fourth branchial pouches and is composed from all three germinal layers. The thymus gland is mostly active in the pre-adolescent period and it the largest in size. It starts to coalesce and becomes completely atrophic with remnant adipose tissue by the late teens. Nonetheless, lymphopoiesis of the T cells continues during adult life. Tumors of the thymus gland are the most commonly encountered abnormal tissue growth of the anterior mediastinal compartment. Lymphatic and germinal tumors are the second most frequent. Thymic tumors are usually epithelial in origin, with low-grade neoplasm and slow growth rate. The propensity of a thymoma to be malignant is determined by the invasiveness of the thymoma. Thus, thymomas without local invasion are considered benign tumors. Other tumors include parathyroid, thyroid tissue, vascular, and mesenchymal tissue masses. Occasionally, thymic tumors can be found in the posterior mediastinum or other locations like lower neck. Calcification can occur in benign and malignant thymomas and up to 40 percent of thymomas present with some type of calcifications [1]. In this review, we will go over types of thymoma calcifications and their clinical significance.Thymoma is a rare neoplasm that account for approximately 0.2-1.5% of all malignant neoplasms. Among the anterior mediastinal tumors, thymoma is the most frequent. It represents 20% of all mediastinal neoplasm in adults [2,3]. Thymoma usually affects patients in the middle age with no sex predominance. About 35 percent of thymic tumors are malignant with the exception of patients between the ages of 20 to 40 where cancers account for about half of thymic tumors. Thymoma occurs with increasing frequency as age increases. It goes from 3% at age of 20 to about 12% at ages 21 to 45 years. About 35 percent of thymic tumors occur after 46 years of age [4]. Men and women are eq
Coscarón-Blanco E,Martín-Garrido EP,Ursúa-Sarmiento I
Revista de la Sociedad Otorrinolaringológica de Castilla y León, Cantabria y La Rioja , 2011,
Abstract: Benign vascular tumours , specially those arising from lymphatic vessels, occur so unfrequently on the tonsil that are scarcelly reported. Their appearance may be similar to other polypoid lesions of the tonsils which include fibroma, lipoma, papilloma, cysts and others but their clinical behaviour may be very different. Their pathogenesis is not clearly determined yet. An asympthomatic clinical pattern is the most frequently reported behaviour at diagnosis but sudden growth, with airway or deglutory pathway compromise, may occur and so, complete surgical treatment should be performed. A case of sympthomatic pedunculated tonsillar linphangiona is reported and a medical literature review is provided.
Cervical thymoma
Rapoport, Abr?o;Dias, Claudiane Ferreira;Freitas, Jo?o Paulo Aché de;Souza, Ricardo Pires de;
Sao Paulo Medical Journal , 1999, DOI: 10.1590/S1516-31801999000300008
Abstract: context: cervical thymoma is a primitive thymic neoplasia. it is very rare. this disease presents higher incidence in female patients in their 4th to 6th decade of life. we present a case report of a cervical thymoma case report: 54-year-old female patient, caucasian, with no history of morbidity, presenting a left cervical nodule close to the thyroid gland. during the 30 months of investigation a left cervical nodule grew progressively next to the thyroid while the patient showed no symptoms, making accurate diagnosis difficult. tests on her thyroid function did not show changes, nor were there changes in any subsidiary tests. the diagnosis of the disease was made intra-operatively through total thyroid individualization. the results were confirmed by the histological findings from the ressected material. cervical thymoma is a very rare disease, with difficult preoperatory diagnosis. some additional study methods which are employed today are thallium 201, technetium 99 and iodine 131 scintigraphy, magnetic nuclear resonance and especially histopathological findings and classification.
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