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Diagnostic Pathology

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Open Access 01-12-2007 | Research

Thymomas: a cytological and immunohistochemical study, with emphasis on lymphoid and neuroendocrine markers

Authors: Borislav A Alexiev, Cinthia B Drachenberg, Allen P Burke

Published in: Diagnostic Pathology | Issue 1/2007

Abstract

Background

The current study correlates cytologic morphology with histologic type and describes immunophenotypes with a focus on epithelial, neuroendocrine, and lymphoid characteristics in an institutional series of surgically excised thymomas.

Methods

Fine needle aspirates (FNAs) and surgical specimens were retrospectively analyzed, and immunohistochemical stains were performed for EMA, cytokeratin 7, cytokeratin 20, CD57 CD5, bcl-2, calretinin, vimentin, CD3, CD20, CD1a, CD99 and Ki67. Tumors were classified by WHO criteria.

Results

There were eleven male and six female patients with an age range of 41 to 84 years (mean, 61 years) and a male to female ratio of 1.8:1. Four thymomas (4/17, 23.5%) were associated with neuromuscular disease: myasthenia gravis (n = 3) and limbic encephalitis (n = 1). FNA, under CT guidance, was performed in 7 cases. The positive predictive value for thymoma by FNA cytology was 100% and the sensitivity was 71%. Thymomas associated with neuromuscular disorders were WHO types B2 (n = 1) and B3 (n = 3), and showed a strong expression of CD57 in the majority of neoplastic epithelial cells accompanied by large numbers of CD20+ intratumoral B lymphocytes. Two of seventeen (11.7%) thymomas (all sporadic B3 type) contained numerous neoplastic epithelial cells positive for CD5 and bcl-2.

Conclusion

Our results suggest that thymomas associated with autoimmune disorders contain a significant population of CD20+ intratumoral B lymphocytes. Strong CD57 positivity in thymomas may suggest a concomitant neuromuscular disorder, notably myasthenia gravis. CD5 expression is of limited value in the differential diagnosis of primary thymic epithelial neoplasms since both thymic carcinomas and thymomas may express CD5.

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Title: Thymomas: a cytological and immunohistochemical study, with emphasis on lymphoid and neuroendocrine markers
Authors: Borislav A Alexiev
Cinthia B Drachenberg
Allen P Burke
Publication date: 01-12-2007
Publisher: BioMed Central
Published in: Diagnostic Pathology / Issue 1/2007
Electronic ISSN: 1746-1596
DOI: https://doi.org/10.1186/1746-1596-2-13

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Thymomas: a cytological and immunohistochemical study, with emphasis on lymphoid and neuroendocrine markers

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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