A Case of Giant Atypical Thymoma in the Thoracic Cavity

14 References
  • KOGA Mamoru
    Second Department of Surgery, Nihon University School of Medicine
  • OHMORI Kazumitsu
    Second Department of Surgery, Nihon University School of Medicine
  • HASEGAWA Masae
    Second Department of Surgery, Nihon University School of Medicine
  • NEGISHI Nanao
    Second Department of Surgery, Nihon University School of Medicine

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  • 胸腔内に巨大な腫瘤を形成した atypical thymoma の 1例

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Case:A 47-year-old company employee had no remarkable past history and physical examination performed in November 1997 yielded no abnormal findings, but chest radiography performed in November 1998 revealed an abnormal shadow. The tumor was 15×10 cm and in the left thoracic cavity involved the pulmonary vein, lingular segment and the chest wall. Needle biopsy yielded a diagnosis of thymoma. The patient received 2 courses of chemotherapy(ADOC)but the tumor size only reduced 11%, which was changed as no change. Thereafter, extended thymectomy was performed with combined resection of the pericardium, the left upper lobe of the lung, and S^6, through a median sternotomy and additional postero-lateral thoracotomy. The resected specimen was Masaoka's stage III, invading the pericardium and the left upper lobe of the lung. The margin was negative, indicating a successful radical resection. Immunohistochemical investigation showed dense staining with bcl-2 and Ki67(MIB-1), suggesting increased proliferative activity. Staining with O13(MIC2)showed that the lymphocytes infiltrating the tumor were immature. Therefore, the tumor was not thymic carcinoma, but was atypical thymoma. Conclusion:Analysis of lymphocyte surface markers was useful in making differential diagnosis between invasive thymoma and thymic carcinoma.

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