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Relationship Between Computed Tomography Manifestations of Thymic Epithelial Tumors and the WHO Pathological Classification

  • Liu, Guo-Bing (Department of Radiology, Zhongnan Hospital of Wuhan University) ;
  • Qu, Yan-Juan (Department of Radiology, Zhongnan Hospital of Wuhan University) ;
  • Liao, Mei-Yan (Department of Radiology, Zhongnan Hospital of Wuhan University) ;
  • Hu, Hui-Juan (Department of Radiology, Zhongnan Hospital of Wuhan University) ;
  • Yang, Gui-Fang (Department of Pathology, Zhongnan Hospital of Wuhan University) ;
  • Zhou, Su-Jun (Department of Radiology, Zhongnan Hospital of Wuhan University)
  • Published : 2012.11.30

Abstract

Objective: To explore the relationship between computed tomography (CT) manifestations of thymoma and its WHO pathological classification. Methods: One hundred and five histopathologically confirmed cases were collected for their pathological and CT characteristics and results were statistically compared between different pathological types of thymoma. Results: Tumor size, shape, necrosis or cystic change, capsule integrity, invasion to the adjacent tissue, lymphadenopathy, and the presence of pleural effusion were significantly different between different pathological types of thymomas (P<0.05). Type B2, B3 tumors and thymic carcinomas were greater in size than other types. More than 50% of type B3 tumors and thymic carcinomas had a tumor size greater than 10 cm. The shape of types A, AB, and B1 tumors were mostly round or oval, whereas 75% of type B3 tumors and 85% of thymic carcinomas were irregular in shape. Necrosis or cystic change occurred in 67% of type B3 thymomas and 57% of thymic carcinomas, respectively. The respective figures for capsule destruction were 83% and 100%. Increases in the degree of malignancy were associated with increases in the incidence of surrounding tissue invasion: 33%, 75%, and 81% in type B2, type B3, and thymic carcinomas, respectively. Pleural effusion occurred in 48% of thymic carcinomas, while calcification was observed mostly in type B thymomas. Conclusions: Different pathological types of thymic epithelial tumors have different CT manifestations. Distinctive CT features of thymomas may reflect their pathological types.

Acknowledgement

Supported by : Natural Science Foundation of Hubei Province

References

  1. Chen G, Marx A, Chen WH, et al (2002). New WHO histologic classification predicts prognosis of thymic epithelial tumors: a clinicopathologic study of 200 thymoma cases from China. Cancer, 95, 420-9. https://doi.org/10.1002/cncr.10665
  2. Engels EA, Pfeiffer RM (2003). Malignant thymoma in the United Stated: demographic patterns in incidence and associations with subsequent malignancies. Int J Cancer, 105, 546-51. https://doi.org/10.1002/ijc.11099
  3. Han J, Lee KS, Yi CA, et al (2003). Thymic epithelial tumors classified according to a newly established WHO scheme: CT and MR findings. Korean J Radiol, 4, 46-53. https://doi.org/10.3348/kjr.2003.4.1.46
  4. Hansell DM, Bankier AA, MacMahon H, et al (2008). Fleischner Society: glossary of terms for thoracic imaging. Radiology, 246, 697-722. https://doi.org/10.1148/radiol.2462070712
  5. Jung KJ, Lee KS, Han J, et al (2001). Malignant thymic epithelial tumors: CT-pathologic correlation. AJR Am J Roentgenol, 176, 433-9. https://doi.org/10.2214/ajr.176.2.1760433
  6. Kondo K, Monden Y (2003). Therapy for thymic epithelial tumors: a clinical study of 1,320 patients from Japan. Ann Thorac Surg, 76, 878-85. https://doi.org/10.1016/S0003-4975(03)00555-1
  7. Kondo K, Yoshizawa K, Tsuyuguchi M, et al (2004). WHO histologic classification is a prognostic indicator in thymoma. Ann Thorac Surg, 77, 1183-8. https://doi.org/10.1016/j.athoracsur.2003.07.042
  8. Maher MM, Shepard JA (2005). Imaging of thymoma. Semin Thorac Cadiovasc Surg, 17, 12-9. https://doi.org/10.1053/j.semtcvs.2004.12.003
  9. Marom EM (2010). Imaging thymoma. J Thorac Onco, 5, S296-303. https://doi.org/10.1097/JTO.0b013e3181f209ca
  10. Marom EM, Milito MA, Moran CA, et al (2011). Computed tomography findings predicting invasiveness of thymoma. J Thorac Oncol, 6, 1274-81. https://doi.org/10.1097/JTO.0b013e31821c4203
  11. Nakagawa K, Asamura H, Matsuno Y, et al (2003). Thymoma: a clinicopathologic study based on the new World Health Organization classification. J Thorac Cardiovasc Surg, 126, 1134-40. https://doi.org/10.1016/S0022-5223(03)00798-0
  12. Okumura M, Ohta M, Tateyama H, et al (2002). The World Health Organization histologic classification system reflects the oncological behavior of thymoma. A clinical study of 273 patients. Cancer, 94, 624-32. https://doi.org/10.1002/cncr.10226
  13. Okumura M, Shiono H, Minami M, et al (2008). Clinical and pathological aspects of thymic epithelial tumors. Gen Thorac Cardiovasc Surg, 56, 10-6. https://doi.org/10.1007/s11748-007-0177-8
  14. Priola AM, Priola SM, Di Franco M, et al (2010). Computed tomography and thymoma: distinctive findings in invasive and noninvasive thymoma and predictive features of recurrence. Radiol Med, 115, 1-21. https://doi.org/10.1007/s11547-009-0478-3
  15. Rosai J, Sobin LH (1999). Histological typing of tumours of the thymus. World Health Organization, International histological classification of tumours, 2ed; New York, NY: Springer-Verlag.
  16. Sadohara J, Fujimoto K, Muller NL, et al (2006). Thymic epithelial tumors: comparison of CT and MR imaging findings of low-risk thymomas, high-risk thymomas, and thymic carcinomas. Eur J Radiol, 60, 70-9. https://doi.org/10.1016/j.ejrad.2006.05.003
  17. Strobel P, Bauer A, Puppe B, et al (2004). Tumor recurrence and survival in patients treated for thymomas and thymic squamous cell carcinomas: a retrospective analysis. J Clin Oncol, 22, 1501-9. https://doi.org/10.1200/JCO.2004.10.113
  18. Tian J, Chen W, Du S, Chen S (2003). CT manifestations of invasive thymomas and pathological results. Chin J Clin Radiol, 22, 197-9.
  19. Tomiyama N, Johkoh T, Mihara N, et al (2002). Using the World Health Organization Classification of thymic epithelial neoplasms to describe CT findings. AJR Am J Roentgenol, 179, 881-6. https://doi.org/10.2214/ajr.179.4.1790881
  20. Tomiyama N, Muller NL, Ellis SJ, et al (2001). Invasive and noninvasive thymoma: distinctive CT features. J Comput Assist Tomogr, 25, 388-93. https://doi.org/10.1097/00004728-200105000-00010
  21. Travis WD, Brambilla E, Muller-Hermelink HK, et al (2004). WHO classification of tumors. Pathology and genetics of tumors of the lung, pleura, thymus and heart. Lyon: IARC Press.
  22. Yanagawa M, Tomiyama N (2011). Prediction of thymoma histology and stage by radiographic criteria. Thorac Surg Clin, 21, 1-12. https://doi.org/10.1016/j.thorsurg.2010.08.008
  23. Yang WT, Lei KI, Metreweli C (1997). Plain radiography and computed tomography of invasive thymomas: clinicoradiologic-pathologic correlation. Australas Radiol, 41, 118-24. https://doi.org/10.1111/j.1440-1673.1997.tb00695.x

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