• Title, Summary, Keyword: Thymic tumors

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A clinical study of the mediastinal tumors and cysts. [50 Cases Analysis] (종격동 종양 및 낭종 50례에 대한 임상적 고찰)

  • 조순걸
    • The Korean Journal of Thoracic and Cardiovascular Surgery
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    • v.18 no.4
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    • pp.849-854
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    • 1985
  • We have experienced 50 cases of mediastinal tumors and cysts from March, 1979 to August, 1985 at Kyung Hee University Hospital. The results of this cases analysis were as followings; 1. Of all 50 mediastinal tumors and cysts, 26 patients were male and 24 patients were female. There was no sex preference. The age distribution was from 27 months to 64 years, and mean age was 33.5 years old, and also no age preference. 2. The most common mediastinal tumor was benign cysts [12 cases], which comprise 24% of all mediastinal tumors and cysts. The second common mediastinal tumor was teratoma [9 cases-18%], and followed by thymic tumors and tuberculous granuloma [7 cases-14% each], neurogenic tumors [5 cases-10%], and other tumors [10 cases-20%]. 3. The anterior mediastinum was most common tumor location, and followed by middle, superior, and posterior. 4. All 9 teratomas were developed at anterior mediastinum, and 4 of 5 neurogenic tumors were developed at posterior mediastinum. Thymomas were developed at anterior and superior mediastinum. The bronchogenic cysts had no predilection of location. 5. The most common chief complaint at admission was chest pain or discomfort [23 cases-46%], and followed by cough with or without sputum, and exertional dyspnea. Asymptomatic patients were only 7 patients [24%]. 6. Of all 50 cases, 38 cases [76%] received radical tumor resection, 7 mediastinoscopic biopsy, 3 explo thoracotomy and biopsy, and 1 neck mass biopsy. 7. There were 2 hospital deaths, one of which was a patient who suffered malignant thymoma and Myasthenia Gravis. The patient received radical tumor excision, but died at 7th POD. The other patient was a patient with malignant transformation of the benign cystic teratoma. The operative mortality was 4%.

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A Case Report of Accessory Cervical Thymus (경부 이소성 흉선종 1예 보고)

  • Lee, Ki-Yun;Chun, Yong-Soon;Nam, Jeong-Su;Lee, Nan-Joo;Yoon, Hye-Kyoung
    • Advances in pediatric surgery
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    • v.14 no.1
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    • pp.83-87
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    • 2008
  • Accessory cervical thymic tissue has been rarely reported. However, it should be included in the differential diagnosis of neck masses in children, along with branchial anomalies, lymph nodes and other tumors. This lesion occurs along the descending line of the thymus between the angle of mandible and superior mediastinum. A 2-month-old infant presented with an asymptomatic left sided neck mass. MRI revealed a well defined homogeneous mass in the deep lobe of left parotid gland. At operation, an easily identified soft tissue mass was found in the left submandibular area, measuring $3{\times}1.5cm$. It was completely excised. Microscopic examination revealed normal thymic tissue.

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Therapeutic Effect of 18β-Glycyrrhetinic Acid on HT-29 Cancer Cell in a Murine Xenograft Model (HT-29 암세포 이종이식으로 유발된 종양에 대한18β-Glycyrrhetinic Acid의 치료효과)

  • Han, Yongmoon;Kim, Jeonghyeon
    • YAKHAK HOEJI
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    • v.59 no.4
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    • pp.164-169
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    • 2015
  • In the present study, we determined the effect of $18{\beta}$-glycyrrhetinic acid ($18{\beta}$-GA) in the mice model bearing xenografts of HT-29 human colon cancer cell line. Data from the cytotoxicity assay displayed that $18{\beta}$-GA induced cell death in HT-29. The cytotoxicity was enhanced as the $18{\beta}$-GA treatment was prolonged. In case of 72 hrs treatment, $LD_{50}$ of $18{\beta}$-GA was approximately $90{\mu}M$, and the efficacy at $100{\mu}M$ of $18{\beta}$-GA appeared to be equivalent to that of doxorubicin at $1{\mu}M$. Based on the in vitro data, we tested the anti-tumor effect of $18{\beta}$-GA in thymic mice (Balb/c strain). Xenograft tumors were generated by subcutaneous injection of HT-29 ($3{\times}10^6cells/mouse$) to mice and the mice were treated intraperitoneally with $18{\beta}$-GA ($50{\mu}g/time/mouse$) every other day for 4 times. The tumor volumes were measured for a period of 14 days. Data displayed that the $18{\beta}$-GA treatment reduced the tumor volumes (P < 0.05) as compared to control mice. However, this activity was demolished when athymic mice (Balb/c nu/nu) were used instead of thymic mice. This observation appeared that T lymphocyte played an important role in the anti-tumor activity. In conclusion, our results indicate that $18{\beta}$-GA has anti-tumor activity in HT-29 tumor-bearing mice, which may be associated with T cells.

A Case of Squamous Cell Carcinoma of Thymus with Negative CD5, Cytokeratin 7 and Positive Cytokeratin 13 (CD5와 Cytokeratin 7에 음성이고 Cytokeratin 13에 양성인 흉선 편평상피세포암 1예)

  • Park, Moo-Suk;Chung, Jae-Ho;Noh, Tae-Woong;Sohn, Joo-Hyuk;Kim, Young-Sam;Chang, Joon;Chung, Kyung-Young;Kim, Joo-Hang;Kim, Sung-Kyu;Shin, Dong-Hwan;Kim, Se-Kyu
    • Tuberculosis and Respiratory Diseases
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    • v.51 no.3
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    • pp.281-288
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    • 2001
  • Background : The most common anterior mediastinal tumors originate from the thymus. Among them, thymic carcinomas occur as an early local invasion and wide spread metastases. However, when squamous cell carcinoma in the thymus or mediastinum is identified, an occult primary lung cancer must be excluded because the histologic types resemble those found more typically in the lung. CD5 and cytokeratin immunohistochemical staining is useful in evaluating biopsy samples from those tumors. Squamous cell carcinoma of an unknown primary origin in the mediastinum is a rare occurrence and there are only a handful of case reports. Here we describe a case with an anterior mediastinal mass of squamous cell carcinoma with unknown primary origin. A resection of the mediastinal mass without an association with the lung was performed. Immunohistochemical stallings were positive using cytokeratin 13, and negative using CD5 and cytokeratin 7. This was followed by chemotherapy for presumed thymic carcinoma.

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Clinical Study of 61 cases Benign Lung Tumor (폐양성 종양 61례의 외과적 고찰)

  • 박종원
    • The Korean Journal of Thoracic and Cardiovascular Surgery
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    • v.22 no.2
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    • pp.272-289
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    • 1989
  • Benign lung tumors compose a heterogeneous group of solid growths that present variations in clinical features, depending on whether the origin is within the bronchus on lung parenchyma or from visceral pleura. Benign tumors of the lung are relatively uncommon, and series are to be found in the literature and the classification of benign tumors of the lung continues to be controversial because of disagreement concerning the origin and prognosis of many common lesions. We adopt Liebows original classification but excluded bronchial adenoma which no longer considered as benign tumor and added pulmonary A-V fistula and congenital cystic adenomatoid malformation. We analyzed 61 cases of benign tumors which were composed of 16 original Korean cases and 45 cases which were reported on journal of Thoracic & Cardiovascular Surgery. The results were. [1] Incidence; Of 61 cases, chondromatous hamartoma was 2 cases [41 %], congenital cystic adenomatoid malformation 10 cases [16.4 %], pulmonary A-V fistula 5 cases [8.1 %], sclerosing hemangioma 4 cases [6.5 %], teratoma, plasma cell granuloma & mesothelioma were 3 cases [4.9%], Castlemans disease 2 cases [3.3%], and mucous gland adenoma, paraganglioma, and leiomyoma 1 case [1.6 %]. [2] Age & Sex distribution; Male 30 cases and female 31 cases. Mean age was 31.4 years old. [3] Main symptom; was coughing, 32.8%, and no symptom, 24.6%. [4] Sixty eight percentage of chest film showed mass density, and 4 cases showed calcification, 2 cases had lobulation. [5] Size of mass was large and multiple mass was 2 cases. Endobronchial tumors were 9 cases, 14.9 %. [6] Three cases of endobronchial tumor were preoperatively diagnosed by bronchoscopy and 2 cases of pulmonary A-V fistula were diagnosed by pulmonary arteriography. [7] Seven cases, 11.5%, had associating diseases such as bronchogenic cyst, thymic cyst, Schwannoma, situs inversus, bronchiectasis and bronchogenic carcinoma. [8] Minor resection such as excision 8i: wedge resection were 15 cases, 26.2 %, and 6 cases, 75.4 %, of lobectomy were performed including 5 cases of pneumonectomy 5 cases had. [9] Postoperative complications; One case, 1.6 %, expired due to respiratory insufficiency. Two cases had re-operation due to bleeding and hemoptysis.

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Clinical Analysis of Primary Mediastinal Tumors (원발성 종격동 종양의 임상적 고찰)

  • 변정욱;조창욱
    • The Korean Journal of Thoracic and Cardiovascular Surgery
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    • v.30 no.1
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    • pp.55-60
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    • 1997
  • We reviewed 40 cases of primary mediastinal tumors which were operated on at Seoul Paik Hospital from September, 1987 to December, 1995. Of these, 18 were male and 22 were female. The patient ranged in age from 4 years to 68 years with a mean age of 34.1 years. The most common symptoms included chest pain(12.5%), cough(12.5%), dyspnea(7.5%). and palpable neck mass(7.5%), and symptoms were absent at the time of diagnosis in 37.5% of cases. Chest roentgenography and computed tomography(CT) were performed in all patients, and magnetic resonance imaging(MRI) in 5 patients, and transthoracic needle aspiration (TTNA) performed In 22 patients. The sensitivity of TTNA was 72.7%(16 of 22 patients). The lesion was located 60% in the anterosuperior mediastinum, 35% in the posterior mediastinum, and 5% in the middle mediastinum. The primary tumors included thymic neoplasms(11 cases), germ cell tumors(7 cases), neurogenic tumors(10 cases) and a miscellaneous group. The malignant tumors(12.5%) were invasive thymoma(3 cases), spindle cell sarcoma(1 case), and non-Hodgkin's Iymphoma(1 case). A complete excision was done in all 35 benign tumors and 3 malignant tumors. There was no operative mortality, and postoperative complications occurred in 3 cases.

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A Case of Thymolipoma Simulating Cardiomegaly (심장비대와 감별이 필요했던 흉선지방종 1예)

  • Ju, Hun Su;Kim, Sang Ha;Kim, Jung Kwon;Hong, Tae Won;Lee, Nak Won;Yong, Suk Joong;Shin, Kye Chul;Lee, Kwang Gil;Lee, Won Yeon
    • Tuberculosis and Respiratory Diseases
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    • v.56 no.1
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    • pp.103-108
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    • 2004
  • Thymolipoma is rare benign tumor of the thymic gland and mostly occurs at anterior mediastinum. Thymolipoma comprises 2~9% of thymic tumor and less than 1% of mediastinal mass. Therefore, thymolipoma should be differentiated from anterior mediastinal tumor such as thymoma, germ cell tumor and lymphoma. These tumors resemble cardiomegaly, pleural effusion, basal atelectasis, pericardial tumor and cyst, pleural tumor, lung cancer and pulmonary sequestration, and differentiated from above mentioned diseases. Though most cases are asymptomatic, there can be dyspnea with compression of adjacent organ by mass effect, and myasthenia gravis. We experienced a thymolipoma simulating cardiomegaly and report the case with the review of literatures.

A Clinical Analysis of Thymoma (흉선종의 임상적 고찰)

  • 이헌재
    • The Korean Journal of Thoracic and Cardiovascular Surgery
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    • v.23 no.4
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    • pp.715-719
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    • 1990
  • Thymoma is defined as a neoplasm of the epithelialreticular framework cells of the thymus. The treatment of choice and the prognosis for patients with thymoma are still controversial subjects due to lack of a uniform histological classification and standardized criteria for typing thymic tumors. Between June 1985 and May 1989, eight patients underwent thymomectomy at the Department of Thoracic and Cardiovascular Surgery, Korea University Medical Center. A clinical analysis was performed and the following result was obtained. In histologic cell type, epithelial type was 2 cases, lymphocytic type 3 cases, and mixed type was 3 cases. The clinical stage was classified by Masaoka’s classification that Stage I was 4 cases, Stage II; 2 cases, Stage III; 2 cases and Stage IV was none. Myasthenia Gravis was associated with thymoma in 5 patients. In 8 patients, thymomectomy were performed. Adjuvant radiotherapy was performed in one patient with Stage I due to suspicious tumor remnant and in Stage II, III patients routinely. Combined chemotherapy was performed in one patient with Stage III due to local recurrence. We concluded that the most important prognostic factor of thymoma is extent of tumor invasion. And the presence of Myasthenia Gravis is no more prognostic factor. Surgical resection of thymoma is treatment of choice, If local invasion or distant dissemination is present, postoperative radiotherapy and /or combined chemotherapy is recommended.

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A Clinical Study of Management In Myasthenia Gravis (중증 근무력증 환자의 임상적 고찰)

  • Kim, Hun;Lee, Du-Yeon;Jo, Beom-Gu;Hong, Seung-Rok
    • The Korean Journal of Thoracic and Cardiovascular Surgery
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    • v.20 no.1
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    • pp.112-127
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    • 1987
  • Myasthenia gravis is a neuromuscular transmission function disorder characterized by fatigue and weakness of voluntary muscles. This muscular weakness is intensified by activity and stress, and improved by the use of anticholinesterase compounds. It was initially described by Erb in 1879 and later named myasthenia gravis by Jolly in 1895. Although the pathogenesis is Known to be an autoimmune related reduction in the number of available acetylcholine receptors at neuromuscular junctions, the role of thymus in myasthenia gravis is still unclear and under investigation. Thymectomy in the management of myasthenia gravis has become increasingly important since Dr. Blalock observed in 1939 that some patients with thymic tumors and myasthenia gravis improved following thymectomy. A clinical study of 102 cases of myasthenia gravis was performed at Yonsei University College of Medicine. Seoul, Korea from Jan. 1976 to Jun. 1986. In order to determine which factors are of prognostic significance, attention is focused upon pre-operative patient evaluation, problems in operative and post-operative care, and long-term follow-up observations. The results were as follows: 1. The sex distribution was 67 females and 35 males, the mean age of onset was 28.95*1.69 years, and the maximal incidence occurred between 21 and 40 years of age [56 cases: 54.9%]. 2. Clinical manifestations of ocular symptoms were seen to 70 patients [68.6%] extremities weakness in 33 [32.3%], bulbar weakness in 29 [28.4%], and dyspnea in 13 [12.7%]. 3. Study cases more than two thirds were classified as mild types [MG 1 and MG 11A] and 6 cases as grave [MG 1V] based on the modified Osserman`s classification system, 4. Thymectomy was performed in 19 cases which presented in severe myasthenia symptoms and showed no improvement with cholinergic drugs. Histologic examination of the excised thymus glands revealed no abnormalities in 4 cases, thymic hyperplasia in 5, benign thymoma in 5, and malignant thymoma in 5. 5. Immediate post-operative complications included 2 cases of pneumothorax which were treated by tube thoracostomies, there was no operative mortality. 6. The response to cholinergic drugs in 36 cases younger than 20 years old and in 27 cases older than 40 years was relatively poor, while that in 35 cases between the ages of 21 and 40 years old was good. 7. Thirty of 39 cases in groups IIB, III & IV improved markedly with medical or surgical management while only 16 of 59 cases in the mild groups [I and IIA] improved, almost all surgical cases improved in all categories. 8. There were 5 deaths. occurring between 7 months and 3 years 3 months of treatment of myasthenia gravis. The causes of death were myasthenic crisis in 2 cases, respiratory failure due to candidiasis & radiation pneumonitis in one case, cerebral hemorrhage due to high blood pressure in two case.

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CT findings of the Mediastinal tumors (종격동 종양의 전산화단층촬영 소견)

  • Chung, Ho-Son;Lee, Sang-Jin;Son, Mi-Young;Kwon, Hyuk-Po;Hwang, Mi-Soo;Kim, Son-Yang;Chang, Jae-Chun;Park, Bok-Hwan
    • Yeungnam University Journal of Medicine
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    • v.6 no.2
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    • pp.79-90
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    • 1989
  • Computerized Tomography is now well established and important noninvasive method of diagnosting mediastinal mass lesions because of its superior imaging of their size, location and internal composition. Authors ana lysed and present CT findings of 30 surgically proven mediastinal tumors and cysts that were studied and treated at the Yeungnam University Hospital during recent 6 years. The most common tumor was thymona(9 cases), and teratoma(6 cases), lymphoma(6 cases), bronchogenic cyst(4 cases), neurogenic tumor (4 cases), pericardial cyst(1 case) were next in order of frequency. There were 5 cases of thymoma showing homogenous solid density mass, 2 cases were malignant thymoma and myasthenia gravis was present in 2 cases. A case of thymolipoma and a case of thymic carcinoma were included. All teratomas were cystic masses but pathognomic fat, and calcified density were seen only in 4 cases. 5 cases were located in anterior mediastinum and 1 case was in posterior mediastinum. Lymphoma(3 Hodgkin's and 3 non-Hodgkin's) appeared as irregular lobulated mass in anterior mediastinum. Neurogenic tumor(2 ganglioneuroma and 2 neurilemmoma) appeared as homogenous density mass located in posterior mediastinum. Among the 4 bronchogenic cysts, 2 were located in retrotracheal area, 1 was located in subcarinal and 1 was in parathoracic area. One case of pericardial cyst was oval shaped cystic mass located in left pericardiac border.

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