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Thymus and Thymoma

Thymus and Thymoma. Jeffrey L Arnold University of South Carolina SOM Class of 2010 July 30, 2009. Great Moments in Thymus History. “Organ of mystery” Seat of the soul Cushion Great importance… T Cell maturation. Galen of Pergamum (130-200 AD). Thymus. Pyramid shaped

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Thymus and Thymoma

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  1. Thymus and Thymoma Jeffrey L Arnold University of South Carolina SOM Class of 2010 July 30, 2009

  2. Great Moments in Thymus History • “Organ of mystery” • Seat of the soul • Cushion • Great importance… • T Cell maturation Galen of Pergamum (130-200 AD)

  3. Thymus • Pyramid shaped • 3rd and 4th pharyngeal • Anterior Mediastinum • Baby  adult, involutes • Cellular Immunity • Unique Pathology

  4. Thymus Histology nhscience.lonestar.edu/biol/lymphatic/thymus.htm

  5. Thymoma • RARE • Most common tumor of anterior mediastinum • Male=Female, >40 yo • 70% non-invasive • 50% asymptomatic • Clinical complications • Paraneoplastic syndromes • DDX, the 4 Ts • Thymus • Teratoma • Thyroid • Terrible Lymphoma Myasthenia Gravis

  6. DDX?

  7. 26 yo F c/o weakness

  8. Thymoma on CT

  9. Thymoma on CT

  10. Thymoma Histology

  11. Thymic Neoplasms • Difficult based on morphology alone • Masaoka staging system based on surgery • WHO classification 1999  invasivness • Most clinicians and radiologists are unfamiliar with these systems • MRI, PET • CT

  12. Treatment • Surgery • Chemo • Radiation Image taken from VATS

  13. So many questions…

  14. References • Nishino, M., et al. The Thymus: A Comprehensive Review. Radiographics 2006; 26:335-348 • Web resources cited in PPT notes section

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