Clinical management of cervical ectopic thymus in children

Wang, Jun; Fu, Honghai; Yang, Huawei; Wang, Lizhen; He, Yue

doi:10.1016/j.jpedsurg.2011.05.002

Cited by 20 publications

(22 citation statements)

References 22 publications

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“…Our study showed only a rare case with evidence of Hassall's corpuscles, and more commonly showed small lymphocytes with scattered large epithelioid cells, without the typical tingible body macrophages seen in reactive lymphoid hyperplasia. Ancillary studies are important to confirm the presence of immature and maturing T‐cells, and this typically involves triaging the specimen for FC and/or immunohistochemical stains . Given that FC is helpful in these cases to immunophenotype the lymphocytes, on‐site evaluation for these FNAs can be critical to triage the aspirates appropriately…”

Section: Discussionmentioning

confidence: 99%

“…Ancillary studies are important to confirm the presence of immature and maturing T-cells, and this typically involves triaging the specimen for FC and/or immunohistochemical stains. 17 Given that FC is helpful in these cases to immunophenotype the lymphocytes, on-site evaluation for these FNAs can be critical to triage the aspirates appropriately. 18 Other studies of ectopic thymic tissue in the neck of children have found variable incidence, ranging from 0.99% of cases to 33% of cases.…”

Section: Cytomorphological and Ancillary Study Findingsmentioning

confidence: 99%

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Cytomorphology and sonographic features of ectopic thymic tissue diagnosed in paediatric FNA biopsies

et al. 2018

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Ectopic thymic tissue is rarely present as a neck mass or thyroid nodule on FNA biopsy. The ultrasound imaging findings reveal a well-defined fusiform lesion with punctate bright echoes that could be misinterpreted as papillary thyroid carcinoma. The aspirates show a small lymphoid population, immunophenotypically compatible with thymic T-cells, in addition to scattered epithelial cells. Therefore, knowledge of the typical ultrasonographic and cytopathological features can help make a definitive diagnosis and avoid more invasive procedures in paediatric patients.

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Section: Discussionmentioning

confidence: 99%

Section: Cytomorphological and Ancillary Study Findingsmentioning

confidence: 99%

Cytomorphology and sonographic features of ectopic thymic tissue diagnosed in paediatric FNA biopsies

et al. 2018

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“…The thymus gland is composed of two lobes and it is normally located in the superior and anterium mediastinum, just behind the manubrium of the sternum (Wang et al 2011) (Fig. 12a).…”

Section: Vessels Development In Murine Natal and Postnatal Thymusmentioning

confidence: 99%

“…In rare cases, this gland may found at an ectopic site, at any level of the pathway of normal thymic descent, from the angle of the mandible to the superior mediastinum. Thymus shape and size have a pretty large range of variability and change throughout the life of the subject, being large in infants and pre-adolescent period and gradually coalescing and being substituted by fat in the early adulthood (Wang et al 2011;Chowhan et al 2010;Herman and Siegel 2009;Mizia-Malarz et al 2009;Prasad et al 2006) (Fig. 12b).…”

Section: Vessels Development In Murine Natal and Postnatal Thymusmentioning

confidence: 99%

Thymus and aging: morphological, radiological, and functional overview

Rezzani

Nardo

Favero

et al. 2013

AGE

159

112

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Aging is a continuous process that induces many alterations in the cytoarchitecture of different organs and systems both in humans and animals. Moreover, it is associated with increased susceptibility to infectious, autoimmune, and neoplastic processes. The thymus is a primary lymphoid organ responsible for the production of immunocompetent T cells and, with aging, it atrophies and declines in functions. Universality of thymic involution in all species possessing thymus, including human, indicates it as a long-standing evolutionary event. Although it is accepted that many factors contribute to age-associated thymic involution, little is known about the mechanisms involved in the process. The exact time point of the initiation is not well defined. To address the issue, we report the exact age of thymus throughout the review so that readers can have a nicely pictured synoptic view of the process. Focusing our attention on the different stages of the development of the thymus gland (natal, postnatal, adult, and old), we describe chronologically the morphological changes of the gland. We report that the thymic morphology and cell types are evolutionarily preserved in several vertebrate species. This finding is important in understanding the similar problems caused by senescence and other diseases. Another point that we considered very important is to indicate the assessment of the thymus through radiological images to highlight its variability in shape, size, and anatomical conformation.

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“…Diagnosis of ECT previously required surgical excision, which was prone to concomitant risks . However, there has been growing acceptance for the role of surveillance imaging in newer management algorithms .…”

Section: Introductionmentioning

confidence: 99%

Ectopic cervical thymus in children: Clinical and radiographic features

et al. 2019

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Objectives: Ectopic thymus is rare and can be a diagnostic challenge. This study evaluated the management of children radiographically diagnosed with ectopic cervical thymus.Methods: A retrospective review of 100 patients was performed. Data related to clinical presentation, radiological imaging, pathology, and management were collected. Changes in lesion volume were tracked over time. Clinical characteristics were compared based on lesion location in the neck using analysis of variance modelling.Results: There were 115 lesions with radiographic features of ectopic cervical thymus (15 children had bilateral lesions). Diagnosis was based on ultrasound in 98% of patients, magnetic resonance imaging in 18%, and computed tomography in 11%. Mean (SD) follow-up duration was 2 (2.2) years. Forty-four percent (51/115) of lesions involved the thyroid gland, 29% (33/115) were in the central neck but separate from the thyroid, 18% (21/115) had mediastinal extension, and 8% (9/115) involved the submandibular region. Location was unclear for two patients. Submandibular lesions were on average 12.4 cm 3 larger (95% CI, 8.2, 16.6) than mediastinal lesions at diagnosis, P ≤ .001. Volume of thymic tissue decreased over time, from a mean (standard deviation [SD]) volume of 4.3 cm 3 (9.2) at initial ultrasound to 2.7 cm 3 (6.1) at final ultrasound (paired t-test, P = .008). Only two patients required surgery: one for compressive symptoms, and the other to rule out malignancy.Conclusion: Ninety-eight percent of children with ectopic cervical thymus were managed conservatively without issues. We propose a classification system based on location to ease communication among clinicians and to help follow these lesions over time.

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Clinical management of cervical ectopic thymus in children

Cited by 20 publications

References 22 publications

Cytomorphology and sonographic features of ectopic thymic tissue diagnosed in paediatric FNA biopsies

Cytomorphology and sonographic features of ectopic thymic tissue diagnosed in paediatric FNA biopsies

Thymus and aging: morphological, radiological, and functional overview

Ectopic cervical thymus in children: Clinical and radiographic features

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