Micronodular thymoma with lymphoid stroma diagnosed 10 years after the first operation: a case report

Abstract

IntroductionMicronodular thymoma with lymphoid stroma is a rare subtype of thymoma. Here we report a case of micronodular thymoma with lymphoid stroma that was completely resected after incomplete resection 10 years earlier.Case presentationA 70-year-old Japanese woman who had undergone resection for a thymic cyst 10 years earlier was found to have a solid nodule with a multilocular lesion at the site of the previous operation. We suspected that the tumor was a malignant tumor and performed trans-sternal radical thymectomy and diagnosed the lesion as micronodular thymoma with lymphoid stroma pathologically. When we reassessed the thymic cyst that had been resected 10 years earlier, a few lesions of micronodular thymoma with lymphoid stroma were found in the cyst wall. Based on these findings, we concluded that only the cystic component of micronodular thymoma with lymphoid stroma had been removed, and that the residual lesion grew locally over the next 10 years before being completely resected by reoperation.ConclusionWe experienced an unusual case of micronodular thymoma with lymphoid stroma, which is a rare subtype of thymoma. Greater care should be taken to exclude a thymoma with a cystic lesion, even if a thymic cyst is strongly suspected on computed tomography and magnetic resonance imaging.

Micronodular thymoma with lymphoid stroma: a clinicopathological study of five cases

“…1 Recognition of this histological subtype of thymoma is important as it has an excellent prognosis, with only a single published case of recurrence that occurred after incomplete initial resection. 2 We identified all MTLS from the archives of Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, NSW Health Pathology, Sydney, and reviewed clinical and pathological features. Over an 8-year time period, five cases of MTLS were identified.…”

Surgical treatment of micronodular thymoma with lymphoid stroma

“…Although there has been no known characteristic symptoms of MTWLS, myasthenia gravis and hypogammaglobulinaemia have been reported . Surgical resection would be the treatment of choice because there have been no reports of recurrence in the literature . However, further long‐term follow‐up studies would be required for the clear understanding of pathology.…”

Difference in the distribution of tumor‐infiltrating CD8+ T cells and FOXP3+ T cells between micronodular thymoma with lymphoid stroma and micronodular thymic carcinoma with lymphoid stroma

“…The extracted patient data included patient age, sex, surgical procedure, Masaoka stage, 1 TNM stage based on the TNM Classification of Malignant Tumours 8th Edition of the UICC , 12 and clinical outcomes. The clinical courses of two cases (Cases 2 and 11) were previously published as case reports 13,14 …”

“…The clinical courses of two cases (Cases 2 and 11) were previously published as case reports. 13 , 14 …”

“…The clinical courses of two cases (Cases 2 and 11) were previously published as case reports. 13,14 This study was conducted in accordance with the recommendations of the Declaration of Helsinki and was approved by the ethics committees of the participating hospitals.…”