Role of Imaging in the Diagnosis, Staging, and Treatment of Thymoma

Abstract

Thymoma is a rare mediastinal neoplasm but is the most common primary neoplasm of the anterior mediastinum. There have been only a few published reports assessing this disease. Furthermore, many of these reports are from a single institution and span several decades, which may lead to potentially misleading conclusions related to diagnosis, staging, and treatment. Computed tomography is the imaging modality of choice for evaluating thymoma and can help distinguish thymoma from other anterior mediastinal abnormalities. Tumor stage and extent of resection are the most important prognostic factors. Tumors that are encapsulated and are amenable to complete resection have a good prognosis, whereas invasive and unresectable tumors have a poor prognosis regardless of their histologic characteristics. Radiologists must be aware of the full spectrum of imaging findings of thymoma, the standard guidelines for diagnostic evaluation, and how imaging findings affect therapeutic decisions.

Diffusion-weighted MR Imaging in Thymic Epithelial Tumors: Correlation with World Health Organization Classification and Clinical Staging

“…Different imaging modalities have been used for assessment of thymic epithelial tumors (1,(7)(8)(9)(10). Computed tomographic (CT) imaging is commonly used to assess thymic epithelial tumors, Implication for Patient Care n Diffusion MR imaging is a fast sequence that can be readily implemented with commercially available MR imagers and enables noninvasive assessment of thymic epithelial tumors in conjunction with routine MR imaging findings.…”

Computed tomography characterization of neuroendocrine tumors of the thymus can aid identification and treatment

“…6) (14,15). Thymomas are the most common primary neoplasm of the anterior mediastinum, and they consist of an encapsulated non-invasion and invasion types.…”

ITMIG Classification of Mediastinal Compartments and Multidisciplinary Approach to Mediastinal Masses

“…Thymic Epithelial Neoplasms.-A solid, homogeneous or slightly heterogeneous mass in the prevascular mediastinal compartment in men and women older than 40 years with immunologic diseases such as myasthenia gravis (most common) or other paraneoplastic syndromes such as pure red cell aplasia/Diamond-Blackfan syndrome, hypogammaglobulinemia, or aplastic anemia likely represents a thymoma (46) (Fig 8a). More than 80% of thymomas can be accurately diagnosed with multidetector CT or MR imaging in this setting, and tissue diagnosis is typically unnecessary (22).…”