Thymoma: Clinical experience from a tertiary care institute from North India

Kumar, Narendra; Kumar, Ritesh; Bera, Anjan; Ghoshal, Sushmita; Kapoor, Rakesh; Radotra, BD; Sharma, Suresh C.

doi:10.4103/0973-1482.113364

Cited by 10 publications

(18 citation statements)

References 24 publications

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“…Global data have reported no sex predilection for TETs; however, the Indian studies had shown male predominance similar to the observation in the present series101415171823. Only two studies from India demonstrated a female-predominant population1316.…”

Section: Discussionsupporting

confidence: 83%

“…Its incidence in the Indian population has not been defined and in the power analysis carried out by Marchevsky et al 11, only 20 cases of thymomas were included from India. Among the Indian studies with more than 10 cases121314151617181920, Julka et al 18 had the largest sample with 71 cases (all thymomas) from the same centre; however, histomorphological spectrum was not described in this study. Except for studies by Vaideeswar et al 19 and Sundaram et al 20, none of the studies assessed the histomorphology of TET, especially thymic carcinomas.…”

Section: Discussionmentioning

confidence: 68%

“…It was also seen that MG was significantly associated with lower-stage lesions. The Indian literature reviewed has also depicted Stage I disease as the most common Masaoka staging except a few study121318. The distribution of different histological types in various stages reveals Type A and AB thymomas to present more commonly in lower stages as compared to Type B thymomas11.…”

Section: Discussionmentioning

confidence: 99%

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Histotyping of Indian thymomas

Guleria

Parshad

Malik

et al. 2019

Indian Journal of Medical Research

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Background & objectives:Thymomas are rare, but most common anterior mediastinal lesions. The histomorphologic spectrum of thymic epithelial tumours (TETs) in Indian population has not been explored in depth. This study was aimed to assess the histomorphology of TETs in the Indian patients and correlate clinical parameters with pathological features.Methods:It was a retrospective study conducted in a tertiary referral hospital in north India. All morphologically confirmed cases of TETs since 2009 were included. Clinical details and histology slides were reviewed using the Modified Masaoka-Koga staging system and WHO 2015 classification. Clinicopathological correlation and survival analysis were done. A comparative review from other published Indian studies was performed.Results:A total of 219 cases of TETs (138 resections and 81 biopsies) were identified. The most common histomorphologic type was B2, and the most frequent stage was I. Types A/AB were common in older age (P<0.01). Clinically, higher stage tumours were found mostly in men (P<0.01), and these were Type B thymomas (P<0.01). Myasthenia gravis was more common in women (P<0.02) and in lower stages (P<0.05). Survival analysis revealed significant association between recurrence and tumour stage. Although thymic carcinoma was diagnosed on biopsy, no resectable case was identified.Interpretation & conclusions:Our findings showed that the thymomas in Indian patients were most commonly Stage I tumours of B2 and AB histotypes. Resected thymic carcinomas were conspicuously absent in our study. More studies need to be done to establish the frequency and biology of TETs from India.

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Section: Discussionsupporting

confidence: 83%

Section: Discussionmentioning

confidence: 68%

Section: Discussionmentioning

confidence: 99%

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Histotyping of Indian thymomas

Guleria

Parshad

Malik

et al. 2019

Indian Journal of Medical Research

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“…and the mean age in adults was (47.7 yrs.). [3][4][5][6][7][8][9][10][11][12][13] The remaining 4 (9.3%) cases were in paediatric age group (<16 yrs.) aged between 04-15 years (9.30%) with mean age of 9 years, of these four paediatric cases two were benign lesions diagnosed as thymic cysts (Fig-1a & b) aged 04 and 07 yrs.…”

Section: Resultsmentioning

confidence: 99%

Histopathological Spectrum of Mediastinal Lesions in a Tertiary Care Centre, Andhra Pradesh, India

Parasa¹,

Remala²,

Turlapati³

2019

jemds

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BACKGROUNDMediastinal lesions are uncommon and infrequent, encountered as mediastinal masses with wide histopathological spectrum which cause diagnostic difficulty to the clinicians and radiologists because of the variations of presenting symptoms, locati on and accessibility. Mediastinal lesions also pose difficulty in obtaining samples directly by Fine Needle Aspiration or Needle Core Biopsy technique, Ultra Sound/ Computed Tomography guided techniques aid in getting adequate material and to arrive at a definitive diagnosis in cases where resection of the lesion is not possible, and accessibility is poor. We wanted to present the spectrum of histopathological diagnosis of various mediastinal lesions both benign and malignant, encountered in this institution, a tertiary care center in India. METHODSThis is a retrospective study conducted from June 2015-December 2018 on Fine Needle Aspirations (FNA), Needle Core Biopsies (FNB) and surgically resected specimens of all mediastinal lesions sent to the Department of Pathology for histopathological examination. RESULTSA total of 43 cases of mediastinal lesions was taken into consideration. Out of these 43 cases, 17 (39.53%) were CT guided FNA, 5 (11.63%) CT guided FNBs and 21 (48.84%) were excised specimens. In 3 (6.97%) of these cases of FNA diagnosis was inconclusive and in 2 (4.65%) cases no opinion could be given as material was necrotic and inadequate. Of the total 43 cases 27 (62.8 %) cases were males and about 16 (37.2%) were female patients. M:F ratio was 1.7:1. Age distribution was between 04 -70 yrs. 4 (9.30%) of the cases were in paediatric age group (<16 yrs.) and 39 (90.60 %) were in adult age group (>1 6 yrs.). Mean age in adults was (47.7 yrs.). CONCLUSIONSThe present study emphasizes on the importance of awareness of various lesions that can occur in mediastinum, spectrum of histopathological variants and a definitive diagnosis in guiding the treating clinician to initiate the appropriate treatment at the earliest especially in cases of malignancies and non resectable lesions. Wherever necessary IHC should be done. In the present study, thymic lesions and lymphomas are the most common lesions encountered in adults (8 and 7 of the total 43 lesions). In paediatric age group, we encountered two thymic cysts and two lymphomas of which one was Hodgkin's and the other was Non-Hodgkin's lymphoma. HOW TO CITE THIS ARTICLE: Parasa GD, Remala KR, Turlapati SPV. Histopathological spectrum of mediastinal lesions in a tertiary care centre, Andhra Pradesh, India. BACKGROUND Mediastinal lesions are uncommon lesions which occur in the central portion of the thoracic cavity, limited by pleural cavities laterally, thoracic inlet superiorly, the diaphragm inferiorly and vertebral column posteriorly. Diagnosis of these lesions is a difficult task for clinicians, radiologists and pathologists because of its variable presentation clinically, inaccessibility and also due to histomorphological variations. Mediastinal masses present as space occupying masses situated in differ...

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“…The exact cause of thymomas remains unknown. These are typically slow-growing tumors that manifest themselves by local extension and when metastatic, the lesions are generally confined to the pleura, pericardium, or diaphragm [4-6]. The incidence of thymomas is estimated to be 1.3 cases per million population in the United States [7,8].…”

Section: Introductionmentioning

confidence: 99%

Management of metastatic malignant thymoma with advanced radiation and chemotherapy techniques: report of a rare case

D’Andrea¹,

Reddy²

2015

World J Surg Onc

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Malignant thymomas are rare epithelial neoplasms of the anterior superior mediastinum that are typically invasive in nature and have a higher risk of relapse that may ultimately lead to death. Here we report a case of an advanced malignant thymoma that was successfully treated with neoadjuvant chemotherapy followed by surgical resection and subsequently with advanced and novel radiation therapy techniques. A 65-year-old male was diagnosed with a stage IV malignant thymoma with multiple metastatic lesions involving the left peripheral lung and pericardium. Initial neoadjuvant chemotherapy with a cisplatin-based regimen resulted in a partial response allowing the inoperable tumor to become operable. Following surgical resection of the residual disease, the tumor recurred within a year. The patient then underwent a course of targeted three-dimensional intensity modulated radiation therapy (IMRT) and image-guided radiation therapy (IGRT). Five years after radiation therapy, the localized soft tissue thickening at the left upper lung anterior pleural space had resolved. Seven years after radiation therapy the tumor mass had completely resolved. No recurrences were seen and the patient is well even 8 years after IMRT/IGRT with a favorable outcome. Chemotherapy with targeted three-dimensional IMRT/IGRT should be considered the primary modality for the management of advanced malignant thymoma patients.

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Thymoma: Clinical experience from a tertiary care institute from North India

Cited by 10 publications

References 24 publications

Histotyping of Indian thymomas

Histotyping of Indian thymomas

Histopathological Spectrum of Mediastinal Lesions in a Tertiary Care Centre, Andhra Pradesh, India

Management of metastatic malignant thymoma with advanced radiation and chemotherapy techniques: report of a rare case

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