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Thymuskarzinome

Thymic carcinomas

  • Schwerpunkt: Mediastinum
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Zusammenfassung

Thymuskarzinome sind etwa 10-mal seltener als Thymome, wegen ihrer größeren Aggressivität, selteneren chirurgischen Sanierbarkeit und der mangelnden Verfügbarkeit langfristig wirksamer onkologischer Strategien klinisch aber äußerst relevant. Bei Kindern und Jugendlichen sind Thymuskarzinome zudem häufiger als Thymome und müssen besonders in dieser Altersgruppe gegen Keimzelltumoren abgegrenzt werden. Darüber hinaus ergeben sich für den Pathologen zwei weitere typische Schwierigkeiten: die therapeutisch wichtige Unterscheidung zwischen Thymuskarzinomen und ähnlich aussehenden Thymomen sowie die Differenzierung zwischen Thymuskarzinomen und histologisch ähnlich erscheinenden Metastasen oder Ausläufern anderer Primärtumoren. Die Überwindung dieser diagnostischen Herausforderungen steht im Zentrum der neuen WHO-Klassifikation der Thymuskarzinome. Ziel der vorliegenden Arbeit ist es, die diagnostisch wichtigen Neuerungen der neuen WHO-Klassifikation der Thymuskarzinome darzustellen und therapierelevante differenzialdiagnostische Fragen zu beantworten.

Abstract

Thymic carcinomas (TC) are approximately 10 times less prevalent than thymomas but of high clinical relevance because they are more aggressive, less frequently resectable than thymomas and usually refractory to classical and targeted long-term treatment approaches. Furthermore, in children and adolescents TC are more frequent than thymomas and particularly in this age group, germ cell tumors need to be a differential diagnostic consideration. In diagnostic terms pathologists face two challenges: a), the distinction between thymic carcinomas and thymomas with a similar appearance and b), the distinction between TC and histologically similar metastases and tumor extensions from other primary tumors. Overcoming these diagnostic challenges is the focus of the new WHO classification of thymic epithelial tumors. The objectives of this review are to highlight novel aspects of the WHO classification of thymic carcinomas and to address therapeutically relevant diagnostic pitfalls.

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Authors and Affiliations

  1. Institut für Pathologie, Universitätsmedizin Göttingen, Robert-Koch-Straße 40, 37075, Göttingen, Deutschland

    P. Ströbel

  2. Institut für Pathologie, Universitätsmedizin Mannheim der Universität Heidelberg, Mannheim, Deutschland

    C.-A. Weis & A. Marx

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  1. P. Ströbel
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  2. C.-A. Weis
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  3. A. Marx
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Correspondence to P. Ströbel.

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P. Ströbel, C.-A. Weis und A. Marx geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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H.A. Baba, Essen

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Ströbel, P., Weis, CA. & Marx, A. Thymuskarzinome. Pathologe 37, 425–433 (2016). https://doi.org/10.1007/s00292-016-0194-4

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