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Klinisch-pathologische Studie zur Klassifikation und Prognose von Thymustumoren

I. Histologische und ultrastrukturpathologische Untersuchungen

A comparative clinical and pathological study on the classification and prognostic features of 57 thymomas

I. Microscopy and ultrastructural pathology

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Summary

Fifty-seven thymomas, defined as neoplasms of the epithelial-reticular framework cells of the thymus, were assessed in respect to histologic type, inclusive of there ultrastructural aspects. The median age of the 57 patients was 40.4 years, with a range of 2 1/2–72 years.

All neoplasms were located in the anterior mediastinum. The tumours in 40 cases were encapsulated and without invasion of adjacent tissue or implants (= non-invasive thymomas). The tumors in 17 cases were invasive of adjacent tissue, particularly mediastinal pleura, pericard and trachea. Six of 57 patients (= 10.5%) with thymomas have had a thoracic and supraclavicular lymph node metastasis, and osteolytic metastases in the vertebrae and sternum.

Thirty-seven (=64.9%) were so-called lympho-epithelial, 7 (=12.3%) pure epithelial, 4 (= 7.0%) atypical (or anaplastic) with granulomatous focuses, 3 (= 5.3%) carcinoid and one (=1.8%) seminomatous tumors. One patient have had a thymic cyst as a tumor-like conditions of the thymus, and four patients (= 7.0%) have had a thymo-lipoma. The histologie type of thymoma had no proof value in predicting prognosis with the exception of the so-called atypical or anaplastic thymoma.

The fine structural aspects of thymomas and the fine structural differential diagnosis of anterior mediastinal tumors are discussed.

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Literatur

  • Adams, J.E.: Leukemogenic thymoma. Report of an unique case. Amer. J. clin. Path. 40, 173–182 (1963)

    Google Scholar 

  • Bailey, L.L., Hilde, R.L., Smith, T.R., Thompson, R.J.: Cervicomediastinal thymic cyst with vocal cord paralysis. Cancer (Philad.) 39, 347–349 (1977)

    Google Scholar 

  • Berard, C.W., Dorfman, R.F.: Histopathology of malignant lymphomas. Clin. Hematol. 3, 39–76 (1974)

    Google Scholar 

  • Bieger, R.C., McAdams, A.J.: Thymic cysts. Arch. Pathol. 82, 535–541 (1966)

    Google Scholar 

  • Bloodworth, J.M.B., Hiratsuka, H., Hickey, R.C.: Ultrastructure of the human thymus, thymic tumors, and myastenia gravis. Pathol. Ann. 10, 329–391 (1975)

    Google Scholar 

  • Buerki, H., Locher, G.W., Graepel, P., Ruchti, Ch., Brun del Re, G., Hess, M.W.: Humoral antibodies against spermatopoietic cells associated with mediastinal germinoma. J. Path. 121, 183–186 (1977)

    Google Scholar 

  • Capella, C., Solcia, E., Vassallo, G.: Identification of six types of endocrine cells in the gastrointestinal mucosa of the rabbit. Arch, histol. jap. 30, 479–495 (1969)

    Google Scholar 

  • Castleman, B.: Tumors of the thymus gland. In: Atlas of Tumor Pathology, Sect. V, Fasc. 19. Washington,D.C.: Armed Forces Institute of Pathology 1955

    Google Scholar 

  • Döhnert, G.: Über lymphoepitheliale Geschwülste. Erkenntnisse anhand der Gewebekultur und vergleichender klinischer, morphologischer und virologischer Untersuchungen. In: Sitzungsberichte der Heidelberger Akademie der Wissenschaften. Mathematisch-naturwissenschaftliche Klasse. J. 1977, 3.Abhandl. Berlin-Heidelberg-New York: Springer 1977

    Google Scholar 

  • Dunn, B.H., Frkovich, G.: Lipomas of the thymus gland: with an illustrative case report. Amer. J. Pathol. 32, 41–51 (1956)

    Google Scholar 

  • Ewing, J.: The thymus and its tumors. Report of three cases of thymoma. Surg. Gynecol. Obstet. 22, 461–472 (1916)

    Google Scholar 

  • Fahmy, S.: Cervical thymic cysts: their pathogenesis and relationship to branchial cysts. J. Laryngol. Otol. 88, 47–60 (1974)

    Google Scholar 

  • Fechner, R.E.: Hodgkin's disease of the thymus. Cancer (Philad.) 23, 16–23 (1969)

    Google Scholar 

  • Fielding, J.F., Farmer, A.W., Lindsay, W.K., Conen, P.E.: Cystic degeneration in persistent cervical thymus: a report of four cases in children. Can. J. Surg. 6, 178–186 (1963)

    Google Scholar 

  • Fisher, E.R.: Pathology of the thymus and its relation to human disease. In: R.A. Good and A.E. Gabrielsen (eds.), The Thymus in Immunobiology. Structure, Function, and Role in Disease, pp.676–726. New York-Evanston-London: Hoeber Med. Div., Harper & Row, Publ. 1964

    Google Scholar 

  • Friedman, N.B.: The comparative morphogenesis of extragenital and gonadal teratoid tumors. Cancer (Philad.) 4, 265–276 (1951)

    Google Scholar 

  • Friedman, N.B.: Tumors of the thymus. J. Thorac. Cardiovasc. Surg. 53, 163–182 (1967)

    Google Scholar 

  • Goldstein, G., Mackay, I.R.: The human thymus. London: W. Heinemann Ltd. 1969

    Google Scholar 

  • Grimelius, L.: A modified silver protein method for studying the argyrophil cells of the islets of Langerhans. In: S.E. Brolin, B. Hellman and H. Knutson (eds.), The structure and metabolism of the pancreatic islets. Oxford, London, Edinburgh, New York, Paris, Frankfurt: Pergamon 1964

    Google Scholar 

  • Grimelius, L.: A silver nitrate stain for a2-cells in human pancreatic islets. Acta Soc. Med. Upsal. 73, 243–270 (1968)

    Google Scholar 

  • Hammar, J.A.: Zur Histogenese und Involution der Thymusdrüse. Anat. Anz. 27, 23–30 u. 41–89 (1905)

    Google Scholar 

  • Hamperl, H.: Über argyrophile Zellen. Virchows Arch. path. Anat. 321, 482–507 (1952)

    Google Scholar 

  • Hellerström, C., Hellman, B.: Some aspects of silver impregnation of the islets of Langerhans in the rat. Acta Endocr. 35, 518–532 (1960)

    Google Scholar 

  • Henry,K.: Mucin secretion and striated muscle in the human thymus. Lancet 1966/I, 183–185

    Google Scholar 

  • Henry, K.: An unusual thymic tumour with a striated muscle (myoid) component (with a brief review of the literature on myoid cells). Brit. J. Dis. Chest. 66, 291–299 (1972)

    Google Scholar 

  • Hertel, G., Mertens, H.G., Ricker, K., Schimrigk, K. (Hrsg.): Myasthenia gravis and andere Störungen der neuromuskulären Synapse. Stuttgart: Thieme 1977

    Google Scholar 

  • Hodgman, C.D., Weast, R.C., Selby, S.M. (eds.): Handbook of Chemistry and Physics, pp. E 40, F 7. Cleveland: Chemical Rubber Publ. 1970

    Google Scholar 

  • Hosoda, S., Suzuki, H., Kito, H., Hiai, H., Akamine, Y., Murakami, M., Kosukegawa, K., Kato, N., Yura, J., Miyachi, Y.: Argyrophilic thymic carcinoid. Clinico-pathologic study of four cases. Acta Path. Jap. 25, 717–740 (1975)

    Google Scholar 

  • Imura, H., Matsukura, S., Yamamoto, H., Hirata, Y., Nakai, Y., Endo, J., Tanaka, A., Nakamura, M.: Studies on ectopic ACTH-producing tumors. II. Clinical and biochemical features of 30 cases. Cancer (Philad.) 35, 1430–1437 (1975)

    Google Scholar 

  • Janzen, R.W.Ch., Lachenmayer, L.: Parathymische Syndrome. Dtsch. med. Wschr. 101, 1292–1294 (1976)

    Google Scholar 

  • Judge, D.M., Changaris, D.G., Harvey, H.R., Trapukdi, S.: Malignant APUDoma (Carcinoid) of the anterior mediastinum. Simplified methods of demonstrating biogenic amines in endocrine neoplasms. Arch. Pathol. Lab. Med. 100, 491–494 (1976)

    Google Scholar 

  • Katz, A., Lattes, R.: Granulomatous thymoma or Hodgkin's disease of thymus? A clinical and histologic study and a re-evaluation. Cancer (Philad.) 23, 1–15 (1969)

    Google Scholar 

  • Kay, S.: Comparative ultrastructural studies on three thymic lesions. Arch. Pathol. 90, 416–422 (1970)

    Google Scholar 

  • Kay, S., Wilson, M.A.: Ultrastructural studies of an ACTH-secreting thymic tumour. Cancer (Philad.) 26, 445–452 (1970)

    Google Scholar 

  • Keller, A.R., Castleman, B.: Hodgkin's disease of the thymic gland. Cancer (Philad.) 33, 1615–1623 (1974)

    Google Scholar 

  • Kracht, J.: Pathologie der ektopisch hormonbildenden Geschwülste. Med. Klin. 63, 41–46 (1968)

    Google Scholar 

  • Krech, W.G., Storey, C.F., Umiker, W.C.: Thymic cysts. A review of the literature and report of two cases. J. Thorac. Cardiovasc. Surg. 27, 477–493 (1954)

    Google Scholar 

  • Lattes, R.: Thymoma and other tumors of the thymus. An analysis of 107 cases. Cancer (Philad.) 15, 1224–1260 (1962)

    Google Scholar 

  • LeGolvan, D.P., Abell, M.R.: Thymomas. Cancer (Philad.) 39, 2142–2157 (1977)

    Google Scholar 

  • Levasseur, Ph., Kaswin, R., Rojas-Miranda, A., N'Guimbous, J.-F., Merlier, M., LeBrigand, H.: Profil des tumeurs chirurgicales médiastin. A propos d'une série de 742 opérés. Nouv. Presse méd. 42, 2857–2859 (1976)

    Google Scholar 

  • Levine, G.D.: Primary thymic seminoma — A neoplasm ultrastructurally similar to testicular seminoma and distinct from epithelial thymoma. Cancer (Philad.) 31, 729–741 (1973)

    Google Scholar 

  • Levine, G.D., Bensch, K.G.: Epithelial nature of spindlecell thymoma. An ultrastructurally study. Cancer (Philad.) 30, 500–511 (1972)

    Google Scholar 

  • Levine, G.D., Rosai, J.: A spindle cell variant of thymic carcinoid tumor. A clinical, histologie, and fine structural study with emphasis on its distinction from spindle cell thymoma. Arch. Pathol. Lab. Med. 100, 293–300 (1976)

    Google Scholar 

  • Levine, G.D., Rosai, J., Bearman, R.M., Polliack, A.: The fine structure of thymoma, with emphasis on its differential diagnosis. A study often cases. Amer. J. Pathol. 81, 49–86 (1975)

    Google Scholar 

  • Llombart-Bosch, A.: Epithelio-reticular cell thymoma with lymphocytic “emperipolesis”. An ultrastructural study. Cancer (Philad.) 36, 1794–1803 (1975)

    Google Scholar 

  • Loewenhaupt, E., Brown, E.: Carcinoma of the thymus of granulomatous type. A clinical and pathological study. Cancer (Philad.) 4, 1193–1209 (1951)

    Google Scholar 

  • Lowenthal, R.M., Gumpel, J.M., Kreqq, L., McLaughlin, J.E., Skeggs, D.B.L.: Carcinoid tumour of the thymus with systemic manifestations: a radiological and pathological study. Thorax 29, 553–558 (1974)

    Google Scholar 

  • Lukes, R.J., Butler, J.J., Hicks, E.B.: Natural history of Hodgkin's disease as related to its pathologic picture. Cancer (Philad.) 19, 317–344 (1966)

    Google Scholar 

  • MacAdam, R.F., Vetters, J.M.: Fine structural evidence for hormone secretion by a human thymic tumour. J. clin. Pathol. 22, 407–409 (1969)

    Google Scholar 

  • Marshall, A.H.E., Wood, C.: The involvement of the thymus in Hogdkin's disease. J. Path. Bact. 73, 163–166 (1957)

    Google Scholar 

  • Martini, N., Golbey, R.B., Hajdu, St.I., Whitmore, W.F., Beattie, E.J.: Primary mediastinal germ cell tumors. Cancer (Philad.) 33, 763–769 (1974)

    Google Scholar 

  • Metcalf, D.: The Thymus. Its role in immune responses, leukaemia development and carcinogenesis. In: Recent Results in Cancer Research, Bd. 5. Berlin-Heidelberg-New York: Springer 1966

    Google Scholar 

  • Mikal, S.: Cervical thymic cyst; case report and review of the literature. Arch. Surg. 109, 558–562 (1974)

    Google Scholar 

  • Miller, J.F.A.P., Dukor, P.: Die Biologie des Thymus nach dem heutigen Stand der Forschung. Frankfurt: Akademische Verlagsges. 1964

    Google Scholar 

  • Movat, H.Z.: Silver impregnation methods for electron microscopy. Amer. J. clin. Path. 35, 528–537 (1961)

    Google Scholar 

  • Nickels, J., Franssila, K., Hjelt, L.: Thymoma and Hogdkin's disease of the thymus. Acta path, microbiol. scand., Sect. A, 81, 1–5 (1973)

    Google Scholar 

  • Oberman, H.A., Libcke, J.H.: Malignant germinal neoplasms of the mediastinum. Cancer (Philad.) 17, 498–507 (1964)

    Google Scholar 

  • Otto, H.F., Hüsselmann, H.: Thymus-Carcinoid. Fallbericht und Literaturübersicht. Z. Krebsforsch. 88, 55–67 (1976)

    Google Scholar 

  • Otto, H.F., Hüsselmann, H., Gebbers, J.-O.: Thymus-Carcinoide. Ultrastrukturelle und histochemische Untersuchungen. Verh. dtsch. Ges. Path. 61, 122–126 (1977)

    Google Scholar 

  • Pachter, M.R., Lattes, R.: Uncommon mediastinal tumors. Report of two parathyroid-adenomas, one nonfunctional parathyroid carcinoma and one “bronchial-type-adenoma”. Dis. Chest. 43, 519–529 (1963)

    Google Scholar 

  • Pachter, M.R., Lattes, R.: Germinal tumors of the mediastinum: A clinicopathologic study of adult teratomas, teratocarcinomas, choriocarcinomas and seminomas. Dis. Chest. 45, 301–310 (1964)

    Google Scholar 

  • Pascoe, H.R., Miner, M.S.: An ultrastructural study on nine thymomas. Cancer (Philad.) 37, 317–326 (1976)

    Google Scholar 

  • Pearse, A.G.E.: Histochemistry. Theoretical and Applied. London: Churchill 1960

    Google Scholar 

  • Pearse, A.G.E.: The APUD cell concept and its implication in pathology. Pathol. Annual. 9, 27–41 (1974)

    Google Scholar 

  • Pedraza, M.A.: Thymoma immunological and ultrastructural characterization. Cancer (Philad.) 39, 1455–1461 (1977)

    Google Scholar 

  • Pimstone, B.L., Uys, C.J., Vogelpoel, L.: Studies in a case of Cushing's syndrome due to an ACTH-producing thymic tumour. Amer. J. Med. 53, 521–528 (1972)

    Google Scholar 

  • Ribbert, H.: Die Entwicklungsstörung der Thymusdrüse bei kongenitaler Lues. Frankf. Z. Path. 11, 209–218 (1912)

    Google Scholar 

  • Romeis, B.: Mikroskopische Technik. München u. Wien: Oldenbourg 1968

    Google Scholar 

  • Rosai, J., Higa, E.: Mediastinal endocrine neoplasm, of probable thymic origin, related to carcinoid tumor. Cancer (Philad.) 29, 1061–1074 (1972)

    Google Scholar 

  • Rosai, J., Higa, E., Davie, J.: Mediastinal endocrine neoplasm in patients with multiple endocrine adenomatosis. Cancer (Philad.) 29, 1075–1083 (1972)

    Google Scholar 

  • Rosai, J., Levine, G.D.: Tumors of the thymus. In: Atlas of Tumor Pathology, Second Series, Fasc. 13. Washington,D.C.: Armed Forces Institute of Pathology 1976

    Google Scholar 

  • Rosai, J., Levine, G.D., Weber, W.R., Higa, E.: Carcinoid tumors and oat cell carcinomas of the thymus. Pathol. Annual. 11, 201–226 (1976)

    Google Scholar 

  • Salyer, D.C., Salyer, W.R., Eggleston, J.C.: Benign developmental cysts of the mediastinum. Arch. Pathol. Lab. Med. 101, 136–139 (1977)

    Google Scholar 

  • Salyer, W.R., Eggleston, J.C.: Thymoma. A clinical and pathological study of 65 cases. Cancer (Philad.) 37, 229–249 (1976)

    Google Scholar 

  • Salyer, W.R., Salyer, D.C., Eggleston, J.C.: Carcinoid tumors of the thymus. Cancer (Philad.) 37, 958–973(1976)

    Google Scholar 

  • Schantz, A., Sewall, W., Castleman, B.: Mediastinal germinoma. A study of 21 cases with an excellent prognosis. Cancer (Philad.) 30, 1189–1194 (1972)

    Google Scholar 

  • Schlumberger, H.G.: Teratoma of the anterior mediastinum in the group of military age. A study of sixteen cases, and review of theories of genesis. Arch. Pathol. 41, 398–444 (1946)

    Google Scholar 

  • Schmincke, A.: Pathologie des Thymus. In: F. Henke und O. Lubarsch (Hrsg.), Handbuch der speziellen pathologischen Anatomie und Histologie. Bd. VIII: Drüsen mit innerer Sekretion, S. 760–809. Berlin: Springer 1926

    Google Scholar 

  • Scully, R.E., Galdabini, J.J., McNeely, B.U.: Case records of the Massachusetts General Hospital (Case 50-1976). New Engl. J. Med. 295, 1367–1374 (1976)

    Google Scholar 

  • Simmonds, M.: Die Thymus bei kongenitaler Syphilis. Virchows Arch. path. Anat. 194, Beiheft, 213–224 (1908)

    Google Scholar 

  • Simson, L.R., Lampe, I., Abell, M.R.: Suprasellar germinomas. Cancer (Philad.) 22, 533–544 (1968)

    Google Scholar 

  • Steiner, P.E.: Hogdkin's disease; the incidence, distribution, nature and possible significance of the lymphogranulomatous lesions in the bone marrow: a review with original data. Arch. Pathol. 36, 627–637 (1943)

    Google Scholar 

  • Sundström, C., Wilander, E.: Thymic carcinoid. A case report. Acta path, microbiol. scand., Sect. A, 84, 311–316(1976)

    Google Scholar 

  • Tanaka, T., Tanaka, S., Kimura, H., Ito, J.: Mediastinal tumor of thymic origin and related to carcinoid tumor. Acta Path. Jap. 24, 413–426 (1974)

    Google Scholar 

  • Teplick, J.G., Nedwich, A., Haskin, M.E.: Roentgenographic features of thymolipoma. Amer. J. Roentgenol. Radium Ther. Nucl. Med. 117, 873–880 (1973)

    Google Scholar 

  • Tesseraux, H.: Physiologie und Pathologie des Thymus unter besonderer Berücksichtigung der pathologischen Morphologie. In: Zwanglose Abhandlungen aus dem Gebiet der inneren Sekretion, Bd.9. Leipzig:J.A. Barth 1959

    Google Scholar 

  • Thomson, A.D.: The thymic origin of Hodgkin's disease. Brit. J. Cancer 9, 37–50 (1955)

    Google Scholar 

  • Toker, C.: Thymoma. An ultrastructural study. Cancer (Philad.) 21, 1157–1163 (1968)

    Google Scholar 

  • Trump, B.F., Smuckler, E.A., Benditt, E.P.: A method for staining epoxy sections for light microscopy. J. Ultrastruct. 5, 343–348 (1961)

    Google Scholar 

  • Velde, R.L. van de, Friedman, N.B.: Thymic myoid cells and myasthenia gravis. Amer. J. Pathol. 59, 347–367 (1970)

    Google Scholar 

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  1. Pathologisches Institut der Universität, Martinistraße 52, D-2000, Hamburg 20

    H. F. Otto

  2. Pathologisches Institut des Allgemeinen Krankenhauses, D-2100, Hamburg-Harburg, Bundesrepublik Deutschland

    H. Hüsselmann

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  1. H. F. Otto
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Otto, H.F., Hüsselmann, H. Klinisch-pathologische Studie zur Klassifikation und Prognose von Thymustumoren. Z. Krebsforsch. 91, 81–102 (1978). https://doi.org/10.1007/BF00305975

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