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Atypical thymoma (WHO B3) with neuroendocrine differentiation: report of a case

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Abstract

We report a case of type-B3 thymoma manifesting neuroendocrine differentiation. The patient was a 42-year-old woman who complained of shoulder pain but had no symptoms of myasthenia gravis or anemia. The tumor was located in the anterior mediastinum and had directly invaded the pericardium and left lung. Histological examination revealed that the tumor was lobulated by bands of fibrous tissue, perivascular spaces were scattered throughout the tumor, and there were a few intraepithelial lymphocytes. The vast majority of lymphocytes in the perivascular spaces and in the lobulated tumor were immunohistochemically positive for TdT, MIC2, and CD1a. The majority of tumor cells were polygonal and medium or large in size. The tumor cells were weakly positive for synaptophysin, chromogranin A, CD56, and NSE. Small nests of small, relatively uniform polygonal cells were observed facing the fibrous bands. These cells resembled the cells of carcinoid tumors and were strongly positive for NSE, synaptophysin, chromogranin A, and CD56. Ultrastructurally, sparse dense-core granules were observed in the cytoplasm of a few tumor cells. This is a unique case of thymoma with neuroendocrine differentiation, and to the best of our knowledge this is the first such case ever reported.

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Acknowledgements

The authors thank Yukio Shimosato, MD, Keio University, Yoshihiro Matsuno, MD, National Cancer Center Research Institute and Hospital, and Tsunekazu Hishima, MD, Tokyo Metropolitan Komagome Hospital for reviewing the surgical specimen and for critical discussion of the case. The authors also thank Toshihiro Nagai of Keio University for preparing the electron micrographs.

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Authors and Affiliations

  1. Department of Pathology, Japanese Red Cross Medical Center, 4-1-22 Hiroo, Shibuya-ku, Tokyo, 150-8935, Japan

    Junichi Shiraishi

  2. Department of Thoracic Surgery, Saiseikai Central Hospital, Tokyo,, Japan

    Hiroaki Nomori

  3. Department of Pathology, Saiseikai Central Hospital, Tokyo,, Japan

    Hideki Orikasa & Kazuto Yamazaki

  4. Department of Pathology, Keio University School of Medicine, Tokyo,, Japan

    Taisuke Mori

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  1. Junichi Shiraishi
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  2. Hiroaki Nomori
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  3. Hideki Orikasa
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  4. Taisuke Mori
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  5. Kazuto Yamazaki
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Correspondence to Junichi Shiraishi.

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Shiraishi, J., Nomori, H., Orikasa, H. et al. Atypical thymoma (WHO B3) with neuroendocrine differentiation: report of a case. Virchows Arch 449, 234–237 (2006). https://doi.org/10.1007/s00428-006-0218-1

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  • DOI: https://doi.org/10.1007/s00428-006-0218-1

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